Common Workers’ Compensation Questions

Workers’ compensation is an insurance program that helps protect employees that are injured while working. Each state has its own rules and regulations about workers’ compensation. Typically, an employee that was injured while working or have developed a work-related illness is eligible for benefits.

Who is Covered by Workers’ Compensation?

Not all employees are covered by workers’ compensation. It can vary from state to state on which employees qualify. The type of business and type of work employees are doing can qualify or disqualify an employee for workers’ compensation. For example, many farmers or agriculture workers may not qualify for workers’ compensation under a state’s rules.

Are All Injuries Covered by Workers’ Compensation?

The majority of work-related injuries are covered by workers’ compensation. If the injury occurred while an employee was intoxicated, violated a company policy, committed a crime that caused the injury, was not at work or was not doing work-related activity when the injury happened, then it’s likely the injury will not qualify for workers’ compensation.

Are Only Trauma-Related Injuries Covered By Workers’ Compensation?

Not only is workers’ compensation available for those who were injured at work from an accident, but it also covers those who have developed an injury or disease over time. For example, if repetitive movements and overuse of muscles have caused a stress-related injury, then you may be covered. If you devolved an occupational disease, such as lung disease, from your job then you may qualify or workers’ compensation as well.

Am I Only Covered by Workers’ Compensation if I Was At My Workplace?

You do not necessarily have to be at your workplace to be covered by workers’ compensation. If you were traveling for work, at a jobsite, or attending a work function and were injured while completing a work-related task, you may still be covered by workers’ compensation.

Will Only My Medical Bills Be Covered by Workers’ Compensation?

Your medical bills that were acquired from treating and diagnosing your injury will be covered under workers’ compensation. You may also be eligible for payments while you are not able to work. This is often about two-thirds of your salary. Depending on your state’s workers’ compensation requirements and the extent of your injury, you may also have any rehabilitation or retraining costs covered by your workers’ compensation.

Do I Need To See a Doctor To Get Workers’ Compensation?

If you do not seek medical care for your injury or work-related illness, it’s likely that your workers’ compensation claim will be denied. Many workers’ compensation insurance providers require you receive medical attention from a specific doctor. You can ask your employer for a list of approved doctors to make sure you are receiving care from an approved doctor.

How Is Workers’ Compensation Calculated?

There are different factors that are taken into consideration when figuring out how much you may receive in workers’ compensation. Your medical expenses, ongoing medical care costs and missed wages will be factored in. This means that someone who cut their hand at work, received stitches and was able to go back to work fairly quickly may receive less in compensation than someone who fell at work, broke their leg, now requires surgery and is bedridden for a couple months.

How Do I File For Workers’ Compensation?

To file for workers’ compensation, you’ll first need to report your injury or illness to your employer. Your employer should then give you the appropriate forms to fill out. Once these are returned to your employer, the forms will be submitted the insurance company. Depending on your state’s requirements, it will either be you or your employer’s responsibility for filing a claim with your state’s workers’ compensation agency. Once all the paperwork is filed, the insurance company will begin an investigation of your claim. If you are denied workers’ compensation, you may be able to file an appeal.

Can I Get Help With My Workers’ Compensation Claim?

If you need assistance with filing your workers’ compensation claim or appealing a denial, a workers’ compensation lawyer may be able to help. Attorneys will be well-versed in your state’s laws, helping you understand the workers’ compensation process. They can negotiate with the insurance company on your behalf or represent you at court.

Often, workers’ compensation lawyers do not require payment upfront, and will instead charge a percentage of your benefit if you win. Complete the Free Case Evaluation on this page to get in touch with a workers’ compensation attorney today!

Additional Resources

• How to Find Workers' Compensation In my State