Workers’ Compensation Basics

Tony CanataUncategorizedLeave a Comment

What Is Workers’ Compensation?

Workers’ compensation — often called workman’s comp — is a legal system run through a state agency, the Department of Industrial Accidents, that provides compensation for employees injured on the job. It is a mandatory, no-fault insurance system, which means that an employee does not need to establish the exact cause of a work-place injury to receive benefits. This also means, however, that the system does not allow or provide for the recovery of money for pain and suffering or future loss of opportunity, which are forms of compensation commonly sought in personal injury cases.

There are many, many kinds of workplace injuries and illnesses, including:

Falls resulting in head, back and other bodily injuries
Injuries resulting from use of defective machinery
Exposure to toxic chemicals
Excessive noise
The presence of harmful or defective products and equipment
Death by heart attack while on the job premises
Psychiatric illnesses with a variety work-related causes
Repetitive stress injuries often suffered by office employees and manufacturing workers
Carpal tunnel syndrome
Workers’ compensation laws provide for four main types of benefits: (1) weekly benefits to compensate for lost wages; (2) payment of medical expenses; (3) job retraining and (4) one-time payments for scarring and/or permanent impairments. Once a worker reports an injury to his employer, the employer must inform the workers’ compensation insurer, which may begin to pay benefits or deny the claim. After a denial or termination of benefits, a worker can submit a claim to the Department of Industrial Accidents and substantiate his claim during a legal process that includes a conciliation (an informal meeting to attempt to resolve a claim), a conference, a hearing and an appeal process, including a review of the claim in state court.

Most people filing a workers’ compensation claim also file for Social Security Disability Insurance (SSDI) benefits. Many also need assistance in filing an ERISA disability claim under their employer-provided group long term disability plan. A worker injured by the negligent act of a third party – but not by his employer – may also pursue a ‘third party’ lawsuit in state court against that person.

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