You may be entitled to workers’ compensation benefits if you suffer from a work-related injury or illness. Typically, these benefits include:
- Wage loss or disability/indemnity payments,
- Necessary medical treatment, and
- Vocational rehabilitation.
A workers’ compensation claim cannot compensate you for pain and suffering.
Each state has its own workers’ compensation law. Depending on where you live, you may have very different rights and duties under the law. Contact a lawyer if you have specific questions about your state’s workers’ compensation system.
All reasonable treatment necessary to cure or relieve the effects of the injury is the right of the injured party. Medical bills, prescriptions, and even roundtrip mileage to the hospital are included in this category.
Depending on the plan, a patient might need to see the company doctor for up to 30 days. A patient may request a different doctor after that time but may have to submit a written request.
Those forced to take time off work due to medical reasons may be eligible for temporary disability payments. These payments provide compensation for lost wages.
Generally, the pay rate is about two-thirds of the employee’s average weekly gross pay. A doctor must verify the inability to work before payments are made every two weeks.
How Are Employees Compensated?
Employees are given benefits to:
- Replace income
- Pay medical expenses
- Cover physical rehabilitation
Employees are typically given compensation either over long-term installments or in one lump sum payment.
What Are the Requirements of Receiving Workers Compensation?
In order to qualify for worker’s compensation, an employee must have:
- An employee-employer relationship
- Work-related injuries
How Do I File for Workers Compensation?
The first step of receiving compensation involves quickly reporting the injury to the employer.
The employer always provides the compensation forms. Then, an employee must:
- Seek medical attention for the injury and follow any doctor’s instructions
- File the worker’s compensation claim with the employer’s insurance company
Can I Be Fired for Filing a Worker’s Compensation Claim?
In most states, employment is at will. An employer may terminate an employee with or without cause at any time. The exception to this rule is that an employer cannot terminate an employee simply because they filed for worker’s compensation. If an employer does this, an employee can sue for retaliatory discharge.
How Can I Prove Retaliatory Discharge by My Former Employer?
If an employer terminates an employee after a worker’s compensation claim is filed, the employee must show:
- They were eligible for worker’s compensation
- They filed or started filing a compensation claim
- Their employer threatened to terminate, actually terminated, or acted against them
- The termination was initiated because the employee started to or actually filed a compensation claim
What Happens When I Return To Work?
Workers’ compensation benefits will likely cease if the employee returns to work and earns wages equal to or greater than before the injury. The employee may continue to receive benefits if they are still experiencing a wage loss as a result of their injury. “Temporary partial” and “temporary total” are two examples of benefits available.
Employees who suffer a work injury and are temporarily disabled but who are still able to earn some wages may qualify for temporary partial disability benefits. Benefits are generally based on the difference between the employee’s pre-injury and post-injury earnings.
As a result of a work injury, injured employees are generally entitled to temporary total disability benefits. In some jurisdictions, a percentage of the injured employee’s pre-injury wages may be used to calculate these benefits.
What is an Occupational Disease or Illness?
Your work activities or environment may cause or significantly worsen occupational diseases.
The following are examples of occupational diseases:
- Asbestosis, black lung, and other respiratory diseases,
- Contact dermatitis and other skin conditions,
- Heart disease
- Hepatitis C and other blood-borne illnesses, and
- Mesothelioma and other cancers.
There are schedules (or lists) of covered occupational diseases in some states, such as Ohio and North Carolina. Some states evaluate occupational illnesses on a case-by-case basis. Law enforcement and firefighters are also protected in some states.
Can an Employee File for Workers’ Comp if They Become Ill?
Workers’ compensation benefits may be available to you if you suffer from a work-related illness. Most states require you to notify your employer of your condition and request benefits. However, workers’ compensation laws vary from state to state. Understand and follow the claims process in your state.
Occupational disease claims are also subject to time limitations in most states. Workers’ compensation benefits will be denied if you do not file a claim within these deadlines. The time limits vary from state to state.
When Can an Employee Get Workers’ Compensation for an Illness?
There must be a clear connection between an occupational disease and your job. The illness must be directly linked to your work, usually through medical evidence or testimony. If your doctor reports that a specific chemical exposure at work caused your contact dermatitis, you may qualify for benefits.
Multiple factors may contribute to an illness. Worker’s compensation may also cover these illnesses, depending on the facts. As an example:
- A foundry worker was exposed to asbestos and other respiratory irritants at work. Additionally, he smokes cigarettes. Chronic lung disease is diagnosed in him.
- While chasing a suspect, a police officer suffers a heart attack. Additionally, he had a family history of heart disease.
Many states require that your work activities contribute substantially to your illness or disease. In order to prove your claim, you will need medical evidence.
Contact a lawyer if you have questions about occupational disease claims and workers’ compensation benefits. In addition to reviewing your medical records, a workers’ compensation lawyer can advise you on your legal rights.
What If a Disease Arises After the Employee Leaves or Retires?
Occupational illnesses can sometimes be discovered after a worker retires or leaves a job. Retired or former employees can still file workers’ compensation claims. Your state’s filing and notice deadlines must be met, however. Moreover, many states limit or reduce a retired employee’s wage loss or disability benefits.
What If the Illness Occurs Because of a Third Party?
Hospitalizations and surgeries can cause infections during medical treatment. In most states, workers can receive benefits for infections caused by work-related medical treatments. There are, however, some limitations.
Sometimes, an accident or medical malpractice is considered an “intervening cause,”—which may result in a denial of benefits. Workers’ compensation benefits may be denied if the intervening cause “breaks the chain” of a working relationship. In other words, you must prove there is a “but for” relationship between the illness and the work injury to be eligible for workers’ compensation benefits.
Examples:
A worker suffered from a work-related blister. He attempted to drain the blister on his own, which resulted in a severe infection and an amputation. The court found a “but for” relationship between the blister and the infection, and he received workers’ compensation. (Dunteman v. IWCC, 2016.)
A kiln operator underwent a diagnostic surgery that found silica-related lung disease. Due to the stress of the operation, he developed bleeding ulcers—which resulted in his death. The court found that his widow was entitled to workers’ compensation benefits. (Knox Porcelain Corp. v. Dockery, 442 S.W.2d 607 (1969).)
Additionally, an injured worker may have a negligence claim against the doctor if there is medical malpractice.
Can a Workers’ Compensation Lawyer Help Me with an Occupational Disease Claim?
It can be difficult to handle a workers’ comp claim when you are ill. Workers’ compensation lawyers understand the legal and medical issues involved in an occupational disease claim.
Hiring a workers’ comp lawyer may be in your best interest—they can evaluate your claim, advise you of your rights, and appeal a denial of benefits.
