Hazards can exist in any workplace, whether it’s an office, factory, or even an outdoor job site. While most business owners and managers stress workplace safety and follow all OSHA (Occupational Safety and Health Administration) regulations, accidents can happen.
So, what should you do if you sustain an injury at work? Do you file a workers’ compensation or a personal injury claim? We’ll take a look at the intricacies of evaluating permanent partial injuries on the job.
Workers’ Compensation Claims vs Personal Injury Lawsuits
Getting hurt on the job is never a fun experience, and we’re not talking about paper cuts. If the injury requires more than a band-aid and a couple of hours for the painful sensation to subside, you may be eligible to file a claim.
However, what type of claim should you file? Employees can file for workers’ compensation or a personal injury claim, and understanding the differences between the different types of claims will make it easier to know which paperwork to start filing out.
Workers’ Compensation
The workers’ compensation system is designed to quickly process employees’ injury claims, and employees are not required to prove their employer is at fault. While the processing and approval process is relatively simple and fast, there is a potential downside for employees.
Once an injured employee receives their workers’ compensation, they cannot file a lawsuit against the company and/or employer for any medical bills or lost wages that resulted from the accident.
Personal Injury Claim
Personal injury claims are filed in civil court and take longer to process than going through the workers’ compensation system. You’ll need to show proof of your accident and that the resulting injury is the direct result of negligence. You’ll also need to prove your injuries are resulting in financial damages, and proving a personal injury claim typically means collecting and submitting a lot of documentation.
An advantage to filing a personal injury claim is you can seek additional damages, regardless of whether you win or lose your case. For example, your first claim may only cover medical expenses, while your second claim can seek to recoup lost wages.
What Does Workers’ Compensation Cover
Workers’ compensation covers most injuries and illnesses that occur on the job. Activities associated with completing or performing your job are covered, along with exposure to hazards like machinery and chemicals.
Reporting the injury as soon as it occurs is crucial. You only have a specific amount of time to file a workers’ compensation claim. The deadline to file a claim varies by state, but most allow one or two years from the date of the accident. To start the claims process, inform your employer, who then contacts the company’s insurance provider.
Why don’t you want to put off filing a claim? The insurance company may view it as a false claim. You may be required to provide proof that the accident occurred on the job site. Delaying filing can also increase your chances the claim will be denied.
Workers’ Compensation Does Not Cover All Work-Related Injuries
Sometimes, your only recourse is to file a personal injury claim against your employee or company. This can create an uncomfortable atmosphere at work, but you are also due compensation for your injuries. While workers’ compensation covers a wide range of injuries, there are some exceptions.
These can include claiming stress and other mental health conditions are the result of your work environment. Self-inflicted injuries are also exempt from workers’ compensation. You cannot file a claim if your injuries are caused by a fight with another employee, manager, or customer. Other examples include injuries sustained during horseplay, if you are under the influence, or hurt committing a crime.
Some employees may be under the influence due to prescribed medications. You may be exempt and able to file a claim as long as you can provide proof the medications are prescribed by a licensed physician and necessary for your well-being.
Tips on Filing a Workers’ Compensation Claim
Filing a workers’ compensation claim is a little more involved than yelling “ouch” to your employer. You must notify your employer and file out the necessary paperwork.
Don’t worry, the claim form is relatively short and simple. You will need to provide the date and time of the injury. The time does not need to be precise. You can round it up to the nearest hour or half-hour. For example, if an accident occurs between 11 a.m. and 11:30 a.m., you can list either time. Most injured personnel do not automatically check the time to see if the accident happened at 11:16 or 11:21.
After filling out the paperwork, it goes out to the insurance company. The insurance provider will send you to an approved physician to verify your injury, and the insurance company uses the physician’s report to determine the amount of compensation.
When Are You Eligible for Workers’ Compensation Benefits
Not all employees are eligible to apply for workers’ compensation benefits. There are a few exceptions.
Independent contractors cannot file workers’ compensation claims. They are limited to personal injury lawsuits. Some small businesses, with only a couple of employees, may not carry workers’ compensation insurance. Whether or not a company is legally required to carry workers’ compensation insurance varies by state.
Accidents outside of the workplace are also not covered; however, this may not apply if the employee is still performing a work-related task.
Pay Attention to Deadlines
You already know employee filing deadlines can vary by state, though most are between one or two years. This deadline applies to notifying the company’s insurance provider, and there’s actually another deadline you also want to pay attention to.
As an employee, you have a deadline for when the employer is notified, which is noticeably shorter than a year. Most states and insurance companies require workers to notify their employers within 30 to 45 days of the accident date, and the notification itself can be verbal or in writing.
Discuss Your Case with an Attorney
Most workers’ compensation cases are relatively straightforward to go through. However, it’s always best to get legal advice to help guide you through these situations, especially when the injury you sustain has lasting, long-term effects.
In some cases, it makes much more sense to file a personal injury claim instead of going through the workers’ compensation process.
