Understanding Workers Compensation

Common Workplace Injuries and Qualifying for Workman’s Comp

Occupational injury or illness effects 1 out of 100 full-time workers annually. According to the Bureau of Labor Statistics, that’s over 1 million work-related injury and illness cases per year. Especially in high-risk jobs that require the use of heavy equipment or consistent manual labor, an occupational injury could be debilitating and result in multiple days off work. 

When an injury occurs on the job, The U.S. Department of Labor’s Office of Workers’ Compensation Programs (OWCP) offers workman’s compensation programs to mitigate the financial burden that can result from a workplace injury or occupational disease. Worker’s compensation is defined as a state-mandated insurance program that provides benefits to employees who have suffered a job-related injury or illness. Benefits can include payments for hospital and medical bills, as well as disability payments while you are unable to work. There are different types of workers’ comp, but generally disability payments are about two-thirds of your regular salary. Depending on the severity of the injury, benefits may also include payments for rehabilitation and retraining. 

Each state has its own laws and programs for worker’s compensation and programs will differ for federal employees. Information on your state’s workers’ comp can usually be found by contacting your state’s worker’s compensation office or by visiting the State Workers’ Compensation Officials page on the U.S. Department of Labor’s website. 

How to Qualify for Worker’s Compensation 

There are a few basic requirements for receiving worker’s comp benefits. To qualify:

• You must be an employee
• Your employer must carry workers’ comp insurance
• You must have suffered a work-related injury or illness
• You must meet your state’s deadlines for reporting the injury and filing a workers’ comp claim

The employer is responsible for paying for workers’ compensation insurance to cover benefits for employees, but as an employee it is your responsibility to file a claim as soon as the injury occurs. As long as your injury is job-related it will be covered, even if did not occur at your physical workplace. However, there are a few injuries that will not be covered. These include: 

• Injuries that have occurred while intoxicated or under the influence of illegal drugs
• Injuries that are self-inflicted or related to a fight
• Injuries that occur while an employee was committing a crime
• Injuries that occur while an employee was not on the job
• Injuries that occur while an employee was violating company policy

Not all employees will qualify for workers’ compensation coverage. Each state has different policies on which types of workers are excluded, but generally farm workers, domestic employees, undocumented workers, casual or seasonal workers, and volunteers will not be covered by workers compensation. When your employer has workers’ compensation insurance, suing in the event of an injury is usually not an option. Only in limited circumstances, like if your employer has intentionally hurt you or did not have legally required workers’ comp insurance, would you be able to file a lawsuit.  

Common Workplace Injuries for Workman’s Comp 

Workplace injuries can result from accidents like a fall from a ladder or even a simple misstep or slip. Other injuries can be the result of repetitive stress or prolonged exertion such as lifting heavy boxes or performing heavy construction. 

Common workplace injuries include: 

• Sprains
• Fractures
• Bone dislocations 
• Soft tissue injuries 
• Severe injuries requiring limb amputations 
• Repetitive stress injuries 
• Chronic back problems 

As soon as an injury occurs, employers should provide initial first aid including: ABC- airway, breathing and circulation; immobilization of the body party affected to avoid further injury; and transportation to a hospital or physician’s office. 

You may also receive benefits for illnesses that are a result of high-risk or high-stress work conditions. Common work-related illnesses can include: 

• Heart conditions
• Lung disease
• Stress-related digestive problems

Doctors’ Important Roles in Workman’s Comp

Doctors play a very important role in a workman’s compensation case. From the initial evaluation and diagnosis to monitoring the recovery process, your doctor will make important decisions that will affect which benefits you receive and how many days off work you will need to take. Your doctor will determine the severity of your injury or illness, your course of treatment, recovery time, and ongoing physical limitations that could qualify you for disability payments. Additionally, sports medicine doctors or orthopedic physicians who specialize in injuries like fractures and dislocations can play an important role in the correct diagnosis and treatment regimen for your injury. They will determine if you need x-rays as well as physical therapy and rehabilitation. Doctors can help you navigate through the worker’s compensation process and ensure you receive the appropriate benefits and recovery time for your occupational injury or illness. 

If you have experienced an occupational injury and need specialized care and comprehensive treatment, visit our staff of orthopedic specialists and surgeons at The Woodlands Sports Medicine Centre today.