When an employee suffers an injury while working for someone else, even without determining liability, state laws provide a system to assure that the employer assumes responsibility for the accident or exposure. A worker who is injured on-the-job or suffering the effects of an occupational exposure is usually entitled to file a claim for his/her employer to pay medical care, lost wages, and rehabilitation. An employer’s responsibility and the employee’s obligations in the process vary under individual state laws, however, so it is necessary for an injured worker to investigate how workers compensation laws are applied in the state where he/she is employed.

An employer required to provide workers compensation for employees may participate in a state provided insurance fund or, if eligible, may elect to operate under its own self-insurance fund. Under either method, the benefits must meet or exceed the state’s minimum requirements. In general, those requirements provide for 100% of the cost for hospitals, doctors, medical treatment, medication, medical supplies, and transportation required for care. While an injured employee is unable to work, an employer may be responsible to pay a non-taxable benefit from one-half to two-thirds of the employee’s normal wage. Finally, if an employee requires training, therapy, or other accommodations in order to return to work, the employer may also be responsible to pay for any necessary rehabilitation expenses.

Eventually, a compensable injury will be classified as temporary or permanent, and partial or total. This classification impacts the type or duration of certain benefits under the claim. Depending on the extent or nature of the injury, the payments may be short-term, long-term, or may be extended in one or more lump sum payments.

An injured employee has an obligation to inform his/her employer about an on-the-job injury within a specified amount of time. Most states require that the rules about injury reporting be posted in a prominently visible place. The employer then has the right to select and send the employee to a physician or medical care facility. Some very large employers provide a “company doctor” for on-site care and evaluation for employees who sustain on-the-job injuries. Typically, personal health care providers will refuse to treat or offer a diagnosis for a work-related injury and personal health insurance coverage is not required to pay for care for work-related injuries.

If an employer fails to meet legal obligations, the employee has the right to obtain legal advice and representation, and/or to pursue compensation through the courts.

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