Filing a workers' compensation claim
Learn when to file a workers' compensation claim, how to file a claim, what responsibilities you and your employer will have, and the potential outcomes.
If you’ve suffered an injury at work, you may find yourself wondering, "what is workers' compensation, and how will it help me?" Workers' compensation is a resource that can help replace your lost income. Here’s the main things to know about it:
Workers' compensation is what its name implies. It’s an arrangement to provide compensation to workers who suffer an injury on the job, or a job-related illness that’s severe enough to prevent them from performing their job duties.
The Federal Employees Compensation Act (FECA) is the primary federal law dealing with workers' compensation. It only covers employees of the federal government, and makes them ineligible for workers' compensation through state or local governments.
FECA covers injuries that occur at work, as well as work-related diseases that develop over time. The Department of Labor is responsible for administering FECA benefits.
These benefits cover medical expenses related to the illness or injury, as well as any wages that you might lose due to a temporary or permanent disability.
If a close family member who worked for the federal government died while on the job, you may be eligible for survivor's benefits.
Keep in mind that FECA does not cover all federal employees. There are separate federal workers' compensation laws that apply to certain types of federal workers, such as coal miners, longshoremen, railroad workers, and harbor workers. Members of the US military likewise are not covered by FECA.
Each state has its own workers' compensation laws, and you can learn more through your state's department of labor.
Laws regarding workers' compensation may vary widely from state to state. For example, in Alabama, the state has loose regulations that allow individual businesses to determine for themselves how they insure their liability for workers' compensation. Conversely, states like California have stricter regulations.
Some states don’t require all employers to carry workers' compensation insurance. In Delaware and other states, for instance, only businesses with one or more employees need insurance. Also, some businesses that can self-insure don’t have to purchase insurance from an outside provider.
While specific laws are different from state to state, there are three general guidelines that determine whether or not a person is eligible to receive workers' compensation benefits:
The illness or injury must be work-related.
The employer must carry workers' compensation insurance, or be legally required to do so. If your employer doesn’t have insurance, but is required to carry it, you’re still entitled to benefits.
You must be an employee of the company whose workers' compensation insurance you expect to use. This means that volunteers and independent contractors aren’t entitled to benefits.
You may have noticed that above guidelines don’t mention fault. That’s because you’re usually still eligible for benefits even if the incident that caused your injury was mostly your fault.
Finally, remember that some states don’t require all employees to be covered by workers' compensation insurance. For example, farm workers or domestic workers may not be eligible for benefits in every part of the country.
The process for filing a workers' compensation claim isn’t the same in every state. However, there are some general procedures that you should follow:
Make sure your employer knows about your injury or illness, as well as how it happened.
Get needed medical attention.
Fill out workers' compensation claim forms. Some states have a workers' compensation agency you will have to file the forms with.
If you think it’s possible that your employer will challenge your claim, or if you just want to make sure you cover all your bases, you may want to speak to a lawyer who is familiar with workers' compensation laws in your state.
There are a couple of ways in which the workers' compensation insurance agency may choose to pay you: with a lump sum, or with regular monthly payments.
If you're offered a lump sum, give the matter serious thought before you accept. If you anticipate a long recovery time, it may be wiser to take monthly payments because these can last for as long as it takes for you to fully recover. If you feel you are close to being able to return to work, a lump sum may be the wiser choice. The amount of money you receive is likely to depend on the severity and nature of your illness or injury.
Workers' compensation is a valuable resource for people who suffer a work-related illness or injury. If you've been injured on the job, learning about workers' compensation will help you handle your situation appropriately.
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