Frequently Asked Questions on Workers Compensation
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Frequently Asked Questions on Workers Compensation
Because workers' compensation law is highly specialized, it frequently presents much confusion concerning your legal rights and options. You likely have many questions.
Despite the regulations of the Occupational Safety and Health Administration (OSHA), work-related injuries happen every day and greatly differ depending on the job. Construction accidents and injuries are often the most severe, and rehabilitation can take months and be extremely expensive.
Workers' compensation is a system of state laws for handling claims by employees who are injured on the job. Workers' compensation is usually the only remedy for employees' work-related injuries or illnesses, meaning they generally can't file lawsuits against their employers to get money or damages for injuries.
The workers' comp system basically is a trade-off: employees give up their right to sue their employers and potentially win damages in court. Employers give up many of their legal defenses in exchange for limits or caps on how much they have to pay for those injuries through workers' comp insurance.
Workers' compensation usually pays for the employee's medical treatment, lost wages and disability benefits, but the benefit coverage can vary greatly from state to state. Employers and employees with questions about workers' comp coverage should check the laws in their states or talk to a skilled workers' comp attorney.
Under the laws of most states, most employers must provide workers' comp coverage to their employees, even if they have only one employee. There may be some exceptions, such as when you're the business's only employee (you're a "sole proprietor"); you don't have employees, but rather hire only independent contractors; or the business is an agricultural or farming operation that works only part of the year.
These and other exceptions vary from state to state. If you have any questions about if your business must get workers' comp insurance, you should talk to a worker's compensation attorney. Our lawyers assist clients in Marin County, Palm Beach County and throughout Florida.
The laws in most states require the name of the workers' comp carrier and a summary of the state workers' comp laws be posted in a visible place, such as near a time clock or in the employee lounge or cafeteria. Employers generally aren't required to advise employees specifically about workers' comp. Employers who have employee handbooks usually describe their worker's comp policy information in the handbook.
Injured employees can sue negligent third parties in common law civil suits if a third party caused the accidental injury. An example is an accident involving a trucker whose work truck is hit by an automobile. The trucker would have a worker's comp claim against his employers' insurance carrier and a third-party negligence suit against the automobile driver.
Yes, employers can "self-insure" for workers' compensation if they meet state requirements and give a bond that guarantees the payment of benefits to injured workers.
No. Independent contractors aren't employees, and so they aren't covered by workers' comp laws.
Usually the insurance carrier decides how to handle claims. An employer may challenge or contest an employee's right or entitlement to benefits, however; such as when it believes an injury isn't work-related. Also, if a worker and an insurance company want to settle a claim, some workers' comp insurance policies require the insurance company to contact the employer and get its opinion about the settlement before the settlement can become final.
States generally require all employees be covered by workers' compensation benefits. Some states have exceptions to the general rule and don't require coverage for certain individuals, such as officers, owners, employees in small companies, domestic workers, farm hands and independent contractors.
Your injuries may be covered by directly filing a claim against the employer, and specifically against the owner. Many states have a fund to pay claims when an employer doesn't have workers' comp insurance. An uninsured employer may have to pay a penalty.
Self-employed individuals, like sole proprietors and independent contractors, aren't required to have coverage, but they may purchase their own workers' comp coverage.
Yes, some big differences. Long-term disability benefits pay for non-work-related medical conditions, such as severe neck and back pain or muscular disorders. Also, for the most part, individuals pay for long-term care disability benefits, although many employers offer benefit plans that include partial payment for this insurance.
Workers' compensation benefits, on the other hand, pay for work-related injuries suffered by employees while they're on the job. In most cases, workers' compensation insurance is paid for entirely by the employer.
Short-term disability benefits pay for non-work-related medical conditions, such as when an employee is sick or injured (in a non-work-related accident, such as falling off a ladder while painting a private home or being involved in a car wreck), and the employee cannot work for a short period of time. This type of insurance pays a percentage of the employee's wages or salary directly to the employee to help him pay for food, rent and other bills until he can return to work.
Usually, individuals pay for short-term care disability insurance policies, although many employers offer benefit plans that include partial payment for this insurance.
Workers' compensation benefits, on the other hand, pay for work-related injuries suffered by employees while they're on the job. Workers' comp insurance usually covers all wages or salary an injured employee loses because of the injury, as opposed to only a percentage. Also, workers' comp usually covers the employee's medical bills. In most cases, workers' compensation insurance is paid for entirely by the employer.
States have money set aside called "guaranteed funds" to take over and pay for benefits when an insurance carrier goes bankrupt. Also, sometimes a new insurance company steps in and takes over a bankrupt carrier's claims.
State legislatures enacted the workers' comp systems in force in each state.
Employees give up their right to sue employers directly in exchange for guaranteed payment of benefits through workers' compensation insurance. To get benefits, an employee need only show he or she was injured while on the job.
If workers were allowed to file lawsuits directly against their employers, they'd probably have to prove their employers were negligent or "at fault" for causing the injury. Employees probably would also have to show they weren't "contributorily negligent," or partly to blame, for the accident or injury.
If you find yourself having trouble clarifying whether or not you may have a case, feel free to contact us for a free consultation and we will guide you to fair treatment.
Reach out to the law office of Scott J. Sternberg & Associates, P.A. online or at 561-687-5660 to arrange a free consultation with one of our lawyers. We offer evening and weekend appointments and can travel to you if you cannot come to one of our locations. With offices in West Palm Beach, Boca Raton, Orlando and Boynton Beach, we are ideally situated to serve clients in our communities and throughout Florida.