Are You Eligible to Receive Workers Compensation Benefits?

If you are injured while at work, whether in a slip and fall accident, a construction accident, an accident with machinery, or a work-related car accident, you may be entitled to receive workers compensation benefits. These benefits are paid out of your employer’s workers compensation insurance policy, which most employers are required by law to carry. But to receive benefits, there are a few things you will need to show.

Are you an employee?

The very first thing you will need to show to get workers compensation benefits is that you were an employee. While this may seem basic, it can get complicated depending on the state where you work.
For example, in some states, undocumented immigrants are required to be covered under an employer’s worker’s compensation policy, while other states do not require it, and undocumented immigrants working for the employer would not be entitled to receive benefits. Similarly, some states do not require employers to get workers compensation coverage for agricultural or seasonal workers, or domestic workers, such as housekeepers or nannies.

Your employment status could also become an issue if your employer claims that you are an independent contractor, and not an employee. An employer has more control over an employee than an independent contractor, setting the hours and place where work is performed, and how that work is performed for its employees.

Was your injury in the “course and scope of employment?”

To qualify to receive workers compensation benefits, you must be able to prove that your injury was connected to the duties and responsibilities of your job, or that the injury happened while you were at work. You may hear the term that the injury occurred “in the course and scope of your employment.”

Whether an injury is considered to have happened in the course and scope of employment depends on the circumstances surrounding your accident and what you were doing at the time. In simplest terms, if what you were doing at the time of your accident was something that was part of your duties for your employer or was being done for the benefit of your employer, you will be considered to be in the scope of your employment, but there are exceptions.

For example, if you are injured in a car accident while driving an employer’s vehicle to make deliveries, you will likely be entitled to workers compensation benefits. But if you decided to visit a friend between deliveries and the accident occurs on the way back from your visit, you may be considered to be outside of the scope of your employment and denied benefits. Similarly, in some states if you break a workplace safety rule and are injured as a result, you might not qualify to receive benefits.

Injuries that happen at the place of your employment are usually covered, but, again, there may be exceptions. For example, if you trip and fall while walking in your office during the work day, spraining your ankle, you will likely qualify for benefits. But if you sprain your ankle while playing basketball in the company gym on your lunch break, you may not qualify for workers compensation benefits.

Injuries that happen when you are traveling to and from work will not be covered, unless you fall under an exception to the rule, such as driving to and from work in a company vehicle, or while traveling on a business trip for your employer.

If you are injured at a company social event, you may be covered if your employer requires your attendance at the event, but if attendance is optional, workers compensation may not apply.

No matter how your injury occurs, you should report any injury you believe to be workplace-related to your employer immediately, in writing, and file a workers compensation claim – there are strict reporting and filing requirements which could prevent you from obtaining workers compensation benefits you might otherwise be entitled to if you miss the deadlines.

As you can see, workers compensation claim can be tricky, and the rules that apply will be very specific to the facts of your case. If you have been injured at work, post a summary of your accident on our site to find a lawyer near you who can help.

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Posted - 03/01/2021