Frequently Asked Questions About Workers’ Compensation

Most employees are eligible for Workers’ Compensation benefits if they are injured on the job or develop a work-related illness. This includes full-time, part-time, and some seasonal or temporary workers. However, independent contractors, freelancers, and volunteers are generally not covered. Eligibility may also depend on whether the injury occurred while performing job duties. Each state has specific rules, so it’s important to check local laws to determine coverage.

Workers’ Compensation typically covers injuries or illnesses that occur as a direct result of employment. Common examples include slip-and-fall accidents, repetitive strain injuries (like carpal tunnel), machinery-related incidents, and occupational illnesses caused by exposure to hazardous materials. Mental health conditions may be covered in some cases if work-related stress or trauma is a direct cause. Injuries sustained outside of work or due to intoxication or horseplay are generally not covered.

Workers’ Compensation benefits may include:

• Medical care: Full coverage for treatment related to the injury or illness.
• Wage replacement: A percentage of lost wages (usually around two-thirds of your average weekly pay).
• Disability benefits: Payments for temporary or permanent disability.
• Rehabilitation services: Assistance with physical therapy or job retraining.
• Death benefits: Compensation for dependents if a worker dies from a job-related injury.

Benefit amounts and duration vary by state and the severity of the injury.

To file a Workers’ Compensation claim:

• Report the injury to your employer as soon as possible (usually within a few days).
• Seek medical attention and inform the provider it’s a work-related injury.
• Complete a claim form, which your employer or state agency will provide.
• Submit the form to the appropriate Workers’ Compensation board or insurance company.

Timely reporting is critical. Missing deadlines can result in denied claims.

No, it is illegal for an employer to retaliate against an employee for filing a legitimate Workers’ Compensation claim. Retaliation can include termination, demotion, reduced hours, or harassment. If you believe you’ve been retaliated against, you may have grounds for a wrongful termination or retaliation lawsuit. It’s wise to consult an employment attorney if you suspect retaliation.

You are not required to hire a lawyer to file a Workers’ Compensation claim. However, legal representation can be beneficial if:

• Your claim is denied.
• You receive less compensation than expected.
• Your injury causes long-term or permanent disability.
• Your employer disputes the claim.

An attorney can help navigate complex paperwork, deadlines, and appeals processes to protect your rights.

If your Workers’ Compensation claim is denied, you have the right to appeal. The process typically involves:

• Reviewing the denial letter to understand the reason.
• Filing an appeal with your state’s Workers’ Compensation board.
• Attending a hearing where you may present evidence and testimony.

It’s highly recommended to consult a Workers’ Compensation attorney for guidance through the appeal process, as laws and deadlines vary by state.

This depends on your state’s Workers’ Compensation rules. Some states allow you to choose your own doctor, while others require you to see a provider from an approved network or one selected by your employer or their insurer—at least initially. After a certain period, you may be able to switch to a doctor of your choice. Always confirm your state’s regulations to avoid risking your benefits.

The duration of Workers’ Compensation benefits depends on the nature and severity of your injury and your state’s laws. Temporary disability benefits typically last until you reach maximum medical improvement (MMI) or return to work. Permanent disability benefits may continue for a set number of weeks or, in some cases, for life. Medical benefits can often last indefinitely, as long as treatment is necessary and related to the original injury.