Who Is Responsible for Providing Workers’ Compensation Benefits?

The short answer to the title question is your employer. Virtually all states require private sector employers to carry workers’ compensation insurance. The precise requirements, however, vary from state to state. For instance, some states require employers to purchase this insurance from a state fund. Other states allow employers to purchase it from a private insurer. Still others allow large employers to self-insure. At present, only Texas allows employers to opt out of providing any workers’ compensation to their employees.

You can find out if your employer has worker’s compensation insurance and the name of and contact information for the carrier by checking your company’s bulletin board. By law, companies must post this information in a location easily accessible by their employees.

Exclusive Remedy

If your employer provides workers’ compensation insurance, this represents your exclusive remedy for receiving compensation if you sustain a job-related injury or develop a job-related illness or condition. In other words, you must file a workers’ compensation claim for these types of illnesses and injuries, which a workers comp lawyer like one from Hurwitz, Whitcher & Molloy, LLP can assist you with. You cannot sue your employer directly for personal injury, at least not initially.

Rules and Procedures

You must also strictly adhere to all the rules and procedures inherent in filing your workers’ compensation claim. Common rules include the following:

  • Notifying your employer, in writing, of your injury or illness within a specified period of time, usually quite short, after it occurs
  • Including the details of your injury or illness in your notice, such as its nature, the date and time when it occurred and how it happened
  • Receiving treatment from company-approved health care providers
  • Filing a formal workers’ compensation claim, again within a specified period

Excluded Coverages

Keep in mind that the whole purpose of workers’ compensation is to pay your medical bills and provide you with a percentage of your wage or salary when you have to take off work because of your on-the-job illness or injury. However, not all job-related injuries and illnesses qualify for work comp benefits. For instance, you likely will not be able to receive benefits for illnesses or injuries you bring about by yourself, such as the following:

  • Self-inflicted injuries
  • Injuries resulting from your fighting with or engaging in horseplay with another employee
  • Injuries you sustain while under the influence of alcohol or drugs
  • Injuries you sustain while violating company policies
  • Injuries you sustain while commuting to or from work

In addition, you likely cannot receive benefits for psychiatric illnesses or injuries, especially those caused by stress.

Hiring an Attorney

Workers’ compensation claims can become very complicated very quickly. Your wisest strategy is to consult with an experienced local workers’ compensation lawyer whenever you become ill or injured at work.