Workers Compensation – Claims and Benefits

The law requires employers to offer workers’ compensation coverage to their employees. This form of insurance covers most workers. Even if the employer has a single employee, that employee should be covered by this policy. Still, it’s recommended for employers to consult with a lawyer to understand more about the workplace injuries and medical conditions that qualify for long term disability insurance cover and get insured.

If a worker is hurt on the job, his or her eligibility for work comp benefits will depend upon the circumstances of the injury. In general, you may be eligible for worker’s compensation payments if you injured while on official duty, your pre-existing injury gets worse due to your work, or develop a work-related illness.

Besides, you can pursue the workers’ compensation benefits even if you are at fault for your injuries. However, accidents that happen while traveling to or from work or during breaks generally do not qualify for worker’s compensation, unless you are driving is part of your official duties.

Most illnesses and injuries caused by work-related accidents are covered under the Workers Compensation Acts. The ones that are not covered include:

  • injuries that result when a third person attacks you for a reason not related to your job
  • Intentionally self-inflicted wounds, including suicide
  • Damages that are caused by breaking the law
  • Injuries caused by your intoxication or illegal drug use
  • Injuries that result when a co-worker attacks you for personal reasons

Filling a workers’ compensation claim

The victims of workplace-related injuries and illnesses should report their issues to the employer as soon as possible and ensure that the employer files the accident report.  In most states, the victims have up to 120 days to inform their employer about a sustained injury at work. Failure to notify the employer that you were injured within that period may lead to your claim getting denied. Besides, you only have three years to file your claim injury since the day you were injured.


As a victim, you receive worker’s compensation payment when a medical professional places you in a medical leave from work for at least seven days. For you to get paid for your seven days, you missed the job, and you have to be off the work and under doctor’s care for more than 14 days. If your work comp claim has been approved, you can receive the following payments:

  • Medical Benefits
  • Total Disability Benefits
  • Partial Disability Benefits
  • Death Benefits
  • Specific Loss Benefits
  • Scarring

In most states, payments for lost wages are 2/3 of the victim’s weekly wage, up to a pre-set maximum.  If you are beneficiary of other fees such as local security, severance pay, pension, unemployment compensation, and more, your benefits may be reduced.

In summary, when you file your claim, you should try to bring in as much evidence as you can, to make sure your side of the argument wins. If it does get rejected, however, you can always file an appeal, or even go to court. Again, you’ll need to make sure you have the right proof with you, and that you can show within reason that your problem started at work.