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Does Your Injury Qualify You For Workers’ Compensation?

by kelliedennie on January 31, 2013

Does Your Injury Qualify You For Workers Compensation?

(U.S. Injury Law and generally) When an employee is injured on the job, the law provides employees the right to receive certain compensation for their injuries and coverage for any medical costs. Every state has a workers’ compensation program. While workers’ compensation statutes are not uniform among all 50 states, the nature of injuries that are covered tends to be consistent across the nation.

Injuries Qualifying for Workers’ Compensation

Physical injuries are a common source of workers’ compensation claims. They can be cumulative; a repetitive stress injury can impede an employee’s ability to perform work just as surely as a broken leg. Back, leg, hand, and neck wounds can all occur on the job whether through falls, being struck by equipment, or being involved in an automobile accident while working for the company. Illnesses and diseases incurred as a result of the job are also covered; increased exposure to chemicals can cause respiratory, skin, and other health problems.

Nearly any injury on the job that results in a reduction in the employee’s ability to perform work may be covered by workers’ compensation. The type of grievance and the extent of it will determine the type of workers’ compensation awarded. Medical care will be covered until the wound has healed, but if the grievance did not result in a reduction in an ability to perform work, the employee may not be entitled to a change in work assignments or any other compensation.

Not all injuries are covered. Workers’ compensation is intended to cover employees for physical damages incurred on the job. As a result, the wrong must have occurred while the employee was acting within the course and scope of his or her employment. Each state will have different rules and different case law as to what type of actions will constitute acting within the course and scope of employment; depending upon the state, running personal errands on company time or traveling to and from work may or may not be covered.

In addition to limiting coverage to damages suffered while working, the laws require employees to act somewhat reasonably. If the harm was suffered as a result of gross negligence on the part of the employee, the grievance will not be covered. If the injury was deliberately self-inflicted, the employee will not be covered under workers’ compensation. Finally, the harm must not have been incurred while the employee was under the influence of drugs or alcohol.

What to Do When Injured?

Applying for workers’ compensation is simple, but the process varies by state. Also, know the insurer’s guidelines, especially when dealing with a company known for its high denial rate – such as a workers compensation Liberty Mutual claim – make sure each step meets their requirement to qualify for due compensation. Generally, workers must begin the process by notifying their employer as soon as it is practical to do so upon suffering harm. In most states, employees will receive a workers’ compensation form from their employer. They fill out the form, which always contains a description of the injury, the employee’s information, and the treating physician’s information. The worker then submits a copy of it to his or her employer. The employer then fills out its own form and submits it to a claims administrator.

In some cases or in other states, an employer may not furnish an employee with any documentation following a grievance. An employee may still file for workers’ compensation by downloading the forms off the web site of the relevant state agency that governs workers’ compensation and manually submit them. If the process is not on the web site, injured employees can call their state agency and ask for addresses, forms, and clarifications regarding the application process. Employees who disagree with the extent to which they are considered disabled as a result of their injury may appeal the decision.

Workers’ compensation is a simple and efficient system to compensate employees for most workplace injuries. In many cases, employees need to do little beyond submitting one form and receiving due medical care. If the employer is non-compliant for some reason and refuses to provide coverage, simply complain to the state agency that regulates workers’ compensation practices in that state.

Kelly Dennie is a business owner and freelance writer in the Metro Atlanta area. The attorneys of Doyle Raizner LLP are well aware of the fraudulent activity in workers compensation Liberty Mutual bad faith cases. During litigation, it has been uncovered that medical evidence was ignored and coverage was willfully denied.  When this happens, further damage can be caused to the harmed employee by their deteriorating medical condition, as well as, the loss of monetary stability and good credit rating while their claim is unlawfully delayed.

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