Eligibility for workers’ compensation benefits generally depends on several factors, including your status as a worker for an employer that carries workers’ compensation coverage for its employees. Most state laws provide specific timelines that eligible workers must follow when reporting their work-related injuries and illnesses to their employers and filing their workers’ compensation claims. While eligibility for workers’ compensation benefits varies by state, these general factors will help you know if you are eligible for workers’ compensation.
In addition to differences in state general eligibility requirements, state law might bar some categories of workers from qualifying for benefits. For instance, some states treat agricultural or temporary workers differently for the purposes of workers’ compensation eligibility. Some states also make workers’ compensation optional for some sizes and types of employers, so a person who may qualify for workers’ compensation benefits in one state may not be eligible for benefits in another.
Employment Status and Workers’ Compensation
State laws define who is an employee for workers’ compensation eligibility in different ways. Some state laws explicitly exclude independent contractors, which includes those workers who receive a 1099 tax form for the work that they complete each year, from being eligible for workers’ compensation. Other state laws include some or all these types of contractors in workers’ compensation eligibility. Understanding your status as an employee or independent contractor at your workplace is critical to know if you are eligible for workers’ compensation.
Likewise, some employers intentionally misclassify workers as independent contractors instead of employees to avoid workers’ compensation coverage or for other reasons. In these cases, workers may have to take the matter to court to get a determination that they had employee status at the time of their injury, therefore making them eligible for workers’ compensation. The Internal Revenue Service (IRS) explains how this determination usually rests on the amount of control that the employer exercises over the worker and other characteristics regarding the relationship between the employer and the worker.
Work-Related Illnesses and Injuries
You qualify for workers’ compensation benefits only if you suffer a work-related disease or injury. Many of these incidents occur within the workplace, but injuries that employees suffer outside the workplace also might qualify for coverage. For example, if an employee must deliver goods to a store or residence, they likely do so by driving a company delivery van or truck. If they suffer injuries in a motor vehicle while on the clock, they likely have suffered a work-related injury that makes them eligible for workers’ compensation coverage.
In some cases, you might have a legal claim against a third party in addition to a workers’ compensation claim. Going back to the motor vehicle accident example, if a drunk or speeding driver caused the accident that led to your injuries, you likely would still qualify for workers’ compensation benefits. However, you also might have a personal injury claim based on negligence against the driver who caused the accident.
Timelines for Reporting Work Injuries and Filing Workers’ Compensation Claims
As a rule, employees who suffer on-the-job injuries should report them to their employers immediately. However, state laws typically require employees to report the injuries within 30 days. Failing to report a work-related injury or illness within the mandatory time frame could result in becoming ineligible for workers’ compensation benefits.
State laws also establish varying statutes of limitations or deadlines by which injured or ill workers must file formal workers’ compensation claims. In many cases, employers will file the claims with their insurance companies, but workers also often have the right to file claims on their own or report the matter to their state workers’ compensation board.
Whatever the case may be, employees must file their workers’ compensation claims within the appropriate statutes of limitations for their states, or they risk being ineligible for workers’ compensation benefits. You can look to the Office of Workers’ Compensation Programs for contact information for the workers’ compensation board in each state. If you work for the federal government, you might want to contact the Federal Employees’ Compensation Program for information about filing workers’ compensation claims.
Get Answers to Your Questions About Workers’ Compensation Eligibility
When you suffer a job-related injury or illness, you will likely have many questions about your eligibility and the potential benefits you could receive. You can get answers to these questions and learn more about your rights in a workers’ compensation claim by speaking with the team at Ben Crump Law, PLLC.
You should not have to bear the financial costs of injuries or illnesses that you suffered while on the job all on your own. We offer legal representation on contingency, meaning that we receive no payment unless you receive your workers’ compensation settlement. Give our office a call today at (800) 603-4224 and start getting the answers to those questions.
