What Is Workers' Compensation?
Workers’ compensation, or workers’ comp, is a government-mandated insurance requirement for companies that provides insurance benefits for employees who suffer work-related injuries.
Workers’ compensation typically covers medical expenses and a portion of lost wages when an employee gets injured while on the job.
The purpose of workers’ comp is to protect employees from financial losses due to workplace injuries.
Workers’ compensation also protects employers from being sued by their employees for negligence if they are covered under workers’ comp insurance.
The specific compensation requirement varies per state, as the workers’ compensation laws are unique per state government laws.
Benefits Coverage of Workers’ Compensation
Workers’ compensation differs for each state, and so does coverage.
Workers’ compensation generally includes medical expense coverage and compensation for lost wages.
Some of the most common benefits of workers’ compensation include:
- Medical Benefits: Medical benefits cover all medical expenses and treatments for an injured worker’s injury or illness. This benefit may include doctor visits, hospital stays, surgeries, rehabilitation services, prescriptions, and necessary medical equipment.
- Disability Benefits: This benefit covers a portion of an employee’s lost wages due to a work-related injury or illness.
- There are four types of disability benefits, which include temporary total disability (TTD), temporary partial disability (TPD), permanent total disability (PTD), and permanent partial disability (PPD).
- Rehabilitation Benefits: Some workers’ compensation policies also cover rehabilitation services like physical therapy and vocational training. This coverage helps the injured worker recover and return to work in a different role if they can’t perform their previous job duties.
- Death Benefits: In case of death, workers’ compensation may provide death benefits to the employee’s surviving spouse or dependents.
How Does It Work?
Injured workers may receive reimbursement for medical expenses and lost wages while recovering from a work-related injury or illness.
Workers’ compensation usually doesn’t cover all damages caused by a construction site accident.
Workers’ comp laws prohibit employees from suing their employers for work-related accidents or injuries.
Workers’ compensation is designed to provide a no-fault system that allows employees to receive benefits without needing to prove fault on the part of their employer.
How Does Workers’ Compensation Work in Construction Injuries?
Workers’ compensation applies the same way in construction accidents as with other work-related injuries.
It’s common in the construction industry to outsource or subcontract work.
In such cases, injured construction workers may be covered by the workers’ compensation insurance of the contractor who hired them instead of their direct employer.
Construction sites are known to carry a higher risk of accidents and injuries due to heavy equipment and hazardous materials involved.
Employees and employers in the construction industry must understand their rights and responsibilities in such cases.
Scope of Coverage
Any work-related physical injuries could be covered by workers’ compensation.
This coverage includes injuries from sudden accidents, repetitive strain injuries, and occupational illnesses.
Here are some of the most common injuries that may be covered under workers’ compensation:
- Falls: Workers who suffer from fall-related injuries may be eligible for workers’ comp benefits. However, if the worker’s fall was due to their negligence or intoxication, they may not qualify for benefits.
- Struck-by Injuries: Being struck by falling objects like tools, debris, or equipment can cause serious injuries on construction sites. These types of accidents are also covered under workers’ compensation.
- Electric Shock and Burns: Construction sites often use high-voltage equipment and electrical wiring, which can lead to electric shock accidents. Workers’ compensation covers medical expenses and lost wages due to these injuries.
- Exposure to Hazardous Materials: Many construction materials and chemicals used on construction sites can harm workers’ health if not handled properly.
A key component in qualifying for workers’ compensation is negligence.
As long as the worker’s injuries were due to their job duties and not their own negligence, they should be eligible for workers’ comp benefits.
Limitations and Exclusions for a Workers Compensation Claim
While workers’ compensation has a broad scope of coverage, it also has limitations and exclusions.
These limitations might differ for each state, but these are the most common:
- Pre-Existing Conditions
- Self-Inflicted Injuries
- War Injuries
- Workplace Fight Injuries
- Injuries Outside the Workplace
- Intoxication or Substance Abuse
- Independent Contractors
Pre-Existing Conditions
This exclusion is the most common and obvious, but pre-existing injuries or illnesses are typically not covered under workers’ compensation.
If the worker’s job duties aggravated their pre-existing condition, they may be eligible for benefits in some states.
The employer will determine the recoverable benefits, primarily medical bills or other expenditures.
Self-Inflicted Injuries
Self-inflicted injuries are also ineligible for workers’ comp benefits.
Negligence plays a major role in determining workers’ compensation eligibility.
Workplace accidents often undergo intensive investigations, and if it’s determined that the worker intentionally harmed themself, they may not receive any benefits.
War Injuries
Some states prohibit workers’ compensation for injuries sustained during war or military-related activities.
Certain benefits may still apply to these cases depending on the circumstances and state laws.
While workers’ compensation doesn’t usually apply, numerous laws and programs are designed to provide veterans and military personnel insurance benefits.
Speaking with an experienced construction accident attorney will give you options for your case.
Workplace Fight Injuries
Workplace fights happen every now and then, but that doesn’t mean workers’ compensation will cover them.
Workplace fights are considered assault and battery rather than work-related injuries.
The workers’ compensation may not cover any resulting injuries from a fight occurring in the workplace.
Injuries Outside the Workplace
Any injuries outside the construction site or the job site are excluded from workers’ compensation.
If a construction worker falls and is injured while commuting to work, they may not be eligible for workers’ comp benefits.
There are some exceptions to this exclusion, such as if the worker was performing a work-related task at the time of their injury.
Intoxication or Substance Abuse
If you were drinking with your coworkers after work and got injured while doing so, you may not be eligible for workers’ compensation benefits.
Any injuries sustained while under the influence of drugs or alcohol are typically excluded from coverage.
The case might differ if the accident occurred while drinking at a company-sponsored event.
Independent Contractors
The coverage of workers’ compensation only extends to regular workers.
Construction workers employed as independent contractors are not eligible for workers’ compensation benefits.
Some states require companies that hire independent contractors to provide them with workers’ compensation coverage.
Subcontractors hired by a general contractor are covered by the latter’s workers’ compensation insurance.
What is the Process of Claiming Workers' Compensation?
If you’ve suffered an injury on the job, navigating the process of claiming workers’ compensation is a critical step toward recovery and financial support.
This system is designed to provide relief for medical costs and compensate for any lost earnings due to workplace injuries.
Get Medical Attention Right Away
After sustaining an injury, injured construction workers must seek medical attention immediately.
Construction site accidents are known to cause serious injuries, and prompt medical attention can prevent any further harm.
Some injuries don’t appear until days or weeks after the accident, so it’s essential to document any symptoms that may arise later.
Calling the ambulance or seeing a doctor after an accident creates a medical record.
This document is critical if you want to pursue workers’ compensation benefits and may help build a strong case.
The Employee Informs the Employer
An injured construction worker must inform their employer about the accident within a specific time frame to be eligible for workers’ compensation benefits.
In most states, the deadline is thirty days from the accident date.
The employer might ask for medical records at this point, which you should give to them upon request.
The employer might refer the worker to a specific doctor or medical facility for treatment.
This specificity is because the employer’s insurance company will cover these medical expenses and may have agreements with certain healthcare providers.
Completing the Paperwork
Once the employer is aware of the construction site accident, they should provide the worker with paperwork to complete.
This paperwork is usually a claim form for workers’ compensation benefits.
It mainly asks about the accident, your medical treatment, and lost wages.
It’s essential to complete this paperwork accurately and thoroughly.
Any errors or missing information might delay or jeopardize your chances of receiving workers’ compensation benefits.
Different states might have their own forms or deadlines for submitting these documents, so it’s crucial to familiarize yourself with your state’s specific requirements.
The Employer Informs the Insurer
When all the forms are done, your employer will prepare all the paperwork and supporting documents the insurance company needs.
The construction worker’s doctor might also need to submit their own documentation about the injury and treatment.
Aside from informing the insurance company, your employer might also have to submit an accident report to your state’s workers’ compensation board.
The employer’s insurance company may also request that the construction site be inspected and investigated to determine if there were any safety violations or negligence involved.
The Insurer Approves or Denies the Claim
After a few weeks, the insurance company might have a decision regarding your claim.
If approved, the insurer will inform you and your employer of the benefits you’re entitled to receive.
They will also give you details and instructions on claiming them.
If the claim is denied, the insurance company must inform you of their reasons for rejecting it.
If you disagree with their decision, you can appeal it and present additional evidence to support your case.
Your lawyer can help you navigate the appeals process and help meet all necessary deadlines.
The Employee Returns To Work
After recovering from the injury, the construction worker must inform their employer about returning to the job site.
The employee must also send a written notification to the insurance company in some instances.
This process is essential to inform the insurer and the employer about the current situation of the injured construction worker.
If they sustained a disability or permanent injury, they may be entitled to additional benefits or accommodations upon returning to work.
If they need rehabilitation to regain their complete capacity, the insurer may cover those expenses.
What is the Role of a Construction Injury Lawyer?
After reviewing the general overview of the process, you might assume it is doable without the help of an experienced construction injury lawyer.
Having a lawyer by your side may help you receive your benefits and avoid potential delays or issues.
A construction injury lawyer specializes in handling workers’ compensation cases for construction workers.
Attorneys are well-versed in the laws and regulations surrounding this industry and have experience dealing with insurance companies.
An experienced lawyer can guide you through the process, from filling out paperwork to appealing a denied claim.
They can also negotiate for a better settlement on your behalf and help ensure that the insurance company or your employer does not take advantage of you.
Alternative Legal Remedies for a Construction Injury
When pursuing workers’ compensation for your injuries, your research might show you that a significant limitation of this type of compensation is it does not cover non-economic damages like pain and suffering.
Other claimants have also argued that the provided coverage is insufficient for their injuries.
A construction injury lawyer might recommend pursuing an alternative legal remedy in these cases.
This action could include filing a personal injury lawsuit against a third party if they were responsible for the accident, such as a manufacturer of faulty equipment or a negligent contractor.
Your lawyer might also advise you to file a lawsuit against your employer in certain cases.
Pursue a Personal Injury Lawsuit
If you think the workers’ compensation coverage doesn’t suffice for your injuries, you may be entitled to compensation through a construction accident lawsuit.
You might be eligible to receive non-economic damages like pain and suffering, which are not covered under workers’ compensation.
Pursuing a construction accident case requires proving that a third party’s negligence caused your injuries.
Your lawyer must gather evidence and build a strong case against the responsible party.
Pursuing construction accident lawsuits can be time-consuming and costly but may result in more substantial compensation for your injuries.
Seeking Compensation From the Property Owner or Other Third Party
Another way to seek construction accident claims is to sue the property owner or other third parties involved in the construction project.
These parties could include architects, contractors, or subcontractors who contributed to the unsafe working conditions that led to your injury.
Your lawyer can investigate and determine if any of these parties played a role in your accident.
They might find that the construction equipment that caused your injury was defective or that the property owner failed to maintain a safe working environment.
It’s also possible for multiple parties to share responsibility for the accident, and your lawyer can help you determine who to hold accountable.
Pursuing this legal remedy can result in additional compensation for your injuries and financial losses.
TorHoerman Law: Talk to Our Experienced Construction Accident Attorneys
Construction companies are responsible for providing a safe working environment for their employees.
Accidents can still happen, and construction workers may sustain injuries while on the job.
In such cases, workers’ compensation is often the primary source of financial support for injured workers.
Understanding the nuances behind workers’ compensation is crucial.
Seeking professional legal advice from an experienced construction accident attorney can help ensure you seek justice and avoid potential issues or delays.
Experienced construction accident attorneys can help injured workers recover compensation for medical bills, lost wages, pain and suffering, and much more.
Talk to our experienced attorneys today for a free consultation.
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