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Workers' Comp: The Basics

Workers' comp is available to employees who are injured in the course of their jobs. Most employers are required by state law to purchase workers' compensation insurance for their employees. Workers' compensation insurance pays employees who are injured or disabled on the job and protects the employer from being sued by injured employees.

There are situations where you may be denied workers' comp. In such cases, you will have to appeal to the proper state agency to seek benefits. In addition, you may need to seek out the assistance of a workers' comp attorney to help secure your benefits.

What Does Workers' Comp Cover?

Most people would probably define workers' compensation as payment for an employee's injuries suffered in the course of an on-the-job physical accident. Although this is true, the definition of workers' compensation is much broader than this.

Workers' comp covers the following types of injuries:

  • Physical traumatic injuries
  • Repeated trauma injuries
  • Mental injuries
  • Occupational diseases

Physical traumatic injuries are the most common type of injuries that result in workers' comp claims followed by repeated trauma injuries. Repeated trauma injuries are injuries that result over time rather than from one particular incident. For example, a worker on an assembly line who must execute a repeated motion day in and day out may eventually suffer injuries to the tendons and ligaments due to the constant stress on joints.

Mental injuries can include the mental anguish an employee feels after suffering a traumatic physical injury. It can also include the mental stress an employee is subjected to after witnessing another employee suffer a severe physical injury, such as a limb amputation. Some states even allow such workers' comp claims for jobs that put an employee under excessive mental stress.

Finally, occupational disease claims are allowed for specific illnesses suffered as a result of an employee's job activities. These types of claims are only available to workers in certain states.

What Types of Benefits Are Available?

Whether your injuries are the fault of your employer or not, you may be entitled to the following types of workers' comp benefits:

  • Total disability
  • Permanent partial disability
  • Temporary total disability
  • Payment for medical bills

How disability is determined will vary from state to state. Some states have schedules that list how much a certain type of injury pays out. For example, some schedules will detail a specific monetary amount for each body part amputated as a result of a workplace injury.

Depending on state requirements and the workers' comp insurance of your employer, you may also be eligible to receive vocational rehabilitation training to help you find a job in light of your disability. You may be able to continue to work for your current employer if there is a position available that meets your abilities in light of your injury.

Collecting Workers' Comp

You should file a workers' compensation claim with your employer as soon after injury occurs as possible. State laws typically spell out exactly how much time you have to alert your employer about your injury. Some states specify that this notice must be given in writing.

Your employer will then alert its workers' compensation insurer. The two will decide mutually whether to accept responsibility for your injury and accept your claim. If liability is accepted, then you will receive your workers' comp benefits. If the claim is denied, then you will need to hire an attorney who has experience with workers' comp cases and appeal to the proper state agency.

To determine the legitimacy of your claim, the administrative agency in charge of granting workers' comps claims will review your workers' compensation file. Your lawyer will ensure your file contains all relevant medical reports, which includes such information as your diagnosis, how your injury relates to your employment, your course of treatment, and whether permanent disability is anticipated.