An employee injured at work may be entitled to receive workers’ compensation benefits. However, once a worker receives these benefits, they can lose their right to sue the employer for damages in exchange.
Workers’ compensation provides payments to financially support employees who get injured or fall sick due to their job. Although workers’ compensation exists in almost all states, the laws can vary. Here is what you need to know about how to qualify for workers’ compensation.
What Is Meant By Workers’ Compensation?
Workers’ compensation coverage is mandatory in most states. It compensates employees who get injured or suffer an illness due to their job. This compensation is paid when the employer or the insurance provider verifies that the injury or illness suffered by the employee is work-related.
What Does Workers’ Compensation Cover?
Typically, workers’ compensation covers the employee’s medical bills, including hospital visits, emergency surgeries, and medications. It also covers the costs of ongoing care, such as physical therapy. Disability benefits are also provided if the injured employee is permanently or temporarily disabled due to a work-related injury. In addition, workers’ compensation covers lost wages if the employee spends time away from work due to their injury.
Eligibility Requirements for Workers’ Compensation
The following are the basic eligibility requirements for obtaining workers’ compensation.
The Injured Worker Must Be an Employee
The definition of an employee varies from state to state. Typically for workers’ compensation, an individual is considered an employee when they enter an employment relationship, whether written or oral. When determining whether the worker falls under the category of an employee for workers’ compensation, courts can consider the working relationship of the worker with their employer and how much control the injured worker has over their work.
Depending on the laws of the state, an individual may be required to be on a payroll to be considered an employee under workers’ compensation law. Part-time and full-time employees who are expected to appear in a workplace setting specified by their employer can be entitled to workers’ compensation. For example, independent contractors are generally not entitled to workers’ compensation if they get injured on the job because they typically set their own work hours and do not use office premises.
Work-Related Injury
A fundamental requirement for workers’ compensation eligibility is for the injury to be work-related. The injury or illness suffered by the employee must result from the working conditions. For example, if exposure to hazardous chemicals causes an employee to have a reaction, it qualifies as a work-related injury.
In some cases, it can be challenging to determine whether the injury was related to the employee’s work or working conditions. For example, if the employee was injured during lunch break, it may be difficult to classify the injury. Additionally, there can be certain exclusions to the workers’ compensation benefits. If the injury resulted from a fight between the employees unrelated to the job, workers’ compensation may not cover costs associated with the injury.
If the injured worker contributed to the injury in some way—like if they were intoxicated at the time—they may not receive workers’ compensation benefits. People who suffer injuries when traveling to work or from it are not eligible for workers’ compensation, either. However, if a person was traveling as a part of their job, they can qualify for these benefits.
Employer Is Insured
If your employer does not have workers’ compensation insurance, you would have to look for other options, such as a lawsuit against your employer, to cover damages for the work-related injury. Generally, almost all states require employers to purchase workers’ compensation, but some employers may be allowed to opt out of the system.
Reporting Requirements
Your eligibility for workers’ compensation also depends on whether the reporting requirements are met. Each state has different deadlines for when a work-related injury must be reported to the employer and when a claim must be filed. If these requirements are not met, you may lose your right to obtain any workers’ compensation benefits. For example, some states give employees around 30 days to inform their employer of the injury.
Which Employees Are Exempt From Workers’ Compensation?
Depending on state laws, domestic workers are generally not entitled to workers’ compensation benefits. However, some states only exempt domestic workers who were not working full-time. In addition, agricultural workers are also exempt from obtaining workers’ compensation in most states. In many states, workers’ compensation does not cover undocumented employees or seasonal workers. Learn more about who qualifies for workers’ compensation at https://www.nyworkerslaw.com/workers-compensation-lawyer/bronx/.
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