Workers compensation, sometimes referred to as "workman's compensation", is the name given to a system of laws intended to protect injured workers. The goal of the workers compensation system is to make sure that an employee who is injured at work receives appropriate medical care, compensation for lost wages relating to the on-the-job injury, and, if necessary, retraining and rehabilitation benefits, so as to be able to return to the workforce. When workers are killed on the job, members of the workers' families are ordinarily eligible for death benefits.
Workers compensation is a no-fault system, meaning that workers can get benefits for most on-the-job injuries even if they were responsible for their own injury. The trade-off for the near certainty of benefits is that an injured worker cannot ordinarily recover benefits from an employer beyond the benefits provided by the workers compensation system. Where a co-worker or employer is responsible for an employee's injury, workers compensation benefits are significantly lower than the amounts that might be recovered through personal injury litigation.
Injured workers will often benefit from consulting an attorney who can help them obtain their benefits and defend them against the inappropriate denial or premature termination of benefits. They may also benefit from reviewing an overview of workers compensation laws for their state.
Depending upon the jurisdiction, employees may be restricted from collecting benefits if their injuries or deaths result from willful misconduct or from intoxication. Benefits may thus potentially be denied for injuries resulting from mutual fighting, roughhousing or horseplay between employees.
Although worker's compensation may provide some additional compensation for certain severe or permanent injuries or disfigurement, it does not otherwise provide any compensation for an employee's pain and suffering.
There are some special federal laws that provide additional protection to certain classes of worker:
The Jones Act (The Merchant Marine Act of 1920) provides seamen with the ability to seek benefits known as maintenance and cure when they are injured while working on U.S.-flagged vessels.
The Federal Employment Liability Act (FELA) makes railroads engaged in interstate commerce liabile to employees, where the employees' injuries result from the railroad's negligence.
The Longshore and Harbor Worker's Compensation Act (LHWCA) provides Worker's Compensation benefits to certain classes of employees of private maritime employers.
The Black Lung Benefits Act provides compensation to miners suffering from "black lung" disease (pneumoconiosis).
Most injured workers recover quickly and, beyond making the initial injury report to qualify for medical benefits and perhaps a short-term wage loss benefit, will have few issues with the Workers compensation system. Those more seriously injured may have difficulty with their employer or with the compensation system. Those workers may benefit from consulting with lawyers. Workers compensation litigation is designed to be more simple than traditional injury litigation, and takes place in an administrative setting that may involve relaxed evidentiary rules. Most states impose statutory limits on workers compensation attorney fees, or make any fee award subject to court approval.
When to Consult a Lawyer
Workers may need to hire a workers comp lawyer when they are refused benefits to which they are entitled, are told that they can return to work before they are actually medically able, or are denied extended or permanent disability despite significant disabling injury.
If your employer sends you to a doctor who declares that you are able to return to work even though you don't believe you are yet able, or tries to get you to return to work to a special job created to accommodate your injury, you should consider speaking to a comp lawyer right away. Although a typical injured employee does not know the law, a typical employer is very much aware of how the compensation system works and how to terminate an employee's benefits. An injured worker who returns to work in a specially created position may well find that, two weeks later, the position is eliminated and he is laid off - but is no longer eligible for workers comp.
Similarly, many employers utilize doctors who are much more interested in maintaining a good continuing relationship with the employer than with accurately diagnosing the employee - too many declarations of continuing disability will likely cause the employer to send injured employees to a different doctor. A lawyer can help you protect your rights when one of these hired gun doctors tries to block you from getting necessary treatment, cut off your benefits or send you back to work too early.
Choosing a lawyer
It is beneficial to go to a lawyer who handles a lot of worker's compensation cases. Typically, those lawyers will know the administrative judges or hearing officers who preside over workers comp hearings, and may also know the doctors and defense lawyers who are trying to block your claim. Hiring an attorney who knows the ins and outs of the system can help ensure that you collect the benefits that are due or, if you are so inclined, get a maximum pay-off to settle your compensation claim.
Ordinarily an employee who qualifies for workers compensation benefits may not file a personal injury suit against the employer, even when the employer could have prevented the injury. There are two narrow exceptions where workers compensation preemption might not apply, and an employer might be subject to lawsuit:
When an employer intentionally causes injury to an employee.
When an employer is required to carry Worker's Compensation coverage but fails to do so.
The exception for intentional acts is very narrow. It is not ordinarily enough that an employer creates conditions where there is a very high probability that an employee will be injured. Ordinarily the employer must have committed a specific act intended to cause injury to the employee.