Workers’ Compensation FAQ

We’ve noticed while building our blog we’ve had quite a few questions from visitors, and they all tend to be variations on the same few questions, so we thought we’d create a FAQ to answer some of those questions at a glance!

Under work comp laws can I receive payments for any injury or illness?

You are only eligible for workers comp payments if you:

  • are hurt on the job
  • aggravate a pre-existing injury
  • develop a work-related illness, such as asbestosis or carpal tunnel syndrome

Generally, the rule is injuries that occur in the workplace, or that occur while “furthering” the business of your employer, such as travelling to a work-related appointment, will qualify you for workers comp payments. This includes if you are working on site outside of your office; for example loft conversion for a company like this one: http://www.mertonloftconversion.com/.

You can ask for work comp payments if you are at fault for your injury at work. Generally, accidents that occur while commuting to or from work, or during work breaks, do not qualify for Pennsylvania workers compensation.

Under work comp laws, can I receive payments for repetitive motion injuries like carpal tunnel?

If you can prove that your injury is caused by your work, then yes, you can ask for workers compensation. Work that requires repetetive motion can cause RSI injuries such as Tennis Elbow and Carpal Tunnel Syndrome

Under work comp laws, can I receive payments if I was injured while volunteering?

These situations are slightly more complex; workers comp normally requires you to be paid for your work in some way, if you are volunteering, then you are not being paid. However, certain organisations; particularly those that provide a public benefit such as ambulance workers, firefighters and special or community police are able to provide their workers with workers comp.

We highly recommend you contact a lawyer specialising in workers comp in order to investigate if you are eligible for workers’ comp during volunteering work you are carrying out.

Under work comp laws, can I receive payments if I was injured in a car accident while driving to a work seminar?

This has been a topic of much discussion: Yes, you ARE eligible for workers comp in this situation, as you were doing required work for your job in travelling to a seminar they’ve asked you to attend.

Though workers comp doesn’t apply while commuting to or from work, when you are travelling to a business appointment, or another event where your presence is required, you’re then travelling while “engaged in the business” of your employer. This then becomes time when you are eligible.

Under work comp laws, can I receive payments if my work injury was my own fault?

You can receive payments if your work injury was your own fault, and regardless of who’s fault it was. There are caveats to this which we will explain in a moment though. It’s important to note that intentional, self-inflicted injuries are not covered under workers compensation.

Under work comp laws, can I receive payments if I am a traveling salesman and I’m injured in a car accident while driving home from a sales convention?

Generally speaking, workers who have no fixed place of work – like consultants, traveling salesmen, and freelancers – are covered once they take to the road. This is because the transient nature of their business. Work comp covers just about every injury in this case

Under work comp laws, can I receive payments if I am injured at work while under the influence of alcohol or drugs?

In this case, it’s most likely you won’t be eligible for workers comp payments. You would have to prove that your injury was not caused by your inebriation, and this is notoriously difficult to do. As well as this, most companies have a no tolerance policy on drugs and alcohol which you would be in breach of regardless of if you were injured or not. This would invalidate you for any benefits.

Under work comp laws, can I receive payments if I am injured on my lunch break?

The likelyhood is you would not be eligible. Generally, any personal breaks and time taken are not covered under workers comp laws. Breaks, smoking breaks, lunch and commuuting to and from work are times you are not covered.

The exception to this is if you are travelling to a lunch hosted by your employer, then you have a chance of receiving workers comp payments. This is another time we would recommend you see a lawyer specialising in workers comp.

Can I receive work comp payments if a previous injury was aggravated on my current job?

This very much depends on if your injury is related, but a new one that has occured due to your job, or a re-occurence of the old injury. If the case is the former, then you will be eligible for workers comp, however, if it’s the latter, things become much more complex.

If your pre-existing injury re-occurs or becomes aggravated due to work, then we highly recommend you get in touch with a lawyer to discuss the situation.

Can I receive work comp payments if I was injured at home while doing work for my employer?

This case depends on if you were asked by your employer to work from home or you chose to do so yourself. If you chose to, then you wouldn’t be eligible for workers’ comp. If your employer asked you, then you will be covered as this was required by your employer.

Can I receive work comp payments if a scar results from a work-related injury?

Absolutely. If you were to receive a scar due to your work, then you would be able to gain additional workers comp. You don’t need to have missed any work days due to the scar to gain the comp as well.

We hope this FAQ has been of use to you!

What role does OSHA play in Workers’ Comp?

While your Workers’ Compensation won’t be paid out by OSHA (Occupational Safety and Health Administration), they play an important role in the prevention of injury, providing support and ensuring that procedures are kept when claiming for compensation, and in aftercare and changes to be made when an accident happens.

Prevention of Injury

OSHA is directly responsible for making sure employers take every precaution they can to make sure their employees’ health and safety at work is taken care of. The employer must do everything they reasonably can to prevent faulty or aging equipment, poor practice, inadequate procedures and malpractice from doing harm to their employees. Workers are also responsible for following procedures and using common sense in order to prevent harm to them or their peers.

OSHA will periodically implement new rules and guidelines as it learns more about the dangers in each workplace, and make their rules more efficient in order to aid workers. They will then enforce these rules on workplaces to ensure workers’ health and safety are protected. Any companies that ignore OSHA’s warnings will be fined.

Providing Support

OSHA can provide support during an injury claim by having access to injury and workplace health records that are provided by the employer. Anytime an injury – No matter the extent of it – occurs in the workplace, it must be recorded. This means that when you are injured at work, you can then refer to this record in order to provide evidence to the insurance agents and courts. Once this occurs, then OSHA will double-check the information and confirm it with the insurance agents if needed.

They can also provide support by ensuring that these standards and measures are kept up in the workplace. They will randomly and periodically check a workplace is following the correct measures for recording injuries, and if the workplace isn’t, then the employer will be fined.

However, be aware if they find that you, or a work colleague are responsible for the injury by not following correct procedures, or knowingly using faulty equipment without reporting it, then they will be honest in that you are responsible for the accident.

Aftercare

Once an injury occurs at work, if it is caused by the employer or workplace, rather than the worker, OSHA may investigate the cause of the injury and if it is something that the employer can reasonably change to aid in keeping workers’ healthy and safe, then OSHA will ask the employer to implement the change. OSHA may also – if seen to be required – ask the industry as a whole to make the requested change.

In the case that the employer wasn’t following a regulation or act that was put in place by OSHA, then they will investigate the employers and directors at the company, and if found to be wilfully ignoring these regulations, they will be fined and in the worst cases, imprisoned for manslaughter or murder.

This is especially important in an industry that all uses the same tools or procedures as if you are hurt, then many others may be over the long run too. This frequently happens when new methods of working are introduced or new materials are created or found and used in workplaces.

It is important to note that OSHA will not be responsible for your compensation fees in any way; they don’t hold money from the employer as insurance agents do, and they will not go to court for or against you, but they can provide evidence for the court to take in your case. This evidence could either aid or harm your case, as the circumstances dictate.

If you want to find out more about OSHA, then do visit the website linked at the top of this article. If you want to ask us any questions, then send us an email!

What to look for in a lawyer

Firstly, a big thank you to https://www.youtube.com/watch?v=ENJdcIRoTf0 for some of the information contained in this post!

In the unfortunate event that you suffer an injury at work and need to find a lawyer that can help you apply for workers’ compensation benefits, you may be wondering what you should look for in a lawyer. We’ll try and give you some guidance in this blog post.

What you should look for in a lawyer to represent you

Experience

The most important thing you should look for in a lawyer representing you is experience. You should search for a lawyer that has specialized experience in the field of workers compensation and knows the pitfalls and hidden dangers to watch out for, as well as the best way to handle any situation that arises.

Success Rate

Obviously, as these lawyers will be fighting for your cause in the case, you want to make sure that the lawyers you choose have a track record of winning cases for their clients. There are a few ways you can do this; finding client testimonials, Checking out their Google reviews, or if you wanted to be very thorough, you could look through the court’s records for instances of the lawyer’s cases.

Honesty

You want to make sure you choose a lawyer with honesty. Lawyers have a bad reputation for dishonesty, so when you meet with yours, you want to make sure you feel as comfortable as possible in their presence. If you feel comfortable they are telling the truth, then so will others, and trust is how court cases are won.

Communication Skills

Lawyers make their living through their communication skills. If they were unable to communicate they wouldn’t be able to get their point across in the courtroom, they wouldn’t be able to interpret evidence and they wouldn’t be able to understand what people mean rather than say. If a lawyer has poor communication skills, they would be unable to efficiently speak to you, their client, insurance agents or the courtroom productively.

Commitment

You have to be sure your lawyer is committed to working with you and giving you the best service possible. This doesn’t just mean that they want to win your case but are also committed to making your life better, easier to work with them and making sure the process of taking your employer or insurance agent to court is as easy as possible. They must be committed to making sure your life is as easy as possible following your injury if you need time to recover.

Cost

And last but not least, the cost of the lawyers. There are two main schools of thought when it comes to fees for lawyers: “No Win, No Fee”; those that charge nothing upfront and only take a percentage of the benefits you earn as a result of the court case, and those that do charge upfront and don’t take a percentage.

Which one you choose will be a personal decision depending on your financial situation, but we would always recommend paying up-front for a lawyer if you can afford to. This is because not only will you most likely have less to gain if you give a percentage of your final benefits to your legal team, and end up paying more in the long run, but also those that charge upfront know how good their service is and so price accordingly. They are confident they can fulfill your case which improves your chances of winning.

We hope this guide has been helpful!

Why you could be refused benefits

While the introduction of Worker’s Compensation Benefits have helped the majority of workers injured or diseased by work, there are of course gaps in every system. Especially legal systems where laws can be changed constantly and re-written.ome of the reasons you may need to hire a lawyer to help you with your claim:

Some of the reasons you may need to hire a lawyer to help you with your claim:

  • If you’re uncomfortable or unable to understand any part of the process of filing a claim – In this case it is always best to seek a lawyer’s services as they will have the knowledge to help you out. If you claim in an incorrect fashion, then the claim can be voided and you will lose out on your compensation.
  • Your employer won’t file or produce a report for your injury – Unfortunately this is the most common reason that workers hire lawyers to help them in their claims. Workplaces often don’t like to produce injury reports as it portrays them in a bad light, can often highlight bad health and safety practices, poor work conditions and mismanagement and invites OSHA to scrutinise the company. In this case you would certainly have to hire a lawyer to aid you in your claim
  • The insurance company threatens to refuse paying your compensation – This can often happen if certain procedures aren’t kept, for example your workplace misfiled documents, you have failed to appear at hearings or the insurance company suspects fraud. In most cases you would have to hire a lawyer to track the problem and deal with it effectively
  • You have returned to work after the injury has healed, then become injured again and the insurance company refuses to restart your benefits – This can often happen due to the insurance company wanting you to file a new claim for the injury, or that their records system has become confused by the injury occuring twice. This doesn’t always call for a lawyer, as you can normally organise this with the company yourself, however if the indurance company is difficult to deal with or will not fix the situation then you will need a lawyer.
  • If your work injury has caused scarring to always visible areas i.e. Head, face or hands – In this case you may be able to collect extra payments for the scarring as it may cause you to not be hired at another workplace. This kind of case always requires legal representation as you require someone with expertise in persuasion and legal knowledge.
  • If you are offered a lump sum of money to pay for your future medical bills, rather than a monthly stipend – This case is always complicated as the workplace or insurance company will often do this so that they can save money in the long-term due to inflation, not including certain bills they know you can’t foresee and other reasons. If you are happy with the settlement, then by all means accept it, but it is always best to seek legal advice with a lawyer experienced with it so they can tell you about any possible future expenses they can foresee.
  • If you’re offered a lump sum of money to settle your claim, rather than going through the process of filing the claim – You should always seek a lawyer in this case as accepting the settlement will often cause you to lose some of your rights.
  • You’re informed a petition has been created to refuse, modify or pause your benefits – These cases always require a lawyer as a party will have seen an error or what they believe is something wrong in your claim and you will need legal counsel and representation to fight their perception of the claim.

We hope this guide has been helpful, and as ever, if you have any questions or would like some guidance or information, then please do contact us!

What to do when you are injured at work

When injured at work, it’s important that you take steps to aid your recovery, but to also make sure that you fulfill your obligations in order to apply for worker’s compensation. There are naturally then, 3 major steps that you must take.

Step 1: Immediate first aid

More important than anything when you’re injured at work is to first obtain medical treatment as soon as possible. Gain immediate first aid at work to aid in any medical procedures later. Once this is done, you must see a healthcare provider that has been authorized by the Worker’s Compensation Board, unless it is an emergency situation. Your workplace should be able to provide you a list of authorized providers in your state, or you can search online for one. It may also be

It may also be necessary to use an authorized pharmacist or diagnostic provider if required by your state. As long as the case is not disputed, the cost of your necessary medical expenses

As long as the case is not disputed, the cost of your necessary medical expenses will be paid for by your employer or their insurance carrier. The health care provider, may however, ask you to fill in paperwork stating that you will pay for the costs if the Workers’ Compensation board disallows the claim or you do not pursue workers’ compensation.

Step 2: Notify your supervisor/manager of the incident & injury

Get in touch with your manager or supervisor, inform them of the injury, how it happened, and when, as soon as sensibly possible. If the injury requires you to find urgent medical treatment, then do that first, and get in touch with your supervisor as soon as the injury is under controlled. Otherwise, inform them before you seek treatment so they are aware of the situation and take steps themselves to enable your workers compensation claim.

If you do not notify your supervisor within 30 days of the accident that caused the injury, then you will lose your right to the Worker’s Compensation benefits.

If you have an occupational disease, rather than an accident causing injury, then you must inform your supervisor/manager within 2 years after coming under disability due to the disease, or within 2 years of you finding out that the disease is related to the workplace.

Step 3: Apply for Workers’ Compensation Benefit

Approach your employer asking for a Workers’ Compensation Benefit claim form – normally a C-3 form. You must then mail this to your state’s nearest Workers’ Compensation board. As above, if you do not do this within a certain time-frame, you will lose your right to claim for the compensation.

What to do afterward

After the previous steps have been taken, it is then advisable to do everything in your own best interests. Your first priority should be to make sure you do everything your doctor tells you to, to aid in a quicker recovery from your injury. You should also have an examination performed by an independent doctor so that you have a valid, unbiased second opinion on your condition.

You should also go back to work as soon as practically possible so that your financial situation isn’t too badly effected.

Finally, you should ensure you go to any hearings that are organized for your case by the Workers’ Compensation Board, or again, you may lose your right to compensation benefits.

Hopefully, this guide has given you some good information on what to do in the unfortunate event you do suffer from an injury at work. Remember, if you have any questions, don’t hesitate to get in touch with us!

What is Worker’s Compensation?

Worker’s Compensation laws were created in order to provide benefits to workers who are injured on the job or contract a work-related disease. In America, there are five types of benefits that are generally available to someone if they can prove they were injured due to a work-related issue or disease.  This means that the worker then has the “right to compensation”. They may collect money for:

  • Loss of Earnings benefits for disabilities (as this will affect the earnings they can gain in the future due to the incident)
  • Medical Benefits (as they will have to pay for cures, medical aids & associated costs with caring for their injury)
  • Specific Loss benefits (Losing a specific body part I.E., hand, leg, eye, due to the work carried out)
  • illegally-employed minor’s benefits (due to language not always being clear, a company may believe someone is legally employed, though the state or federal government disagrees. In this case, the worker is entitled to compensation just as a legally employed worker is)
  • Death benefits (If a worker is killed while on the job due to the work being carried out, his dependants or immediate family members are entitled to the compensation, the costs of the funural will also be paid by the employer directly to the funeral home)

Why were workers’ compensation laws enacted?

Before workers’ compensation laws were enacted, the only way a worker could claim compensation for their injuries was to prove the employer was negligent, which caused their injury. In this case, it was up to the worker to prove the onus of responsibility lied on the employer and it was only due to their negligence that the worker was injured.

This held many problems as not only would the employer normally have more resources and money to spend on disproving the workers’ claim but that the burden of proof laid on the injured worker, at a time when sometimes they were unable to return to work and investigate. It would in the majority of cases become a case of workers’ word against employers, which ended up in an unfair trial.

The employer would often win these cases by claiming the worker was injured by not following safety procedures, that the injury was caused by a fellow worker, or it was caused by an ordinary workplace hazard, rather than negligence. This enables them to avoid responsibility.

The rare times a worker would win the case, the worker would often have delays in the being paid the money owed from the court case, as well as having high costs in hiring an attorney to take their case and fight for their rights. The employer would also often have to pay inordinate amounts of money compared to the injury received. Finally, the times where a worker could work while the court case was going on, they would encounter very stressful situations in the workplace due to frictions with managers and other co-workers.

Due to all of these problems, both employers and workers favor the new workers’ compensation laws. They mean that the worker is automatically entitled to the new benefits, which are a predictable amount, meaning companies can budget for the loss. Workers no longer have the difficulty of bringing a case to the courts, while companies are protected from a worker asking for a larger amount.

This would be fine, if it wasn’t for the fact that in the real world, laws often get amended, changed and sometimes completely re-written. This means workers are now often left suffering with no recourse. Therefore, workers are now having to hire attorneys to fight for their rights, and this is why the system doesn’t always work.

The Work Comp Legal Blog

Welcome to the Work Comp Legal blog! In this blog we want to give you the most un-biased, rational and useful information on the web regarding workers’ compensation. We’ll attempt to cover such topics as:

  • Whether pursuing compensation is the right option in your case
  • The right kind of attorney for your case
  • What you can expect to gain
  • The ethics of suing an employer
  • How to start the process in the right way
  • Any interesting historical cases

We’ll also cover other topics we think of throughout the way, as well as any suggestions you, our dear readers may have! If you want to contact us, just head over to our contact page!

We’ll be updating this blog regularly with new information, so make sure to sign up to our RSS feed or bookmark us for later!