U.S. employers and their employees rely on our dependable workers' compensation system to resolve disputes about vocational/occupational injuries and diseases and to provide for related worker needs. Workers' compensation benefits are commonly awarded for work-related injury, illness and death, helping to meet the needs of injured workers and their families who are faced with overwhelming situations. If you or your family member is injured or becomes sick in the course of employment, a workers' compensation lawyer from Pitts & Zanaty, L.L.C. in Anniston, AL, can assess your potential workers' compensation claim.
History and origin of workers' compensation
The idea of workers' compensation has its origins in Germany in the early 1800s. The industrial revolution brought dangerous new workplaces into existence such as railroads, factories and mines with accompanying increases in injuries, deaths and new work-related diseases. Social and political sympathy for the common worker grew and led to the enactment of early workers' compensation legislation.
Almost all U.S. states had some type of workers' compensation system in place by the 1920s. The federal government followed suit for most federal employees and for certain industries shortly thereafter.
Prior to the establishment of workers' compensation benefit programs, American laws were inadequate to protect workers harmed in increasingly hazardous industrial jobs. Ordinary employees rarely had the financial means to bring negligence lawsuits against their employers; when they did, employers usually relied on one of three defenses, dubbed the "unholy trinity," to defeat the claims. An employer usually defended such a suit by asserting that a co-employee was instead responsible, that the injured worker had contributed negligently to the accident, or that the employee had assumed the risk of injury by accepting the job.
Theory and policy
Workers' compensation provides an exclusive remedy to the employee for work-related injury and sickness without regard to fault, when the harm arises out of and in the course of employment. The worker gives up the right to sue his or her employer for the harm in return for automatic monetary recovery, usually for lost wages and medical expenses, but sometimes including other types of benefits. To its advantage, the employer no longer has to worry about defending lawsuits or about disproportionate awards.
States require that employers carry workers' compensation insurance, set aside sufficient resources to cover claims (self-insure) or contribute to state-run workers' compensation award funds. The allowable methods for employer payment vary by state.
The social and economic policy behind workers' compensation is that these employer "costs" are ultimately paid by society as a whole in the form of higher prices for goods and services. Some theorize that the cost of the program is actually covered by lower wages, but that the trade-off to workers is well worth it. Workers' compensation is also seen as an incentive to employers to develop safer workplaces.
Exceptions to the exclusiveness of the workers' compensation remedy
Most states have developed exceptions to the exclusiveness of the workers' compensation remedy in extreme situations. When employers act in bad faith or intentionally or criminally harm employees, many states allow workers to bring lawsuits against their employers outside the workers' compensation system. A lawsuit against a third party may also be possible, such as against a manufacturer of faulty equipment that causes an injury. In such circumstances, the employer may be able to get reimbursement for workers' compensation benefits already paid.
Speak to a workers' compensation lawyer
If you have questions about a workers' compensation claim, a workers' compensation attorney at Pitts & Zanaty, L.L.C. in Anniston, AL, can answer them and advise you of your legal rights.
DISCLAIMER: This site and any information contained herein are intended for informational purposes only and should not be construed as legal advice. Seek competent legal counsel for advice on any legal matter.
Frequently Asked Questions
To take the uncertainty out of the circumstances following a work-related injury or industrial illness, the workers' compensation system provides a reliable procedure for resolving resulting problems. Broadly, if an injury or illness occurs in the course of employment, regardless of whether the employer was negligent or otherwise at fault, the worker receives benefits that may include wage replacement, medical coverage or other assistance. In exchange, the employee is not allowed to sue the employer for the injury and the employer must carry insurance or otherwise legally provide a means to cover workers' compensation expenses. Most employers are subject to the workers' compensation system, but some states exempt smaller employers, and most federal workers and certain national industries are covered instead by comparable federal programs.
Virtually all types of work-related physical injury and industrial illness are covered by workers' compensation. Very commonly covered conditions include repetitive-stress injuries (RSIs) like carpal-tunnel syndrome (CTS), back injuries, traumatic injuries, wounds or bodily reactions to substances. Many states also cover mental or emotional harm, but the standards for psychological coverage vary greatly from state to state. Pre-existing conditions are generally not covered unless aggravated at work.
Available benefits vary from state to state, but usually include compensation for medical expenses and disability benefits to replace wages, at least in part. States use various methods for calculating benefit amounts, such as schedules or formulas that may take into account the severity and type of injury and amount of lost wages. Some states offer other types of benefits, such as vocational rehabilitation. Death benefits are available to surviving dependents of workers who die from occupational injury or disease.
State laws require one of three payment methods or a combination thereof. Employers may need to carry workers' compensation insurance; employers may self-insure by setting up a fund sufficient to cover outgoing benefits; or the state may administer its own fund into which employers are required to pay.
Of course, you should first obtain necessary emergency treatment. Second, give notice of the injury or disease to your employer as soon as possible. State laws vary about what type of notice is sufficient, whether a designated person needs to receive it, how soon it must be given and if there is a deadline. Also, some states require notice to other parties, such as the state workers' compensation agency, local court or workers' compensation insurer. Third, file your workers' compensation claim with the state agency in a timely manner. Consult a knowledgeable workers' compensation attorney as early in the process as possible for advice about how to proceed every step of the way.
Whether you can choose your own doctor depends on your state's law. Most states allow emergency treatment without concern for consultation with the employer or insurer. Beyond an emergency, the choice of treating physician may belong to the employee, the employer, the workers' compensation insurance carrier or the state. Sometimes the employee can choose from a list of providers compiled by the employer, insurer or state agency. Your state law may also control how to change providers or other situations, such as obtaining a second opinion.
Each state has a procedure for appeal of a denied claim. Normally the first review is by the state workers' compensation agency, where there may be more than one level of claim re-evaluation and a hearing is usually held. Typically if the agency ultimately affirms the claim denial, the employee can appeal to the state court system, where there may also be more than one level of appeal. Representation by an attorney is helpful at any stage of appeal, particularly at any hearing and in court.
If you are harmed in the course of employment, you are entitled to workers' compensation, regardless of the cause. You may be able to sue a third party that caused the injury, such as the manufacturer, distributor or seller of faulty equipment that caused the injury. If a co-worker caused the injury, most states do not allow you to sue your colleague, but some do. If you recover from a third party, your employer or its insurer may be eligible for workers' compensation reimbursement or they may be able to join the suit.
