ignored or denied. That’s why every workers’ compensation case must be prepared as if it’s going to go to trial.
The employee requirement
In all 50 states, the general rule is that you must be hired as an employee to be eligible for benefits under your state’s workers’ compensation laws. For example, Illinois workers’ compensation law doesn’t cover independent contractors. The two pivotal factors in determining whether a person was an employee are whether the purported employer controlled how the claimant performed his or her job, and whether the employer exercised that control.
Injury in the course of one’s employment
Unless there’s clear evidence to the contrary, courts are apprehensive about finding that an injury didn’t occur in the course of somebody’s employment. The issue turns on whether an employee was injured while in furtherance of the employer’s business. Even an injury from a fall by tripping or slipping in an employer’s parking lot going to or from work is sufficient evidence of being in furtherance of the employer’s business.
Notice of injury
Employees in every state are required to give their employer notice that he or she was hurt on the job. Each state has its own notice requirements. An employee’s failure to give appropriate notice can operate as an affirmative defense for the employer. Notice must be given in the manner required by law. Improper notice, or no notice of injury can cause a legitimate workers’ compensation claim to be lawfully denied.
Showing that you were on the job
Activities in furtherance of an employer’s business can go beyond your employer’s real estate. Transportation to and from work that’s provided by your employer likely puts you under the purview of workers’ compensation if you get hurt in an accident Don’t think about bringing a workers’ compensation claim if you ride the train into downtown Chicago daily and slip on a patch of ice three blocks from your office.
A traveling employee who files a workers’ compensation claim must still be able to show that he or she was engaged in the course of his or her employment when an injury occurred. An employee who landed at Chicago’s O’Hare Airport who went directly to his or her hotel room and slipped and fell in the shower is likely covered. Injuries from a fall while bar hopping on Lincoln Avenue probably wouldn’t be covered. You’ve deviated from the course of your employment.
Medical evidence of injury
Aside from notice, the lack of appropriate medical evidence of injury is the second leading cause of workers’ compensation claims being denied. Medical evidence includes but isn’t limited to:
- Medical records
- Medical reports from physicians
- Sworn testimony from physicians
Medical evidence will operate to prove the nature and extent of your injury along with any permanent partial disability.
You must prove your damages
Don’t expect an arbitrator or judge to award you damages just because you have a viable workers’ compensation claim with some time off of work and some medical bills. You’re required to prove that your lost earnings and medical bills are compensable under controlling workers’ compensation laws. That’s where reasonable minds differ on just about every case. Unlike the law of personal injury, workers’ compensation doesn’t award damages for pain and suffering and other non-economic damages. Claimants are generally limited to:
- Lost earnings
- Earnings while temporarily totally disabled
- Any permanent partial disability
Other forms of compensation are available in more serious cases, including funeral and burial expenses in death cases.
The Law Offices of Briles & Associates said, “A workers’ compensation claim is usually an injured worker’s sole and exclusive remedy when he or she is injured at work.” Other remedies might be available if the worker was injured while at work by somebody who wasn’t a co-employee. Always consult with a qualified workers’ compensation attorney before making a claim.