Workers' Compensation: Questions and Answers
Q: What should I do if I'm injured on the job?
There are three things to do if you are injured on the job:
- Report the injury to your supervisor immediately;
- Request to see a doctor; and
- Request and complete a workers' compensation claim form.
Until you report the injury and the claim form is returned to your employer, they're under no obligation to provide you with benefits . A common mistake people make is waiting to report the injury until it becomes unbearable and they can no longer work. While it's still possible to pursue the claim, the delay in reporting creates serious problems in getting the benefits started. Prompt reporting and immediate medical care ensures that the workers' compensation benefits aren't delayed while you're off work with no income.
Q: Do I have to receive medical treatment from the company doctor?
If you are injured on the job, you have a right to medical treatment. Whether you must use the company doctor and, if so, for how long will vary by state. You may, for example, be required to use the company doctor for the first month of treatment, but then have the option of choosing your doctor after that. You may also be able to change company doctors if you're not happy with your treatment. Your state might also grant you the right to select a doctor in advance for treating any industrial injury.
Q: What benefits am I entitled to?
Generally, you're entitled to four basic benefits:
- Medical treatment: with the insurance company covering the bills for all treatment reasonably required to cure or alleviate the effects of the injury;
- Disability payments: if you are temporarily unable to work while recovering. This is a partial compensation for lost wages;
- Permanent disability settlement: if the injury causes permanent impairment or restrictions, with compensation based on the significance of the disability; and
- Vocational rehabilitation: or paid training in new employment if you can't return to your usual job and the company has no alternative or modified work you can do.
Q: Who pays the benefits?
A common misconception is that states pay out workers' compensation benefits when, in fact, it is private insurance companies. Employers are required by law to carry workers' compensation insurance to cover employees in case they are injured on the job. Much like personal auto or fire insurance claims, workers' compensation claims are handled by an adjuster from the insurance company and the company pays out any benefits. An important consideration when dealing with adjusters is that their job is to minimize expenses for the insurance company, which is rarely in line with the best interests of the injured worker. Since the adjuster will inevitably have much more experience in limiting claims than you will in protecting your benefits, it's in most people's best interests to have an experienced attorney representing them.
Q: Do I have an overlooked industrial injury?
Many work-related injuries occurring on the job go overlooked by the injured employee. These include:
- Hearing loss: Exposure to loud noises over an extended period of time, even with hearing protection, creates a gradual loss of hearing.
- Lung problems: Exposure to industrial chemicals over an extended time damages the lungs and causes breathing problems.
- Heart attacks: Work stress can cause an attack even away from the job.
- Hand injuries: Repetitive hand movements in many occupations can leads to wrist pain, carpal tunnel syndrome, or nerve damage.
- Hernias and back pain: Lifting heavy objects and other physical exertion can put a strain on your torso.
- Eye injuries: Airborne irritants and eye strain can significantly impact vision.
Any injuries caused in whole or in part by working conditions or accidents may be potentially covered by workers' compensation. If you need help assessing whether your injury is eligble for benefits, start by contacting an experienced attorney who specializes in this field.
Q: Can I be fired while I'm on workers' compensation?
The basic rule is that if you are temporarily disabled on workers' compensation, the employer may not discriminate against you by termination or lay-off. One exception to the rule might be if it is clear through medical evidence that you'll be unable to return to your usual occupation. Another exception is, if your employer needs to replace your position because of business necessity, though the burden on the employer is very high, so they may instead hire a temporary employee rather than replace you. Labor codes tend to protect injured workers' jobs, so an employer that terminates or lays off a recovering worker can often be hit with a substantial penalty, plus back wages. There may also be other remedies available through the Americans with Disabilities Act.
Q: What if I'm injured and can't return to my usual job?
Specific state laws will vary, but, the general rule is that your employer can offer you a modified or alternative position with the possibility of slightly reduced pay, depending on the job. If you refuse the accommodation, the insurance company may not be obligated to provide further job placement or training assistance.
If your employer has no modified or alternate employment available, they'll often need to provide you with vocational rehabilitation benefits. Vocational rehabilitation is designed to get you back into the labor force either through direct placement or retraining to another occupation. Your skills will be assessed and you'll be involved in choosing a new occupation and training school. While in school, you'll be eligible to receive some portion of your usual pay benefits and perhaps even mileage reimbursement. Keep in mind, however, that the total costs of rehabilitation expenses will be capped by law, so any job retraining benefits will be far from a blank check.