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Injured on the Job? How to Know if You Qualify for Workers’ Compensation

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Unfortunately, workplace injuries are a pretty common occurrence, and they can range in severity from a small cut to amputation or even death. Although workers’ compensation claims can be filed for almost any type of work injury, they’re usually only filed when the injury prevents the worker from actually working, and therefore, earning money.

Still, many workers don’t know when or if they should file for workers’ compensation to get their benefits. The requirements for receiving compensation after being injured on the job vary from state to state, but generally, these are the five requirements:

 

#1: You Must be Classified as an Employee

While this requirement sounds simple enough, it depends on how the definition of employee is determined at the state level. Most people would assume that it refers to a person who works for another person or company (so excluding business owners), but most definitions specify that a person is a salaried employee. This definition excludes contractors and other self-employed individuals who receive pay from a person or company.

Employee status can be defined as:

  • Being expected to work a set number of hours in a certain location
  • Your check has withholdings for income taxes/FICA
  • You receive a W2 to file income tax returns

 

#2: Your Injury Must be Work-Related

If you’re injured going to or leaving from work, or while away on break, you’re not eligible to receive workers’ compensation benefits. Also, if your injury does occur during work, but is the result of your own misconduct, you may not be eligible for benefits in this scenario either. However, you will be eligible for benefits if working on the job has caused and of the following:

  • Exposure to harmful substances (including COVID-19)
  • Mental stress (in certain states)
  • Repetitive motion injuries, such as typing on a keyboard
  • Workplace noise that results in hearing loss

If your job requires you to operate a motor vehicle and you’re injured in a wreck, you may be eligible for workers’ compensation benefits.

 

#3: Your Employer Must Have Workers’ Compensation Insurance

Almost all businesses are required by law to have workers’ compensation insurance, so the first thing you must do is ensure that your employer is covered. If they aren’t covered and you’re injured and have to miss work, you’ll have to file a workers’ compensation lawsuit. In some cases, you may also have to file a lawsuit to get your maximum compensation because a lot of employees find that the payout is insufficient. For this reason, it’s essential to be careful about signing off on the compensation offered by your employer.

 

#4: You Must Meet the Deadline to File for Benefits

When it comes to receiving benefits for a work injury, there are two deadlines that must be met. The first one is to notify your employer of your work injury that’s causing you to miss work. The majority of states in the U.S. give you 30 days to notify your employer, but South Dakota and Wyoming residents have only three days, while New Hampshire residents have up to two years.

The other deadline is the amount of time you have to actually file your claim. Most of the time, you’re okay if you file for workers’ compensation within a year of your work injury. Again, it varies by state with many states allowing their residents up to two years to file, and Minnesota allowing its residents up to six years! No matter which state you live in, it’s always best to do it as soon as possible.

 

#5: You Must Attend All Appointments Associated With Your Injury

Sometimes a work injury may require the employee to frequently visit the doctor, or receive ongoing care such as physical therapy. In order to continue collecting all of your workers’ compensation benefits, you must attend all required doctor appointments and exams, and receive all required treatments. It’s okay if you have to reschedule an appointment here and there, but constant rescheduling is a red flag and your employer can legally withhold your benefits on the grounds of medical noncompliance.

Keep in mind also, that workers’ compensation benefits are only required to cover lost wages and medical costs. So if you’re not going to the doctor, there are no medical costs that need to be paid.

These requirements are similar for families of an employee that was killed on the job, or died as a result of injuries sustained from the job. This is known as a workers’ compensation death benefit, and it’s typically limited to the deceased worker’s spouse and or/dependants (e.g., children).

Jhim Gutseler is a reporter who is based in New York. He has previously worked for several media organizations, including NY Wire.

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