Workers’ Compensation FAQ
July 12, 2016
What is Workers’ Compensation?
Workers’ Compensation is a system of legally required employer-paid insurance which provides for payment of medical costs, hospital costs, and weekly disability payments for workers who suffer from an illness or injury which arises in the course of his or her employment.
Must I notify my employer if I am injured at work?
The Workers’ Compensation law requires that you notify your employer that you received an injury in the course of your employment, within certain time limits. If you fail to give notice on time, you may lose part or all of your compensation. You should report the time, nature and circumstances of your injury to your supervisor or another appropriate superior immediately, even if you do not believe the injury to be serious.
- It is never enough to advise your employer that you are ill or injured and cannot come to work. You must specifically tell your employer that you hurt yourself or sustained an injury while you were at work. You must describe the injury in ordinary language, and indicate when and where the injury occurred.
- Failure to report the accident or injury within 21 days from the date of the accident or injury will result in loss of part of your compensation.
- Failure to report your accident or injury within 120 days from the date of the accident or injury will result in loss of eligibility for any compensation.
What injuries, illnesses or diseases are covered?
Usually, Workers’ Compensation covers physical injuries. However, heart attacks and strokes, when related to your employment, can be compensated of they have been caused by unusual physical activity at work or by unusual stress produced by your job.
In rare cases, mental or emotional illnesses or impairments can be eligible for compensation if the condition was caused by a work-related accident, injury, illness or “abnormal” stress. Hearing loss can also be covered if you have been exposed to excessive noise at your work place for a prolonged period of time.
If your job contributed to or aggravated your previous condition or previous disability, you may be entitled to Workers’ Compensation benefits.
Who can file a Workers’ Compensation Claim?
An injured worker, the dependents of a deceased worker (principally the wife, unless or until she remarries, or the dependent children (including illegitimate children) up to age 18), or dependent partents (who must prove their dependency) may file a Workers’ Compensation Claim.
When can I get benefits?
You are entitled to benefits if your disability lasts more than seven days. Generally, if your injury or illness lasts for less than seven days, your Workers’ Compensation insurance carrier will cover only your medical bills and expenses, and you are not entitled to payment for your period of disability.
If your disability results in lost time which lasts for 14 days or more, you should receive benefits which include the first seven days of lost time caused by your injury or occupational disease.
Is there a time limit for filing a claim?
Yes. A claim must be filed within 3 years after the work-related accident, illness or injury occurs, provided a report to the employer of the accident is made within 120 days of its occurrence.
What should I do if my employer or its insurance carrier contests or refuses to pay my claim?
Consult with an attorney if your claim is contested. You will need to work closely with someone who knows the details of the Workers’ Compensation law.
When should I seek the services of a lawyer for my claim?
It is not recommended that an employee try to handle a possible claim for benefits alone. At the very least, you should contact a lawyer in connection with your Workers’ Compensation claim when the following situations occur:
- When you receive notice that your claim has been denied;
- When you suspect that your employer has not reported the injury to its insurance carrier;
- When you are asked to sign a Final Receipt;
- When you are asked to sign any document which may have a bearing on your Workers’ Compensation claim;
- When you are asked to sign a written statement or asked to give a taped, recorded statement;
- When you want to file a claim petition;
- When you receive a form entitled, “Notice of Ability to Return to Work.” This form will be sent by the carrier following an independent medical examination and/or impairment evaluation;
- When your employer files a petition to terminate, modify, suspend or reduce your benefits;
- When your employer or its insurance carrier request that you be examined by a doctor of its choice while you are actually receiving Workers’ Compensation benefits;
- Whenever you believe that you are also entitled to Social Security Disability benefits;
- Whenever you believe someone other than your employer might be at fault, e.g. another company, manufacturer, or distributor;
- When you are injured in an auto accident or injured as the result of another person’s or company’s negligence.