Injuries that may entitle you to workers’ compensation
Could you be entitled to workers’ compensation? Find out what kind of injuries could be covered.
Employers have the responsibility to provide a safe working environment for their workers. If any worker gets injured or suffer from health problems while performing their jobs, they may be entitled to receive compensation and other benefits as mandated by the law.
In the USA and most countries in Europe, business organisations are legally liable under a form of Workers’ Compensation Law. This is the legal framework that corresponding jurisdictions and companies must adhere to when implementing a compensation system for their injured and sick workers. In the UK, this is equivalent to Employers Liability Insurance, which has more limitations. However, it’s better known as worker’s compensation in general terms around the world.
Here, you’ll learn more about the basics of workers’ compensation, including the work-related injuries that may be covered, and the compensations that a worker are entitled to.
The basics of workers’ compensation
Workers’ compensation is a system that allows an injured or ill employee to obtain financial coverage for medical costs, lost wages, and other expenses. These benefits are provided to them typically through a no-fault system, which means the state will not consider individual negligence or fault as a factor. As a result, employees may have to give up their right to sue an employer for negligence and other similar claims.
In some cases, where seriously injured or disabled workers feel they’re eligible for more benefits, a formal complaint may be filed with the help of workers’ compensation lawyers such as Alvine Weidenaar attorneys, to maximise their claims.
A workers’ compensation coverage is typically assigned per jurisdiction; which means medical and wage benefits vary in every territory.
How does it work?
Workers’ Compensation Law is considered a state law, which gives local governments the decision to determine employer’s liabilities to its workers, the injuries and illnesses covered, and the compensation an injured or ill worker is entitled to receive.
Ideally, compensation laws aim to facilitate these payments without litigation. They’re often fixed, depending on the nature of injuries or illnesses incurred by an employee. To be entitled to compensation, injured workers only need to submit a few documents such as medical records to support their claims.
After approval, the employee will receive the state-mandated benefits and may return to work as soon as their health situation permits.
How can employees benefit from workers’ comp?
Generally, workers’ compensation will pay for an employee’s medical expenses, including rehabilitation costs. The workers’ compensation insurance program will likewise cover for income losses of up to two-thirds of the injured staff’s salary until such time that they’re capable and well enough to return to work.
Generally, companies and insurance providers are mandated to provide the following payments to their ill and injured workers:
- Coverage of medical expenses, including rehabilitation fees
- Reimbursement for lost wages
- Compensation in case of long-term disabilities
But this payment scheme is not limited to acute workplace accidents. An employee who eventually suffers from post-injury health problems can be accommodated for job changes and other benefits.
Here’s an example: being a construction worker exposes one to elevated risks of falls, or slip and trip accidents. If an employee suffers from work-related head injuries that result in sensitivity to light, he or she can request a job position that limits exposure to bright lights, and the employer is obligated to grant this request.
What qualifies as a work-related injury?
Any injury or health condition, whether acute or chronic, that occurs while an employee is performing a specific task at work, is considered a work-related injury. For the United States Occupational Safety and Health Administration (OSHA), work-related illness and injury occur when an event or exposure in the work environment causes or contributes to it.
In legal terms, this is called Arising Out of Employment (AOE) and occurring during the Course of Employment (COE).
Work-related injuries and illnesses are easy to prove when it happens in the workplace, but it can get trickier when an accident occurs outside of the work premises or when then illness is caused by cumulative work stress or trauma.
While most injuries may happen at the workplace, for instance, in a construction site, it can also occur outside of the office—as long as the individual was doing tasks related to the job. This includes company events, whether sponsored by the office or a third party.
Work-related injuries cover acute accidents or something that’s been happening for a long period. We’re going to discuss these in-depth in the following sections:
- Occupational illnesses
- Permanent injuries
- Repetitive motion and overuse injuries
- Stress-related injuries
- Pre-existing conditions aggravated by the job
- COVID-19 infection
1) Occupational illnesses
These are defined as illnesses or health conditions that arise out of frequent exposures as required by the employee’s job. From a legal point of view, it can be challenging and quite costly to prove the link between specific chronic diseases and the resulting work injury.
Again, the rules vary from one state to another. In some territories, the law may explicitly rule out common and preventable diseases such as diabetes and lung and heart problems. However, employees who believe their conditions developed because of their job may be entitled to compensation. In such cases, the employee’s claims will have to be backed by medical experts to prove their case.
Some workers, especially members of the police force are subject to special workers’ compensation, as their jobs are considered dangerous. Select states recognise chronic illnesses as part of occupational hazards. For instance, police force members and firefighters who develop specific types of cancer and heart attacks may be eligible for compensation, as their work increases their risks of such illnesses.
Some states may consider the following health condition as work-related illnesses, allowing employees who contract these conditions to claim compensation benefits.
Breathing and respiratory disorders
Certain jobs may expose workers to dust and other types of irritants and pollutants. Prolonged exposure to these may cause a variety of respiratory problems such as asthma, emphysema, and Chronic Obstructive Pulmonary Disease (COPD). Garment workers who don’t wear the proper protective gear are highly vulnerable to these diseases.
If a worker develops any of these sicknesses, it can lead to serious health problems, which can become fatal.
Certain forms of cancer
Although there are a lot of factors that can trigger cancer, there are medical studies that have shown how various works conditions can either contribute to or cause an employee to acquire this deadly disease. For instance, a study has found out that women who work night shifts are more likely to develop cancer compared to their day shift contemporaries by 19%.
Cancer is known to cause work-disrupting symptoms, especially if one is undergoing chemotherapy. Thus, most states have included it among occupational illnesses covered by employees’ compensation benefits.
Work-related skin problems comprise half of all occupational illness cases, which commonly includes occupational dermatitis. From a medical point of view, dermatitis is generally referred to as a form of skin irritation. As such, it can come in many forms—from extremely itchy and dry skin to rashes, blisters, or rashes.
Dermatitis is not infectious, although it can cause discomfort and pain. Topical products such as cream and ointments may be enough to treat this skin condition.
Construction workers are highly vulnerable to this affliction, often because of the chemicals contained in cement and other construction materials.
Nearly 30 million employees are exposed to dangerous levels of noise at work every year, according to OSHA. The agency has set the maximum exposure levels to 90 A-weighted decibels (dBA) for the whole working shift of eight hours and only two hours of 100dBA in a day.
Permanent tinnitus or hearing loss can develop if a person becomes regularly exposed to excessive levels of loud noises.
If you’re an employee who’s suffering from a work-induced hearing problem, you may be entitled to workers’ compensation benefits. In some states, a worker who suffers from a 10% hearing loss can get about 66% of his or her wages for 260 weeks. For workers suffering from 20% loss, the duration is also doubled, at up to 520 weeks.
This chronic lung illness is triggered by frequent exposure and inhalation of asbestos, a common ingredient for various industrial applications; most notably as a building material in construction projects for cement, floor tiles, and insulation decades ago.
With frequent exposure, an individual is likely to develop scarring in the lung tissues and breathing problems. Symptoms can either be minor or severe, and signs may not appear until after several years of exposure.
Occupational asbestos exposure is the leading cause of mesothelioma cancer. It can also increase the risk of a person developing other types of cancer and chronic pulmonary diseases.
This is why since the 1970s, the federal government has regulated the use of asbestos.
Musculoskeletal disorders (MSD) include both illnesses and injuries that involve the muscles, joints, tendons, cartilages, nerves, and spinal discs.
However, for it to be considered work-related, the environment and the employee’s work responsibilities must be proven to have largely contributed to the condition, or their work conditions proven to have made the condition worse or persistent.
When a worker suffers from any of these conditions, it can sometimes cause debilitating pain and other symptoms that could force an employee to miss work.
MSDs affect the musculoskeletal system and connective tissues. Workplace activities such as bending, climbing, crawling and twisting, and other similar motions may cause a variety of health problems such as:
- Muscle tears
- Back pains
- Carpal tunnel syndrome
2) Permanent Injuries
Apart from workers’ compensation payments, an employee who suffered from permanent injuries resulting from a workplace accident can file for additional claims. This is applicable if the employer has committed some form of negligence that has set off the incident.
Non-compliance with the safety guidelines and rules set by the Occupational Safety and Health Administration (OSHA) is considered employer negligence, and the employee, alongside the workers’ compensation lawyer, will have to gather and submit enough evidence to prove the allegation. The lawsuit should establish that the injury leading to permanent disability was directly or indirectly related to the injured person’s employment.
If the plaintiff can prove employer negligence in court, the worker becomes eligible to claim for often large amounts of non-economic damages as a result of difficulties that the worker will likely face for the rest of their lifetime. The payment amount is based on the employees’ level of negligence; gross negligence commands higher amounts while moderate negligence allows lower compensation. The jury will decide the compensation to be awarded following the trial.
3) Repetitive motion and overuse injuries
There’s an increasing number of working individuals who develop Repetitive Strain Injuries (RSIs).
In Canada for instance, one in 10 adults suffers from a movement-limiting RSI, according to Statistics Canada. In its neighbouring country, the United States, repetitive strain injuries are the most pervasive and expensive occupational health issue, according to OSHA—costing over USD$20 billion in workers’ compensation annually.
These types of injuries often develop over time thru repetitive movements at work. Almost all types of employees, whether working indoors or outdoors, are vulnerable to these types of injuries, which include carpal tunnel syndrome, chronic neck and back pain, tendonitis, shoulder injuries, and so on.
4) Stress-related injuries
While the medical field has recognised that long-term exposure to stress can cause a variety of illnesses, states are quite divided about providing compensation for psychological and physical illnesses caused by work-related stress. Some states explicitly rule out payments for emotional or psychological health issues as a result of on-the-job stress.
Other states are more open to considering compensation payments for workers especially for conditions that can manifest physical symptoms and can be supported by medical findings. Many states allow claims for post-traumatic stress disorder and other stress-induced psychological conditions, but only if the employee has experienced sudden and severe traumatic events.
Put simply, depending on which state you live in and the nature and cause of your illness, you may or may not be eligible for workers’ compensation due to long exposure to stress.
5) Pre-existing conditions
Even if employees have pre-existing conditions, they can still get workers’ compensation if a worker can prove that a work-related injury contributed to making the condition worse.
For instance, if an employee who has had back pains for several years developed a slipped disc following a slip or fall accident, he or she may be eligible to file for workers’ compensation, depending on the doctor’s assessment and medical test results.
6) COVID-19 infections
The American Rescue Plan Act of 2021 signed in March includes a provision providing federal employees diagnosed with COVID –19 certain coverage under the Federal Employees’ Compensation Act (FECA). Section 4016 of the law provides that a COVID-19-infected worker who performed duties that exposes them to the infection is presumed to have an illness caused by the employment.
Make sure you get the compensation you are entitled to
Workers’ compensation rules on coverage vary from state to state and across countries. They are also typically highly intricate and complicated. If you incur any work-related injury or illness, notify your employer right after seeking medical attention. Failure to do this will likely affect your benefit claims too.
If you have trouble claiming workers’ compensation, it’s best to consult with an employment lawyer to help you get the benefits you deserve or optimise payments from cases where your employer becomes negligent in ensuring workers’ safety.