Workers' Compensation Law
What is Workers’ Compensation Law?
Workers’ compensation law is a system of rules in every state designed to pay the expenses of employees who are harmed while performing job-related duties. Employees can recover lost wages, medical expenses, disability payments, and costs associated with rehabilitation and retraining. The system is administered by the state, and financed by mandatory employer contributions. Federal government employees have access to a similar program.
States have enacted workers compensation laws to replace traditional personal injury litigation, in an attempt to remove risk for both the employee and the employer. Outside of a workers’ compensation system, employees who become injured or sick as a result of their employment must file a lawsuit and prove their employer is responsible. This can result in delays, and there is a possibility the employee will lose the court case and recover nothing.
From the employer’s perspective, workers’ compensation eliminates the possibility of litigation that could lead to a large damage award. Even if the employer acts negligently and an employee is hurt or killed, the employer will only be responsible for its ordinary contributions into the system (although its rates may increase following such an incident). In essence, workers’ compensation is an insurance program, made compulsory by the government.
In exchange for the certainty it provides, the workers’ compensation system carries a price for workers and employers. Workers are barred from suing their employer or coworkers for negligence, and they stand to recover much less compensation than they might in a lawsuit. For employers, the primary drawback is the premiums charged by the state. This added payroll expense must be paid regardless of whether a workplace accident ever occurs.
Every state provides certain exceptions, allowing workers to bypass the workers’ compensation statutes and file a lawsuit for damages. These include situations in which the employer or a coworker has intentionally caused harm to the worker. Exceptions may also exist for workers injured by defective products, or exposed to toxic substances. Furthermore, workers are free to file suit against third parties, such as drivers, landowners, and subcontractors.
Procedure in Contested Cases
Upon filing a workers’ compensation claim, employees can be surprised to learn the company they work for is disputing the validity of the claim. Employers have an incentive to dispute claims they feel are improper, as the rates they pay into the system will be affected, to some degree, by the number of claims paid on their behalf. Once disputed, the state workers’ compensation board will investigate the claim and render a decision.
During this process, the employee will be seen by a physician who performs evaluations on behalf of the state. While this physician is supposed to maintain an impartial role, employees should realize that doctor-patient confidentiality does not exist. Any statements made during the evaluation may be used by the employer to argue that the incident was not work related, or that the injury is less severe than the employee claims it to be.
If the board rules that the claim is not covered, an appeal process is available. The matter will first be heard by officials within the workers’ compensation department. In most states, this means a hearing will be conducted by an administrative law judge, and if further appeal is taken, the case will be presented to a review panel. Once these administrative remedies are exhausted, the employee can appeal the case in state court.
Despite the fact that workers’ compensation premiums account for less than 2% of the average employer’s cost of doing business, these cases can become highly contentious when employers feel workers are seeking benefits they do not deserve. The situation can easily deteriorate, rightly or wrongly, into a “matter of principle” for the employer. Injured workers facing such an obstacle may feel overmatched and vulnerable.
The best way for an employee to protect his or her rights under the workers’ compensation system is to retain legal counsel. An attorney specializing in this area of the law will be accustomed to dealing with emotionally-charged proceedings and employers who may not have their worker’s best interest in mind. Moreover, an attorney will know how to present the case in a way that maximizes the amount of money and other benefits the employee receives.
Know your Rights!
Articles About Workers' Compensation Law
- Are Same-Sex Couples Entitled to Share Employment Benefits?Traditionally, one benefit of marriage was being able to share in a spouse's employment benefits, like health, vision, and dental insurance. Unfortunately, many same-sex couples have struggled for years to receive the same level of benefits and even the right to be married. With more and more jurisdictions recognizing same-sex marriages, are employers now required to provide same-sex couples with the same level of benefits as heterosexual couples?
- Occupational Disease and Missouri Workers’ Comp: Who’s Entitled?An occupational disease is one that has been contracted as a direct result of a persons employment.
- Long Term Disability ("LTD") Appeals and Lawsuits -- Frequently Asked QuestionsIf your claim for Long Term Disability ("LTD") benefits has been denied or terminated, this article may answer some of your questions and concerns.
- Claimant Unsuccessful in Disability Insurance Lawsuit against Boston Mutual in a Louisiana LawsuitIn an ERISA disability lawsuit against Boston Mutual, Federal Judge upholds decision to deny Southside Machine Works employee’s long term disability benefits.
- Missouri Commission Rejects First Aggressor DefenseThe Missouri workers’ compensation commission has made an unexpected decision by allowing a man to receive workers’ comp benefits. The man and his supervisor had gotten into a physical fight. The case was heard by the Commission in order to determine whether or not what happened constituted a workplace accident.
- Going to Court for a Missouri Workers’ Compensation ClaimHaving to go to court to prove a workers’ compensation claim is not ideal. Resolving the case through settlement or mediation is often preferred because of the expense and stress of going to court. However, in order to receive the compensation you are entitled to, sometimes taking your case to court is necessary.
- What Benefits are Employees Entitled to After Termination?Leaving a job, whether intentionally, by being fired, or through circumstances beyond your control (such as layoffs), is almost always tinged with at least a little (and often a lot) of stress. One of the biggest concerns faced by many in this position is what sorts of benefits they are entitled to? Will their insurance continue? Are they guaranteed a severance? What happens if they cannot immediately find a job?
- Problems with California's Bill Limiting Workers' Compensation for Out-of-State AthletesCalifornia has moved one step closer to making its controversial workers’ compensation bill a reality. Earlier this month, the California Senate voted to pass the bill, which restricts most professional athletes playing for out-of-state teams from filing workers’ compensation claims in California. The bill is now awaiting the signature of Gov. Jerry Brown.
- Illinois Industrial AccidentsIn Illinois, employers have a duty to their employees to provide a safe work environment that protects them for injury on the job. This is even more true where industrial equipment or manufacturing machines are in use. But, industrial workplaces like factories, energy plants and warehouses have a higher than average rate of injury and death for their workers.
- Habitually Absent, Tardy, or Sick? How to Deal with Employees Who Are Not Coming to WorkDo you have a trouble employee that can never seem to make it to work when they are supposed to? Either they are always late or they are not there at all? How should you go about disciplining this employee, particularly if you have let it slide in the past? Is there any risk to firing someone for claiming too much sick time (even if they are entitled to those days under the terms of their employment)?
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Workers' Compensation Boards by State
Workers' Compensation Law - US
- ABA - Workers' Compensation and Employers Liability Law Committee
Committee members include plaintiff’s attorneys, defense and insurance lawyers, public officials, and judges. The group publishes a newsletter and hosts training events for workers’ compensation professionals.
- Black Lung Benefits Act
This law provides benefits to coal miners suffering from black lung disease. Family members of deceased miners may also qualify.
- Division of Coal Mine Workers' Compensation
This federal program handles claims for benefits under the Black Lung Benefits Act. Miners and their families currently involved in the claims process should check back regularly for announcements.
- Division of Energy Employees Occupational Illness Compensation
Information for nuclear weapons workers who suffered radiation exposure while employed by the Department of Energy. Lump-sum payments and reimbursement for medical expenses may be available.
- Division of Federal Employees' Compensation
Millions of government employees are covered by federal workers’ compensation insurance. An electronic filing portal allows workers to file a claim through the website.
- Division of Longshore and Harbor Workers' Compensation
Forms and claim procedures for injured waterfront workers, overseas government and military contractors, offshore oil rig employees, and others covered by the federal longshore programs.
- Federal Employees’ Compensation Act
Indexed version of the act, published by the Division of Federal Employee’s Compensation. This law provides compensation and rehabilitation assistance to non-military employees of the federal government.
- Occupational Safety and Health Organization
Since its creation in 1970, OSHA has made workplaces safer through enforcement of federal regulations, education and training, and industry outreach programs.
- Office of Workers' Compensation Programs - USDOL
News and information about the agency in charge of workers’ compensation programs for civilian employees of the federal government, department of energy workers, longshoremen, and coal miners.
- Safety, Health and Return-to-Employment (SHARE) Initiative
The SHARE Initiative was developed to promote occupational safety for federal employees. A performance chart shows the program’s impact on the largest government agencies.
- Workers' Compensation - Insurance Information Institute
Up-to-date information about workers’ compensation in all 50 states and the federal system. State-specific data is presented in chart format, making it easy to compare each state’s system.
- Workers' Compensation - Overview
A brief summary of workers’ compensation laws in the United States, with emphasis on major pieces of federal legislation. Published by the Legal Information Institute at Cornell University.
- Workers' Compensation and the Americans with Disabilities Act of 1990
Enforcement guidance published by the Equal Employment Opportunity Commission (EEOC). Discusses the relationship between the ADA and state workers’ compensation programs.
- Workers' Compensation Research Institute
Analysis of workers’ compensation laws and administrative actions. The information compiled by this non-profit organization is used by lawmakers looking for objective insight into their state’s system.
- Workers' Compensation Resources - AFL-CIO
Pro-worker advocacy resources, including tools for navigating the workers’ compensation programs in every state. An extensive resource library contains articles, fact sheets, videos, and more.