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
- Truck Drivers and Work Related Injuries in New York StateThere are a variety of injuries and illnesses suffered by workers in New York State. In addition, although it is fairly common to see neck and back injuries in strenuous occupations, even the most sedentary jobs can result in the development of serious orthopedic problems. It is clear, however, that certain jobs present with an increased risk of injury.
- How Much Time Does an Injured Worker Have to Report an Accident in New York State?A very common defense to a work related claim is to contend that the employee did not provide proper notice of the work related accident. Raising lack of proper notice is fairly standard procedure for New York State employers and insurance carriers and can be the subject of considerable litigation.
- Chiropractic Care and the New York State Medical Treatment GuidelinesChiropractic care remains somewhat controversial in New York Workers' Compensation claims. A great majority of injured workers claim great benefit from manipulations, often contending that they are unable to function without treatment. Self-insured employers and insurance carriers view chiropractic care as an unnecessary expense, often claiming that the treatment is excessive.
- What Are Workers' Compensation Vocational Rehabilitation Benefits?Each year millions of workers are injured in on-the-job accidents. While many of those injured workers will be able to return to their existing job after a period of recovery, some injured workers are injured to an extent that they are unable to return to their pre-injury job. In these situations, the injured worker may be able to receive vocational rehabilitation benefits under the applicable state workers’ compensation program in order to help him or her obtain a new job.
- Top Work Injuries and Illnesses in Healthcare IndustryHealthcare is the fastest-growing sector of the U.S. economy, according to the U.S. Centers for Disease Control and Prevention (CDC), employing over 18 million workers – the majority of which (80%) are women. Healthcare workers – including doctors, nurses, lab technicians, pharmacists, and a number of other professionals – are exposed to a wide range of occupational hazards.
- Prisoners and Social Security Disability BenefitsSocial Security disability benefits can be paid to people who have recently worked and paid Social Security taxes and are unable to work because of a serious medical condition that is expected to last at least a year or result in death. The fact that a person is a recent parolee or is unemployed does not qualify as a disability.
- Should I Settle My Workers' Compensation Claim?In New York State, Section 32 of the Workers' Compensation Law permits an injured worker to settle any and all issues is a claim. In the typical situation, a claimant agrees to waive his or her right to future medical care and indemnity benefits in exchange for a lump sum. An injured worker should take great care before accepting such proposal and should carefully consider the ramifications of waiving future rights.
- Common Risks for Workplace Injuries in Construction IndustryConstruction workers are especially vulnerable to work-related injuries. According to OSHA, nearly 6.5 million people work at approximately 252,000 construction sites across the nation on any given day, and the fatal injury rate for the construction industry is higher than the national average for all industries.
- Pre-existing Injuries and New York State Workers' Comp FraudSection 114 (a) of the New York State Workers' Compensation Law governs fraud and carries significant penalties. If an injured worker is found to have committed fraud, he or she runs the risk of a permanent ban on receipt of indemnity benefits and a permanency award. Claimants may be unaware that a failure to disclose a prior similar injury or condition can result in a fraud finding.
- What Happens After Filing an Initial Claim for Long Term DisabilityWhat happens after filing an initial claim for Long Term Disability: The agony of ongoing and periodic LTD eligibility reviews. Throughout the duration of your LTD claim, you will be subject to ongoing and period eligibility reviews.
- All Employment and Labor Law Related Articles
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.