Legal Support for Insurance, Businesses and Individuals

Frequently Asked Questions About Workers’ Compensation

Q: In general, what does workers’ compensation cover?

A: Workers’ compensation covers almost all injury, disease and death that occur in the course of employment. This includes injuries that stem from regular on-the-job events like falls, malfunctioning equipment, repetitive movements, and chemical or environmental contamination.

Commonly covered conditions include carpal tunnel syndrome, wounds, back injuries and industrial diseases. Some states cover mental or psychological harm that can be connected to the workplace. To be covered, injury does not necessarily have to occur at the job site if work is done off-site or work travel is required.

Q: Are there limitations on what kinds of injuries workers’ compensation covers?

A: Workers’ compensation coverage varies from state to state. Some states do not cover certain problems such as some mental health issues; pre-existing injury or illness (unless exacerbated by current injury); self-inflicted injury; injury caused by intoxication, drug use or illegal activity; or injury during activity in violation of company policy.

Q: Can an employer be sued yet still have to provide workers’ compensation benefits for the same injury or illness?

A: Yes. Some situations may leave employers open to lawsuits even while they provide workers’ compensation benefits. For example, if the employer acts intentionally or recklessly in injuring an employee, the employer is probably vulnerable to being sued. Liability in court may also occur when an employer compels a worker to ignore a safety statute and an injury ensues. Suits arising out of discrimination, sexual harassment or similar nonphysical harm could also leave the employer open to suit.

Q: How are my benefits paid?

A: It is the employer’s responsibility to comply with the particular requirements of the state law in question. An employer must purchase workers’ compensation insurance or contribute to a state fund or self-insure program, depending on what the state allows. Self-insurance usually means that an employer with sufficient assets to cover potential claims is allowed to pay those claims directly.

Q: I have a small business with only a few employees; do I have to obtain workers’ compensation insurance?

A: Consult a lawyer or obtain information from the workers’ compensation agency in the state in which you are located. Most workers’ compensation law is state-based; therefore, minimum-employee requirements could vary. Many states do not require very small employers to participate in workers’ compensation.

Q: Can injured employees see their own doctors?

A: This varies widely by state. If you are in a state that allows employees to see their own doctors, specific procedures may be required such as making written requests. Some states require employees to pick from lists of doctors approved by either their employers or the government, and many other procedures for choosing medical providers exist. Emergency treatment is usually treated differently.

Q: Are workers’ compensation benefits always monetary?

A: No. Benefits usually include medical expenses, in addition to money payments as compensation for lost wages. Some states cover vocational-rehabilitation services, such as retraining or interview-skills coaching.

Q: How do I, as an employer, find the correct workers’ compensation law?

A: Consult an attorney with experience in workers’ compensation law. A lawyer will know the correct state workers’ compensation guidelines. As each state’s law varies, it is important to do research about your obligations as an employer. Each state also has a commission, board or agency that oversees workers’ compensation.