Workers’ compensation law provides you with financial and medical benefits if you are injured at work. You might be wondering, however, how to define whether or not my injury is work-related. In the following, we intend to clarify the answers to such questions for you.

In some cases, the insurance company will require you to have an Independent Medical Examination (IME) to verify your claim. The Southern Nevada Occupational Health Center in Las Vegas is one of the few certified centers to perform IME.


What is Workers’ Compensation Law?

If you suffer a work-related injury or illness, your employer is responsible for helping you. Most employers in each state must carry workers’ compensation insurance, which pays a portion of a worker’s regular salaries while they’re recovering from a work-related injury. If you are eligible for workers’ compensation law, you can file a claim for benefits. But if your employer fails to provide coverage, they may be subject to fines, criminal charges, or lawsuits.


Workers’ compensation coverage

Depending on your state, certain types of jobs may not be covered by workers’ compensation requirements. For example, the following jobs are not covered by this law:

  • Seasonal workers
  • Agricultural workers
  • Domestic workers
  • Undocumented workers

Just because you’re not eligible for this law does not necessarily mean your employer doesn’t have any responsibility for your work-related injury. For instance, if you are an independent contractor, your contract may mandate the use of arbitration for disputes such as injuries.


Is your injury work-related?

You need to make sure your injury really is work-related, which means it happened while you were doing your job duties or something else on behalf of your employer. For instance, if you injured your back in a fall, got burned by chemicals on your skin, or met an accident while work goods deliveries, your injury is considered work-related, and you can seek workers’ compensation interests. Repeated motion exposure at work is another aspect of work-related injuries. Wrist injury due to typing or losing your hearing ability due to constant exposure to loud noise are examples of this type of injury.

Work-related physical injuries usually include the following:

  • Muscles, boned and tendons
  • Feet, wrists, hands, and ankles
  • Head, neck, and face
  • Back and shoulders

Stress-related injuries and occupational diseases also include Workers’ compensation. Occupational diseases include conditions that are created or aggravated as a result of performing job duties. For example, people working in the healthcare sector are at risk for contagious infections. Asthma, COPD, silicosis, and asbestosis are other examples of occupational diseases. Some occupational diseases occur immediately, and some over the years of exposure.

Keep in mind that all injuries must be communicated to the employer. There can be other instances that may challenge the workers’ eligibility to gain compensation benefits:

  • Injuries that happen during an employee’s lunch break, or going anywhere outside the workplace premises for personal work, may not fall into the category of the work-related injury.
  • Injuries while at company events may or may not be considered under workers’ compensation, particularly if the employer does not expect the worker to be a part of the off-duty event.
  • Traveling on a business mission or driving a company vehicle are covered under workers’ compensation law. However, injuries that happen during commuting to and from the workplace are not covered.
  • If an employee is injured due to violating the safety rules in the workplace or engages in misconduct that results in harm, such as consumption of alcohol or illegal drugs, they cannot use workers’ compensation benefits.

Employer responsibilities

As an employer, you should provide a safe environment for your employees to work and prevent workplace injuries as much as possible. If a worker is injured, you need to make sure that a First Report of Injury, or other documents, is completed and sent to your workers’ compensation carrier. You must ensure that you do not violate the legal rights of the injured employee. If an injured worker needs medical attention for a severe injury, arrange for the injured worker to be examined by the company physician or allow them to leave the company and go to their own doctor.

You also need to cooperate with your workers’ compensation carrier and their attorneys. They may ask you for more documents about the injured employee’s payroll history. It is likely that they need to talk to the injured employee’s supervise or co-workers to know more about the injured employee’s story. Provide information only to workers’ compensation carriers and their attorneys and no one else.

Once the injured worker is physically ready to return to work, he/she must be able to return to work. You are not allowed to terminate the worker for the mere fact that he/she has filed a workers’ compensation claim. If you do, you may face criminal charges.


Employee Responsibilities

As we explained at the beginning, you will not be eligible for workers’ compensation benefits if you violate the safety rules of your workplace or engage in irresponsible behaviors such as drinking alcohol at work. If you are injured at work, you must notify your employer or supervisor immediately. If possible, report the injury in writing and keep a copy of the report for personal records. In some situations, the employer must complete a form called “First Report of Injury” for the injury that occurred in the workplace. Consider the following about the “First Report of Injury”:

  • Make sure the employer completes this form for you.
  • Review the completed form to make sure everything is accurate.
  • Request that you be provided with a copy for your own records

Cooperate with any requests which are made of you by the insurance company. If the insurance company requires you to do an “independent medical examination”, agree. If you refuse to be examined by a doctor other than your chosen doctor, it raises many suspicions. Besides, in some states, you are fined due to failing to keep appointments with doctors chosen by the insurance company.

Be responsible in how you act at work or outside the workplace when you have a work-related injury. Some insurance companies employ private investigators to follow the injured worker who claims to have sustained workplace injuries. Do not exaggerate the severity of the injury because if it is proven otherwise, you will be caught. You are responsible for how your claim will proceed.

Workers’ compensation is a complex area in some respects. Therefore, we recommend that you consult with an employment law attorney with experience in workers’ compensation statutes.


Let’s sum up …

Workers’ compensation law protects employees against loss of income and for medical payments. You can use this law to obtain financial and medical benefits, provided that the injury is sustained at work. If your claim is denied or you cannot receive compensation, you may need skilled legal assistance. Therefore, we recommend that you get professional help from an experienced lawyer.

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