How Workers’ Compensation Works

Workers’ compensation is a type of insurance program that insures employees for illnesses and injuries that arise out of the job. The program is mandated by the state. Each state and region have different laws and policy regarding how their workers should be compensated.
Employees benefit from the program by receiving medical care after sustaining an injury or illness that is work-related. Injured employees receive a certain portion of their wages while they are off work for the treatment of such injury or illness, depending on state rules.

States also create their own rate of compensation when an employee loses a member, is permanently disabled or dies as a result of the work-related accident. Workers’ compensation is a no-fault insurance program, meaning that the injured employee does not have to go through the courts in order to recover and claim damages. In exchange, the employee generally cannot sue the employer for his or her injuries.

Employees That Are Covered

Each state establishes its own yardsticks for when an employer must acquire such insurance. Some states have a rule regarding the minimum number of employees that an employer has to have in order to be required to purchase workers’ compensation insurance.

Other states require workers’ compensation if the employer has any employees at all. 

States may also exclude certain industries from coverage. For example, a state may exclude agricultural workers, domestic workers or seasonal workers from having to be covered.

If such individuals are injured on the job, they may have a claim under a tort theory of liability but would not have a claim under a workers’ compensation program. Independent contractors are also usually excluded as well.

Injuries That Are Covered

A host of injuries are covered by Workers’ Compensation policies. While Workers’ compensation coverage is meant to compensate employees who sustain work-related injuries, some states further expand this definition to include illnesses that are work related. Other states only allow specific illnesses to trigger coverage. 
The work-related injury may not have to be caused by a single incident. For example, repetitive stress injuries or an illness that results because of continued exposure to certain chemicals in the work environment may trigger a workers’ compensation claim.

Employees do not necessarily have to be at work to be covered under such programs. If they are completing a work-related task at their employer’s request and are injured in the process, workers’ compensation may cover these injuries. However, workers driving to and from work who are injured are generally not considered to be work-related accidents. 

Claim Process

Employers are required to carry workers’ compensation insurance. This may be achieved by purchasing the insurance from an insurance broker registered in the state or through self-insurance. If the employer fails to carry the necessary coverage, it can be fined and may face an employee lawsuit in court.

Injured employees must report their injuries to the employer. If the employee does not report the injury within a certain period of time, the employee may lose his or her right to receive benefits.

If an employee does report their injury but is not given the benefits that they are entitled to from their employer, they should then contact a qualified California workers compensation attorney.

The knowledge of these will put you in better position to claim your benefits.