The employer may be responsible for an injury that an employee may have sustained in the workplace or during the course of their work. The laws in each state require most employers to carry a workers’ compensation insurance, which will possibly cover lost wages because of the injury and during recovery, and others.
Not all workers are covered by workers’ compensation laws such as railroad workers and independent contractors. But there are some instances when employees can sue the employers because of the latter’s willful violations of safety regulations.
Is Your Injury Work-Related?
Workers’ compensation claims should be based on injuries sustained during work or during the performance of a work-related duty. It could also include injuries sustained during company events such as picnics, parties or any company-sponsored social event, even if it happened outside the company’s property.
Workers’ compensation policy of some employers may even also cover injuries at work that you have sustained because you were not following the safety rules of the workplace. There are different views regarding this in state laws, and even courts within the same state.
For the purposes of workers’ compensation and other related claims, read the following list to know if an injury is work-related:
- Injuries sustained during company-sponsored events may still be covered and considered as related to work, even if alcohol consumption contributed to the injury.
- An injury at lunch break will be considered as related to work if it happened in the company cafeteria or if the employer is involved in some way. Otherwise, it is generally considered as not work-related.
- Mental conditions that are proven to have been sustained on the job or because of your job are treated in the same manner as physical injuries.
- If a job caused the worsening of a pre-existing condition, then it is generally considered as a work-related injury.
Workers’ Compensation Coverage
Only those that are properly classified as employees are covered by the workers’ compensation insurance. Most states require employers to carry workers’ compensation. Some states, such as Wyoming and Idaho, do not require that undocumented workers be covered by workers’ compensation. However, in California, Arizona, Texas and others include illegal immigrant workers in their coverage.
Here is a list of some workers that are probably not covered by workers’ compensation (Note: Each state may have varying laws):
- Undocumented workers
- Domestic workers (housekeepers, nannies, babysitters)
- Seasonal workers
- Agricultural workers
Workers’ compensation is usually about two-thirds of the regular salary of the worker. However, if you file for a workers’ compensation claim, you cannot file a separate case in court against your employer for the same injuries. If an employer does not fulfill their obligations regarding the workers’ compensation, they may be fined, or criminally charged, or sued in court.
When Workers’ Comp is Not an Option
Even if you may not be eligible for workers’ compensation benefits, your employer may still be held responsible in some work-related injuries. For example, it may be stated in the contract for an independent contractor that you use arbitration for injuries and settle disputes.
There are some rare cases when an employee can sue the employer for injuries that were sustained because of another person’s willful conduct. Note that this is rare, and often not permitted.
There are some alternatives to workers’ compensation such as the following:
- The Black Lung Benefits Act provides compensation for current and former miners suffering from a mining-related disease known as “black lung”
- Non-military, federal employees are covered by the Federal Employees’ Compensation Act
- The Merchant Marine Act (also called the Jones Act) provides seamen with protections from employer negligence, similar to FELA
- The Federal Employment Liability Act (FELA) holds railroads liable for employees’ injuries if they are found to be negligent
- The Longshore and Harbor Workers’ Compensation Act (LHWCA) provides specialized workers’ compensation coverage for certain employees of private maritime employers
Consult with a workers’ compensation attorney for any work-related injury or to determine if your injuries are covered by the workers’ compensation insurance.