Workers’ compensation is a form of insurance that provides salary replacement and medical benefits for workers injured in the course of their jobs. The insurance is paid for by employers in exchange for the relinquishment of the employees’ right to sue the employer for negligence.
As insurance policies, workers’ compensation plans differ across areas of the country.
- Usually provisions are made for weekly payments to replace lost wages (like disability insurance ).
- There is usually compensation for economic loss due to the injury or illness, and payment or reimbursement for medical expenses (like health insurance).
- Benefits are paid to dependents of workers killed in employment (like life insurance).
Because insured workers have given up their right to sue, access to punitive damages like “pain and suffering” is generally not available. Workers’ compensation is intended to eliminate the need for litigation. Injured employees are relieved of the responsibility to prove that their employer is at fault for the injury or illness.
If there is no need to prove neglect or damages, why is it necessary to hire a lawyer in workers’ compensation cases?
You can get along without a lawyer if your claim is minor.
- The injury suffered at work is very minor like twisted ankles or a cut requiring no more than a few stitches.
- You missed little or no work from the injury.
- Your employer readily admits that the injury occurred at work.
- You don’t have a pre-existing condition that could be blamed for the accident.
You will probably need a workers’ compensation lawyer to collect the insurance benefit if things get more complicated.
- Your employer denies your claim or you don’t get your benefit payment promptly. The workers’ compensation program often counts on the fact that many workers do not appeal legitimate claims that are denied coverage.
- The settlement doesn’t cover the full losses, wages or medical bills. You can’t rely on the system to get a truly fair deal. You will need an attorney to get the best deal.
- A severe injury prevents you from returning to your old job or performing work. In this case an attorney may be essential to overcome the workers’ compensation reluctance to pay.
- Social Security may stake a claim to your benefits if the claim is not properly structured.
- Your employer retaliates against you for making the claim by firing you, demoting you, or discriminating against you somehow.
- If you have the basis to sue a third-party, not your actual employer, for negligence in the workplace in your case.
Some states like Alabama do not require workers’ compensation insurance. Some states like Florida only require it for larger companies. The workers’ compensation legislation also has many exemptions that can limit your coverage. If you are injured on the job where the employer does not carry the workers’ compensation policy you may have to resort to a civil suit for compensation.
Often workers’ compensation insurance denies compensation benefits because the worker simply can’t identify a specific traumatic event that caused the injury or disease.
- A worker in a coal mine, cement factory, foundry, or heavy manufacturing plant who contracts a lung disease because of the gradual buildup of toxins in his or her body can rarely identify a specific traumatic event that caused the disability.
- A person who works over a long time performing heavy labor in the construction industry, manufacturing, material handing or construction and develops a pathological condition of the joints, muscles or bones, not specific fractures, may not be able to identify a specific event that caused the injury.
- A sedentary worker who uses a computer and whose job requires repetitious and unnatural hand or arm movements and who contracts carpal tunnel syndrome also may not be able to identify a specific source of the disability.
These kinds of conditions may be completely insurable as “occupational injury or disease.” However, there are some employers who will routinely deny making a claim. In these cases, an attorney may be instrumental in identifying the issue, gathering the medical evidence and proof, and prosecuting the claim through the workers’ compensation system.
- Doctors could mistake occupational injury and disease when the worker presents with asthmatic-like symptoms, and may diagnose the condition as asthma.
- The doctor may also identify as “not a work injury,” an injury without a specific date of cause.
- A lawyer’s involvement is often necessary to educate the doctor on what is an occupational disease.
The law office of Joshua Borken represents injured workers in the St. Paul and Iron Range area. Contact us to learn more.