When am I Eligible for Workers’ Compensation?

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Understanding the basics of workers’ compensation

The term refers to insurance provided by the company in the form of either cash benefits or medical care to workers who have suffered an injury or damage as a direct result of their job.

Workers’ compensation benefits apply when the workers fall ill or suffer injury due to their designated work on their jobs. There are several condition required by the state law as to what makes employees or workers eligible to receive compensation for the medical bills, lost wages, etc. If the company fails to provide appropriate compensation, the worker has the right to claim their compensation in court and can sue their employers.

Eligibility Requirements

Characteristically, there are three basic conditions that need to be fulfilled before a worker claims compensation benefits:

1.      Employer must cover Workers’ Compensation

Workers’ compensation laws vary depending on the state and country. The responsibility to provide coverage to workers’ compensations depends on the following factors:

  • The total number of employees
  • The industry the company operates in
  • Type of work

In general, employees are required to cover workers’ compensation benefits whether they like it or not. Most employers provide coverage either by self-insuring or by purchasing insurance. This coverage ensures the employer that the worker will not be able to file a lawsuit if he/she is compensated for all the work-related injuries.

2.      Employee of the Company

In order to be eligible for workers’ compensation benefits, you must be a permanent employee. Independent contractors such as freelance writers, computer consultants etc. and volunteers are exempted from such benefits since they are not termed by legislation as ‘employees’.

Claims can be made by the workers if the company denies workers’ compensation declaring them as independent contractors when they are not. In such scenarios, availing consultancy from an attorney will help resolve the case.

3.      Work-related injury or illness

The third condition that applies means that the injury or illness you sustained needs to be in the line of work. You are entitled to compensation if you were involved in doing something for the company or your employer, and became severely injured or ill in the process.

For example, if you work for a construction company and suffer back pains due to frequent loading and unloading of boxes or injure your arm while operating machinery and this injury requires medical assistance, you can file for workers’ compensation benefits.

But there are also such scenarios where workers’ compensation will not cover you. For example, you suffer injury during lunch hours, during transit to your office, or suffered an allergic reaction on the company’s annual picnic or other off-site events. In such cases, the compensatory benefits are determined on the company/employer’s workers’ compensation benefits policies and terms.

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