What is Workers Compensation?

Have you ever thought about the possible consequences of an injury that could occur at your workplace? What happens if you get injured while completing your work tasks? In most cases. if an employee was hurt as a result of work, he or she might be eligible to receive workers compensation benefits.

Workers compensation is a type of insurance that covers the costs of medical care or provides money for employees who suffered an on-the-job injury or illness. Employers pay for workers compensation insurance and cannot require employees to contribute to the cost of it.

The injured employee will receive a payment from the insurance company if their claim is approved. In a case where the employer or insurance provider disputes the claim, no compensation will be given to the worker. The case will need to be brought to court and the workers compensation law judge will determine who is right.

Texas is the only state in the country where an employer is not required by law to carry workers compensation; it is optional.

Who is eligible to receive workers compensation benefits?

In most cases, there are four standard eligibility requirements:

The first requirement states that the injured person must be an employee -- it is important to note that not every worker is an employee. For example, contractors, volunteers, and freelancers are not legally considered as employees. Although there are some exceptions, such as when a worker is misclassified as an independent contractor, receiving worker’s compensation benefits as a non-employee can be a difficult process because the case will have to be taken to court. Then, the worker will present valid facts and details about the work duties and the relationship with the employer, so the judge can determine whether the injured party is eligible for compensation benefits.

The second condition requires that the employer must carry workers compensation insurance. The majority of employers have that type of coverage; many decide to purchase it even if they are not legally obligated to do so. Most states require any employer with at least one employee to have coverage. However, these laws vary based on different factors, such as the industry and company size. Interestingly, Texas allows almost all private employers to decide whether they wish to purchase worker’s compensation insurance for their business.

The third requirement is that the injury or illness must be work-related. If the employee was hurt while completing work tasks at their workplace, there is no question whether the injury is work-related. For example, if a delivery man hurt his lower back during unloading a truck full of furniture, it is obvious that his injury resulted directly from completing his work tasks. However, in cases where the injury occurred during a lunch break or a sports event organized by the employer, it might be more challenging to prove eligibility.

Finally, the employee must report the injury within the state's deadlines. Ensuring that all deadlines are met is a crucial part of successfully reporting the injury and filing a workers compensation claim. Even if the employee fulfills all of the other requirements, missing the deadline can disqualify him or her from receiving the benefits.

Workers compensation laws are established on various factors and vary from state to state. Even though not every company is always required to have this type of coverage, most private employers still choose to purchase worker’s compensation insurance. To successfully file a claim and receive benefits, the employee needs to meet certain requirements first. In a situation where the employer states that the employee is not eligible for workers compensation benefits, it is best to consult with an experienced lawyer.

What if I was injured by someone who doesn’t work for my employer?

Somertimes a person who does not work for the employer causes an injury. For example, a combine harvester driver might work on a farm with other contractors. If one of them causes an injury to the driver, this then becomes a “third-party liability” case. In such situations, the injured party may be able to take legal action in addition to receiving workers compensation benefits. In the farm example, the driver could sue the contractor or the contractor’s employer. Depending on the circumstances and the seriousness of the injury, the injured party might reach a much larger compensation amount compared to filing for the workers compensation benefits alone. However, the respondent might offer a settlement. If the injured worker accepts it, the case will not be taken to court. Although every situation is unique and needs to be reviewed individually, it is possible that the settlement will sufficiently make up for the difference between what the worker used to earn and the received workers’ comp benefits.

If you’ve been injured by a car, truck, 18 wheeler, or company vehicle, call DeSouza Law today.