Are You Eligible for Workers’ Compensation?

workers' compensationWorkers get hurt more often than you think. In 2019, a worker died from a work-related injury every 99 minutes. Millions of more suffered from non-fatal yet debilitating injuries.

Workers’ compensation provides benefits for employees at their lowest moments and can furnish life-saving medical care. But not all workers receive benefits under workers’ compensation.

When is an employer required to carry workers’ compensation insurance? How related to work must an injury be for a worker to get compensation?

Here are the answers to these questions so you can respond to an accident and get the care you deserve.

You Must Work as an Employee

Some states have lenient definitions for “employee.” They assert that any person who works for another under an oral contract counts as an employee. Other states require a written contract for a person to count as an employee.

Independent contractors like freelancers do not usually count as an employee. Volunteers may not be considered an employee. Some states allow volunteer firefighters or law enforcement personnel to receive workers’ compensation benefits.

Members on a board of directors do not count as employees. A company may provide them with a separate insurance package, or they may have no coverage at all.

In Georgia, domestic workers do not receive coverage. Gardeners and renovators may also not be covered.

Your company may be pretending that you are not an employee to avoid providing you with workers’ compensation. If they are withholding taxes from your pay, you should count as an employee. Contact a lawyer experienced in workers’ compensation to understand your legal rights.

Your Employer Must Hold Workers’ Compensation Insurance

State laws require nearly all employers to have workers’ compensation coverage. Georgia allows companies with fewer than three employees in regular employment to avoid coverage.

Some states also make exceptions based on lines of work. Agricultural businesses may be able to operate without coverage.

What that coverage entails can vary. In more lenient states, employers may create an “opt-in system.” Employees can receive workers’ compensation benefits for injuries but cannot sue their employer for their injuries.

Some states have funds for compensation. Others allow employers to buy packages on the private market. The federal government has its own system reserved for its employees.

Your Injury or Illness Must Be Related to Work

The term, “work-related,” can vary. For the most part, insurance protects any injury sustained while an employee was doing something for their employer. This can occur during overtime or off-hours.

Injuries can be cumulative. Typing at a computer over many months can lead to carpal tunnel syndrome. As long as computer work benefits the employer, their package must cover carpal tunnel.

Injuries at work events receive coverage. You cannot claim benefits while commuting to work, but you might be covered if were driving a company vehicle. You may not be able to claim benefits for an injury incurred during a break.

Work-related illnesses can be hard to prove. Exposure to toxic chemicals can cause cancer, but so can other things. You will need detailed medical documents to show a connection to your work environment.

Some workers’ compensation packages provide benefits for COVID-19.

But the terms of these packages vary.

It may be hard to prove you contracted the coronavirus at work. You may need to prove cases in addition to yourself. Engage in contact tracing to show that you could have only acquired it while working.

It does not matter if the injury is “mild.” The most common work injuries seem mild, but they can have long-lasting side effects. You should file for compensation for any injury you receive.

You Were Not Negligent

Workers’ compensation is no-fault. Regardless of whether you were at fault in an accident, you can receive benefits.

But insurance packages do not cover misconduct. If you were engaging in horseplay, you will not receive benefits. If you broke a workplace rule on purpose, the workers’ compensation board can deny you benefits.

Boards might provide benefits if the employer condoned your negligent behavior. You will need to prove that it was a common part of your working environment. Contact a workers’ compensation attorney to launch your case.

Injuries that occurred because the employee was intoxicated or under the influence of drugs do not receive coverage. This applies even if you are taking medical marijuana. You should avoid drinking or consuming drugs before going to work.

You Must Meet State Filing Deadlines

You must report your injury or illness to several people. You must tell your employer as soon as possible, preferably in a written report. You then must file a claim with your state’s workers’ compensation agency.

Deadlines vary from state to state, but you typically have one year to file a claim in Georgia. During this time, you should get a medical and psychological evaluation.

A few states allow for later applications for severe conditions like traumatic brain injuries. But the sooner you file your application, the sooner you can get treatment. You should not assume that boards will be lenient toward you.

You should notify your doctor that you are getting workers’ compensation. This allows them to send their bill to the right place. In Georgia, the bill must be properly submitted to workers’ compensation within one year of the treatment.

The Qualifications for Workers’ Compensation

Workers’ compensation covers many employees, but not all. It does not extend to all volunteers, domestic workers, and freelancers. Not all employers have to carry insurance.

Injuries and illnesses must be related to work, but they occur over many years. You might receive compensation for COVID-19, though you will need a lot of proof.

An injury cannot come through an intentional act or be the direct result of intoxication or drug use. An employee must meet deadlines, notifying their employer and state board.

Find an attorney who will get you the benefits you deserve. Hollington Brown LLP is Augusta’s leading workers’ compensation firm. Contact us today.

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