The workers’ compensation program goes as far back as 1871 when legislation was passed to protect employees in dangerous industries. Today, the program impacts virtually everyone. Here are the answers to basic workers’ compensation questions.
What exactly is workers’ compensation?
The simplest way to say it is that workers’ compensation is insurance against an injury on the job. It’s the responsibility of the employer to provide coverage as a basic tenet of employment. It is a requirement of business ownership in 49 states (Texas being the exception). The penalties for non-compliance vary from state to state. In California, failure to have workers’ comp insurance is a criminal offense. Other states have less severe sanctions.
Are all workers covered?
Most, but not all. The most obvious example is freelance employees and independent contractors, who must generally purchase their own coverage. Other exceptions include seasonal and temporary workers. The most significant omission is farm employees, whom employers are not mandated to cover.
Does the injury need to occur at the place of business in order to be covered?
No. The requirement is that the employee’s injury must take place “within the scope of employment.” So if your boss asks you to run an errand and you get in a car accident, you’re still considered on the job. If you get hurt at a company picnic, you’re considered on the job. One place you are generally not considered on the job is when you’re commuting to and from work, although there are exceptions.
Does it matter if the injury was the employee’s fault?
Generally no, but that’s not a blanket cover for reckless behavior. For example, if an employee is carrying a heavy box and uses too much back and not enough legs while lifting, workers’ comp will still cover them. But if that box is lifted at an office Christmas party and said employee was intoxicated, then the results might be a little different. A good rule of thumb is that horseplay and mind-altering substances won’t go over well.
Are longer-term injuries or illnesses covered?
Yes, so long as they can be directly traced to employment. A person who types a lot will be covered for carpal tunnel. More and more states are recognizing that first responders are likely to suffer from PTSD and including that for coverage. Be aware, though, that the correlation you make between your long-term condition and your employment must be crystal-clear. You’re not likely to get the benefit of the doubt if there’s ambiguity.
Can the employer still be sued if their negligence caused the injury?
No, the law prevents plaintiffs from doubling up. A section of the workers’ compensation insurance plan exempts the employer from liability for injuries.