A M ALGA M ATED TRANSIT UNION Know Your Rights WORKERS’ COMPENSATION
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orkers’ Compensation is a statutory system intended to provide compensation to employees injured in the course of their employment. This article will outline the basic concepts of such workers’ compensation rights. This is only a basic summary. The workers’ compensation system in each jurisdiction is different. For specific information pertaining to your jurisdiction, you should reference: http://www.dol.gov/ esa/regs/statutes/owcp/stwclaw/stwclaw.htm (U.S.); http://www.hrsdc.gc.ca/en/gateways/topics/fxf-gxr. shtml (Canada).
workers’ compensation coverage and subjecting employers to fines and other legal detriments should they fail to do so.
Summary of General Workers’ Compensation Protections In the United States the vast majority of employees who are injured on the job fall under the state system detailed in their state’s workers’ compensation laws. In Canada, each province has its own workers’ compensation laws that are regulated and administered by the respective provincial workers’ compensation board. Workers’ compensation insurance is typically required by the state/province for every employee, although many jurisdictions provide for specific employer exemptions for small companies (generally an employer with five or fewer employees), certain types of employees, and independent contractors.
History Prior to the creation of statutory workers’ compensation laws, employees were only able to seek a remedy for an injury occurring in the course of employment by suing their employers through the civil courts system. In such civil cases, the threshold for successful employee litigation was very high and, therefore, the courts usually decided in favor of the employer. However, when employees were successful in a lawsuit against their employer for a workplace injury, such awards could involve a substantial amount of money. The situation involving the resolution of workplace injuries was less than ideal for both employers and employees. Such mutual detriment led to the creation of a workers’ compensation ‘compromise’ to address injuries occurring during the course and scope of employment.
Workers’ compensation laws are strict liability in nature, meaning that the fault and negligence of the employer does not need to be established in order for an employee to collect medical benefits. However, an employee’s receipt of workers’ compensation benefits requires that the employee’s injury or illness is incurred in the course of employment. Since workers’ compensation law imposes strict liability on employers, the receipt of workers’ compensation benefits is generally the exclusive remedy for an employee’s injuries or illnesses arising out of the course of employment. When employees are injured on the job, they are entitled to certain categories of benefits. First, the injured employee generally has an absolute right to medical care for the workplace injury. Typically these include the cost for hospitals, doctors and necessary medical treatments. In addition, many jurisdictions mandate monetary compensation for temporary disabilities (while you are recovering from the workplace injury) or permanent disabilities (if you will never fully recover from workplace injuries) resulting from a workplace injury. The amount of compensation varies significantly according to jurisdiction. Finally, some jurisdictions require that vocational rehabilitation be provided to those employees who are unable to perform the normal duties of their position after suffering a workplace injury.
Creation of Statutory Workers’ Compensation Mechanism The creation of the statutory workers’ compensation mechanism occurred in the United States and Canada during the first half of the 1900’s. The development of this workers’ compensation system constituted a compromise between the employer and employee. Now employers would accept the responsibility of paying the premium costs for workers’ compensation coverage in exchange for employees agreeing to forego their right to sue the employer for damages resulting from a jobrelated injury. Over time, the workers’ compensation protections for employees have developed into a legal mandate requiring qualifying employers to provide
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Claim Form In order to receive workers’ compensation benefits, the injured employee must take certain actions. After the occurrence of a workplace injury, it is typically the injured employee’s responsibility to complete a claim form (usually available from the employer) and to submit it to the necessary recipient ‘ generally the employer or the workers’ compensation board/agency. After the claim form is submitted, it is forwarded to the insurance company for payment; however, the employer has an opportunity to contest a workers’ compensation claim and, should an employer wish to do so, a hearing is generally held on the matter of workers’ compensation benefits.
an employee’s claim for benefits. Employees required to go to a hearing due to an employer disputing a claim or requested to attend an ‘independent’ medical examination are strongly recommended to consult with an attorney specializing in workers’ compensation in their jurisdiction.
After filing a claim for workers’ compensation benefits, an injured employee may be requested to attend an ‘independent’ medical examination. In practice, such examinations are not actually independent, but are often utilized to defend against the payment of
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