How Does Workers’ Comp Work?

how does workers' comp work

When a worker becomes injured or ill while on the job, it is likely that they will have access to  workers’ compensation insurance. Workers’ compensation, or workers’ comp, is a type of employment insurance that grants benefits to employees who receive workplace injuries. So exactly how does workers’ comp work? The process of filing a workers’ compensation claim for a work-related injury or illness can be challenging, and receiving an appropriate settlement can be even more so.

The personal injury & workers’ compensation lawyers at Gordon & Gordon can help you navigate the legal process of workers’ comp and ensure that you get the best settlement you deserve. In this post, we’ll answer your questions like “How does workers’ comp work?” and more. If you still have additional workers’ comp questions, or want to learn more about the workers compensation disability rating chart, please feel free to reach out to the law firm of Gordon & Gordon today. 

Who is required to buy workers’ comp insurance?

Workers’ comp insurance covers nearly all workers employed in the U.S. today. The vast majority of non-military federal employees have workers’ compensation insurance under the Federal Employment Compensation Act (FECA). This federal law provides workers’ compensation insurance to nearly 90% of all American employees. 

There are some states that don’t require workers’ compensation in certain circumstances. For example, agricultural workers, seasonal employees, and independent contractors may not fall under workers’ comp coverage in certain states. 

In addition, every state has its own requirements for the minimum number of employees that must be working at a company for it to require workers’ comp. Some states require 4 or 5 employees to qualify, while others may only require 1. The state of Louisiana is one of these states. A company can have only 1 employee and need to offer workers’ compensation. 

Part of the regulations surrounding workers’ compensation is that an employer cannot terminate an employee while they are in the claim process for workers’ comp. Doing so may be an act of retaliation, which is against the law. The consequences of terminating an employee on workers’ comp can be severe. So in addition to most all employers needing workers’ comp insurance in place, they must also follow the laws that it carries.

Are all work related injuries covered by workers’ comp?

For the most part, all work-related injuries are, in fact, covered by workers’ compensation insurance. In addition to injuries, illnesses obtained on the job are covered as well. This means that in addition to sudden accidents such as a slip and fall head injury, workers’ comp also covers infectious diseases that may develop over time.

The determining factor does not depend on what type of injury it is, but rather if you can prove that it resulted from your work. If the injury or illness developed as a result of on-the-job exposure, it qualifies as a workers’ comp claim. This could include anything from a broken bone to black lung disease (exposure to coal dust). 

Do I have to be injured at my workplace to be covered by workers’ comp?

In order to receive workers’ comp, you have to be on the job. But what if part of your job is performing off-site duties? Then how does workers’ comp work?

Workers’ comp insurance intends to cover any and all accidents that occur within the “course and scope of your employment.” Therefore, if you were performing an activity that benefited your employer at the time of your accident or exposure, you should receive coverage. This includes injuries that occur off-site, but only if the injuries occurred while you were performing job duties. For example, working from home or taking a work call in the car would fall under workers’ comp coverage. Injuries or illnesses that occur during job-related training or education may also receive workers’ comp benefits. 

Traveling between two work sites or making job-related deliveries also calls for workers’ comp benefits. For example, if you are driving a vehicle for the purpose of benefiting your employer and you get into a car accident. This should be covered by workers’ comp. Workers’ compensation also covers those who may be injured or fall ill while doing business travel. This is whether they are off duty or not. 

In most states, even in the case that you have already clocked out but you still receive an injury while at the workplace, you will receive coverage. For example, say you clock out and are walking to your car in the parking lot when you slip and fall and receive a serious injury. Because it is still on the premises, it is a work-related injury. 

How is workers’ comp taxed?

One question people frequently have when it comes to their workers’ compensation settlement is whether or not it is taxable. The answer, for the most part, is no. Workers’ comp is generally not considered taxable at either state or federal levels, as it falls under the category of “non-taxable income.” However, there are a few exceptions. Find those in our blog: Is Workers’ Comp Taxable?

Do you get a settlement from workers’ comp?

When you file a workers’ compensation claim, you will receive benefits provided by your employer’s insurer. These benefits intend to cover the costs of medical treatment and lost wages that result from your work-related injury. Our Northwest Louisiana work accident lawyers will explain how a workers’ comp settlement actually works. 

First, the injured worker must bring a claim to his or her employer’s insurance provider. After this, the provider makes an initial settlement offer. The employee may either accept or reject this settlement offer. If they do not think the offer is acceptable, they are able to hire a lawyer and pursue a larger settlement. This can potentially result in a larger amount of compensation. It also poses the risk of attaining less than the initial offer.

After establishing what they believe to be a fair settlement with their lawyer, the employee and his or her attorney will present their number to the insurance provider. If both parties cannot reach a consensus, the case will reach the courts. Most states require the court to review this proposed settlement to ensure it is not in violation of any state laws. If it does not, the decision will then fall into their hands to determine what is a fair amount of compensation.  

Can I get workers’ comp if I get COVID-19 on the job?

Many people are not aware that illnesses fall under the category of personal injury in a workers’ comp claim. For example, if you contract COVID-19 while on the job, you may be eligible for workers’ compensation benefits. However, your eligibility may depend on certain factors, such as your line of work and the laws of the state in which you live. Generally, to receive workers’ comp for COVID-19, you would need to meet a certain standard of proof. You must prove that your job presented a serious risk of exposure, beyond the risk for the general public. Further, you must prove that you contracted the virus while actually on the job.

Under Louisiana’s Workers’ Compensation Law, the injury or illness must cause a “violence to the physical structure of the body.” COVID-19 can cause violence to the body. Because of this, it qualifies under that circumstance. However, there are more factors that one must consider in the case of a coronavirus workers’ comp claim.

A claimant must be able to prove a causal connection between his or her COVID-19 diagnosis and their work activities. To do this, there must be evidence of the presence of other cases in the workplace. You must also take into account the incubation period between the time of exposure and when the symptoms actually manifest. Finally, one must consider the potential for exposure in other places aside from the workplace in the 14 days before the symptoms appeared. 

To answer the question, yes, with the proof of causal connection, you may receive workers’ comp for contracting COVID-19 while on the job. While the burden of proof may be higher than that of a physical injury, occupational diseases can still receive benefits through workers’ comp.

Call Ark-La-Tex Workers’ Comp Lawyers Gordon & Gordon Today

Gordon & Gordon Law Firm has been helping residents of Northwest Louisiana secure workers’ compensation settlements for over 30 years. Our legal experience will provide you with the tools you need to get the compensation you deserve. And remember, we don’t charge unless you get a settlement! Call us today at 318-716-HELP or visit our website to begin your journey towards compensation.