Workers’ compensation insurance is typically required for nearly all businesses with employees or contractors to carry. The required coverage varies from state to state, but you are most likely required to have some type of workers’ compensation insurance.
Workers’ compensation claims are made to the employer’s insurance and paid as a settlement benefit to any employee who is injured due to the job. Like most insurance concerns, workers’ compensation tends to become complicated and adversarial. This has created a surprisingly long list of common myths and misconceptions about workers’ compensation that discourage workers from filing claims.
However, employees have a right to workers’ compensation and to understand the full extent of its availability for which the onus falls on employers. To dispel some of those myths, we provide professionals a way to manage their claims with accurate information and guidance.
Myth #1: The injury must occur while an employee is working.
Truth: Workers’ compensation applies to any injury or condition contracted as a result of the job. Employees do not have to be on-shift or performing work tasks for an injury to qualify for a workers’ compensation claim.
Worker’s compensation covers the scope of all workplace-related injuries. If employee is on break, in the parking lot, or even home over the weekend, workers’ compensation still applies if the injury is related to the workplace or his/her role.
Myth #2: An employee must be on-site when injured to file a claim.
Truth: Medical conditions discovered that culminate off-site can still be caused by the job.
Workers’ compensation is designed to cover all medical ailments that are caused by the work itself. This includes lung conditions that occur because of poor air quality and repetitive motion injuries that occur after doing the same task over an extended time. It also includes conditions that culminate and/or are diagnosed away from work but are caused by workplace conditions. For example, if your back goes out and it is discovered that you have a repetitive motion work injury, you may still qualify for a workers’ compensation claim.
Myth #3: Only physical injuries qualify for worker’s compensation.
Truth: Medical conditions and repetitive motion injuries that develop as a result of work actions or environment are covered by workers’ compensation.
Workers’ compensation is often talked about in terms of physical work-related injuries. However, this is not the full scope of coverage. Workers’ compensation insurance also covers medical conditions that are caused by work-related tasks or workplace environment. A common example is air quality or contamination. If a worker inhales damaging air on the job and develops a medical condition, this type of issue is also covered by workers’ compensation.
Myth #4: An employee is disqualified if the injury was caused by his or her actions.
Truth: Generally, workers’ compensation is a no-fault law, meaning that only the work-related injury or condition regardless of who is at fault for such injury or illness.
Often, it is incorrectly assumed that blame is a factor in worker’s compensation. Blame does not factor into eligibility in the vast majority of cases. Mistakes, negligence, even misuse of the equipment can still be covered by workers’ compensation.* Whether the employer, coworker, or employee is responsible for the injury or it was just a by-product of the work itself, workers’ compensation still applies.
*NOTE: While mistakes, negligence, and misuse of equipment can be covered under workers’ compensation, if an injury results from worksite horseplay, an employee’s deviation from job duties can influence a workers’ compensation claim for that injury.
Myth #5: An employee can be fired for filing a workers’ compensation claim.
Truth: It is illegal to terminate a worker, retaliate in any way in response to a worker filing a workers’ compensation claim, or to discourage filing.
Some employers level threats or even punish employees who file a workers’ compensation claim. These methods may also be used to prevent employees from filing a claim or punish them for receiving a reward. Termination is a common response oftentimes to avoid a claim.
All of these actions are illegal. Workers who are injured are protected from retaliatory actions and cannot be terminated as a result of their injury or filing the claim.
Do you have an employee recovering from a recent workplace injury or medical condition? Avitus Group can help. Contact us today to consult on your claim.