State law requires most employers to carry what is known as workers’ compensation insurance. This insurance is designed to compensate workers for work-related injuries they suffer. Workers’ compensation benefits are unique and different from usual personal injury claims in three primary ways. First, to be entitled to benefits, the workers’ compensation claimant need not prove that the employer did something negligent to cause his injury. To recover for his injury all the claimant needs to do is show that his injury is work-related.

Second, a workers’ compensation claim is usually the only claim an employee can bring against his employer. Even if the employer negligently caused the injury, the employee can only file a workers’ compensation claim and may not ordinarily sue his employer or a co-employee for negligence. The employee may, however, be able to sue a third party for his injuries in an appropriate case.

Third, since the employee need not prove the employer was negligent to recover from the employer, the benefits the employee may recover in such a case are much smaller than a private personal injury litigant could ordinarily expect to recover.

The workers’ compensation statutes provide the right to file a claim and its limitations. They provide very specific rules on what can be recovered from such a claim and exactly how and when such a claim must be brought. There are very specific time deadlines for filing claims and bringing actions against employers if a claim is denied. Failure of the employee to adhere to and follow these rules can result in the employee losing his right to recover for his work-related injury.

There are six types of benefits that an employee may potentially recover from his employer for work-related claims if his claim is brought timely and properly. These benefits are: payment of medical bills, vocational rehabilitative retraining, temporary total disability, permanent partial disability, total disability and death benefits.

First, the employee is entitled to have all of his medical bills proximately caused by the work-related injury paid in full by the insurance company.

Second, if the employee is unable to return to his job as a result of the injury, the employee may qualify for vocational rehabilitative benefits. These benefits would pay to train the employee for a new job that he could now perform. Such benefits may also include job placement, training materials, schooling, moving expenses and a maintenance allowance while the employee is being trained.

Third, if the employee has to be absent from his job while recuperating from his work-related injury, he is entitled to total disability payments for the time he misses from work. The amount of this disability payment would be some percentage of his usual wages. This type of compensation will usually continue until a doctor pronounces the employee fit to return to work.

Fourth, if the Workers’ Compensation Commission or a commissioner finds that the employee will suffer a permanent residual injury that will not totally disable the employee, he may obtain additional money depending on the extent of the impairment. The Workers’ Compensation statute has a complex set of formulas and tables that will determine the amount the employee is due. These formulas and tables are based on such factors as age, job and earning level.

Fifth, if the employee is unable to return to any gainful employment because of his work-related injury, then he may be entitled to a total disability compensation.

Sixth, if the employee is killed or dies as a result of a work-related injury, then his dependents (as defined by statute) will receive death benefits.

It is important to remember that if you are injured on the job you may have a cause of action against a third party as well as against your employer. In those cases you file a claim for workers’ compensation benefits against your employer and sue any third party that may have caused your injury. (For example, a sheet metal press malfunctions and crushes an employee’s hand. The employee has both a workers’ compensation claim against his employer since the injury was "work related" and a claim against the manufacturer of the press for product liability). You may not recover twice for the same injury, however, and any recovery against the employer will usually be modified or required to be reimbursed to prevent double recovery.

If you are injured on the job you should notify your employer immediately. Your employee handbook should tell you exactly who you should notify and how. If you have no handbook or it is unclear as to who should be notified or how, ask your supervisor. After you notify your employer of your injury your employer will refer you to a doctor for treatment. If your employer fails to make such arrangements to send you to a doctor then you may find your own doctor.

Your employer will also give you a claim form to fill out. It will require detailed information about your injury and how and when it occurred. Fill out the form carefully and completely and return it to your employer. Make sure you get a copy of the form back from your employer with your employer or his representative’s signature on it. If your claim is denied you may then file a claim with the Workers’ Compensation Commission (WCC).

Make sure that you report your injury, fill out and return the form and file your claim with the WCC quickly because there are very short time limits within which these things must be done. If you fail to do any of these things within the time limits prescribed by the Workers’ Compensation statute, you may be denied benefits.

The laws and rules noted above usually do not apply to employees of the federal government or of railroad companies or seamen. The Federal Employment Compensation Act provides a workers’ compensation scheme for all federal employees except those employed by the military. The Federal Employment Liability Act covers how and when railroads are liable for their employees’ injuries. The Jones Act governs workers’ compensation benefits for seamen.

If you have further questions about workers’ compensation issues, please feel free to contact us.

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