As a worker, you are entitled to medical care for injuries and illnesses related to your job. This can include surgery, hospitalization, medicine, and more. The treatment your doctor recommends must follow applicable treatment guidelines.
Workers’ compensation laws vary widely by state. Learn more about the system to understand your rights and responsibilities better.
What is Worker’s Compensation?
Most states mandate that companies carry workers’ compensation insurance, which pays for medical expenses and replaces a percentage of an injured worker’s lost income. The worker’s family is also eligible for death payments under the insurance policy. The program is not intended to punish employers for workplace accidents or to provide damages for employer carelessness; rather, its goal is to assist employees in returning to work as soon as possible.
Generally, Hawaii workers compensation covers injuries and illnesses that occur during the course and scope of your employment. Your injuries can be physical, mental, or emotional. Usually, you won’t be eligible for workers’ comp if your injury occurred outside the workplace or while you were engaged in non-work activities.
The state’s workers’ compensation statutes differ slightly, but they all follow a similar framework. The laws include provisions for medical care (often in the form of surgery or prescription drugs), weekly payments instead of wages, annuities or lump sum payments to cover past and future economic loss, death benefits to family members, and other expenses. The statutes typically do not include punitive damages for employer negligence or awards for pain and suffering.
Several disputes arise in the workers’ compensation process. For example, there may be disagreements about whether an injury/illness is compensable (existence), how long the disability will last (duration), or the extent of your impairment or limitations on work activities (extent). An informal hearing is sometimes held to resolve such issues. If no agreement is reached, either party can request a pre-formal or formal hearing.
Who is Eligible for Workers’ Compensation?
Each state defines who is eligible to receive benefits. In general, workers’ compensation covers an injured worker’s medical care, replacement of a portion of lost wages (although the exact amount varies from state to state), and funeral expenses for those who die because of work-related injuries or illnesses. General damages for pain and suffering, punitive damage awards, and other non-economic losses are generally unavailable.
Most states require business owners to offer workers’ compensation insurance to their employees. However, not all freelancers and independent contractors might be considered employees under the state’s definition. The best course of action in this case is to see a lawyer.
Although the system is intended to give prompt, essential medical and financial care while avoiding litigation for the employer and employee, many ambiguities and regulations differ greatly between states. The most crucial regulation is that legitimate employees can only claim workers’ compensation claims.
Additionally, some illnesses or injuries that happen off-the-job but are related to the job—for example, a worker becoming ill from exposure to hazardous chemicals at a warehouse—may not be covered by workers’ compensation. Thankfully, a knowledgeable workers’ compensation lawyer can assist in identifying the kinds of benefits you are eligible for.
What are the Rules for Filing a Claim?
Many state workers’ compensation laws have their roots in Prussia’s workers’ comp system. While they vary by jurisdiction, the basic premise is that industrial accidents are accepted as a fact of life, and financial consequences are dealt with quickly and fairly. The various systems offer a range of benefits, including weekly cash payments and medical care. In addition, a worker’s health insurance cannot be charged for treatment received as part of the workers’ compensation process.
In New York, employees must report work-related injuries and illnesses to their employer as soon as possible, within 30 days of the accident or diagnosis. Then, they must file a claim with the Workers’ Compensation Board. The Board then determines whether or not the insurer should reimburse for cash benefits and medical care.
If a worker believes there is an issue with their case, they may submit a request to the Board via eCase or another method. They may also request an independent medical review, or IMR, to challenge the results of a disputed medical treatment decision.
The rules governing workers’ compensation differ by jurisdiction, but an employee generally must be disabled to collect benefits. Some benefits may include payments to cover 2/3 of your lost wages if you cannot return to work, compensation for all medical expenses, and payment for prosthetic devices or rehabilitative therapy. However, workers’ compensation benefits do not pay for pain and suffering or punitive damages for employer negligence.
How Can I Get Help?
If you have been injured or sick on the job, contact your workers’ compensation program for information about available benefits. Each state has a different workers’ comp system, which differs in terms of who is insured, what injuries are covered, and how much you can get in benefits.
Programs for workers’ compensation include health treatment to hurt workers, monetary awards to partially offset lost income, and death benefits to surviving employees. Regardless matter who caused the disease or disability, these benefits are given.
Reporting any illnesses or injuries sustained at work to your employer’s insurance provider is mandatory. Other duties include keeping your doctor informed about your medical condition, refraining from actions that might make your injury or sickness worse, and alerting your supervisor to any limitations on your job activities.
If you and your employer or the insurance carrier cannot agree on the extent of your injury or illness, a hearing may be required before a Deputy Commissioner. These hearings are evidentiary proceedings, and all parties testify under oath. If you are involved in a contested case, you should consider speaking with an attorney immediately. A consultation with a screened and qualified workers’ comp lawyer is free.