In every state, legislatures have enacted workers’ compensation legislation, designed to be the primary process for recovering monetary damages for losses caused by injuries suffered on the job. The workers’ compensation process is viewed as a trade-off of sorts. All workers’ compensation programs establish fixed dollar amounts to be paid, based on the type and seriousness of the injury. Because dollar amounts are fixed, employers don’t have to fear a large judgment in a personal injury trial. For workers, the process for seeking and obtaining benefits is simplified. An employee does not have to hire an attorney (although the employee may want a lawyer to handle the workers’ compensation claim), but can simply complete and submit the request for benefits to his or her employer. There’s no need to pay an attorney to gather evidence, conduct depositions or prepare and file pleadings.
The Workers’ Compensation Process
As a general rule, your employer may either purchase a policy of workers’ compensation insurance, or may choose to self-insure (pay for the costs of a claim out of company revenues). Most employers choose to obtain workers’ compensation insurance.
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When you have been hurt on the job, you must report your injury to your employer within a certain number of days (typically 30-45 days). Once notified, your employer will advise the state workers’ compensation board, as well as the workers’ compensation insurance carrier. If there is no question or dispute about whether your injury was work-related, you should start to receive benefits almost immediately.
Your employer or the insurance company may, however, require that you go see a doctor. This will not prevent you from seeking medical attention from your own physician. The doctor may agree that the injury is work-related, and that you need time off from work to heal. On the other hand, the doctor may conclude that your injury was not caused by your job, or that your injury is not severe enough to keep you from working.
If the insurance company rejects your claim, you can file an appeal with the state workers’ compensation board. Depending on the state, there may also be additional means of appeal, should the state workers’ compensation board deny your claim.
The Types of Injuries Covered by Workers’ Compensation
The specific types of injuries for which benefits are available under state workers’ compensation laws varies somewhat from state to state. As a general rule, though, states distinguish between temporary and permanent disability, and between partial and total disability. The types of injuries for which compensation is generally available include:
- Serious and catastrophic loss, such as broken bones, amputation or loss of limb, paralysis, traumatic brain or spinal cord injury, burns and permanent scarring or disfigurement
- Repetitive stress or motion injuries, such as carpal tunnel syndrome, nerve damage, ligament, tendon and muscle injury
- Joint and connective tissue injury, from foot, ankle, leg and hip trauma to hand, arm and should injury
- Occupational disease, such as mesothelioma, silicosis, cancer and heart disease
- Mental health issues, including depression, stress and anxiety
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