Workers Compensation: What It Is, Why It Matters and When to Take Action

According to the most recent data available from the Bureau of Labor Statistics, private industry employers reported a total “2.7 million nonfatal workplace injuries and illnesses in 2020.” Of these, over 1.17 million incidents caused workers to miss one or more days of work.

Employers have an obligation to provide a safe working environment for their employees. When injuries or illnesses occur as a direct result of work-related activities, the ability to file a workers compensation claim can provide much-needed financial assistance for the injured individual.

As Marie Napoli, partner at Napoli Shkolnik, a personal injury firm based in New York, explains, however, “Many workers don’t fully understand their rights when they suffer an injury on the job. By understanding how workers compensation can help them — and knowing when and how to take action — they can get the financial assistance they deserve.”

The What and Why of Workers Compensation

“The vast majority of private employers in the United States are legally required to carry workers compensation insurance,” Napoli explains. “These policies provide financial coverage for wage replacement, medical care and even death benefits when a work-related injury, illness, disease or death occurs. Specific requirements can vary from state to state, but the gist of it is that if you employ others, you usually have the responsibility to carry this coverage.”

While an employee might not need financial assistance for a paper cut, there is no denying that many workplaces have inherent dangers that greatly increase the risk of injury. According to OSHA, one in five workplace deaths in 2019 were in the construction industry. Hazards from falls and equipment accidents greatly increase the risk for individuals in these and other industries.

However, even a mundane office environment could pose a health and safety risk. For example, working day after day in a building that contains asbestos can greatly increase an individual’s risk for cancer. Because the disease would be linked to a workplace hazard, this could also qualify for workers compensation coverage.

“When you aren’t able to work because of injury or illness, your financial situation can spiral out of control alarmingly fast,” Napoli says. “Most states require that workers compensation be two-thirds of your salary for the duration of the injury, which can make all the difference in helping you get by. However, if you have dependents or suffer a permanent injury or disease, the compensation can be greater to account for your lost earning potential. Workers compensation truly exists to protect employees’ financial well-being — but only if they file a claim.”

When and How to Take Action

As Napoli explains, workers compensation isn’t something that automatically kicks in for employees after they suffer an injury. “The employee or their family must file a claim to receive compensation — and this is when things can get complicated,” she says.

“Depending on your employer, you may need to file through the federal or state government. This can affect everything from the type of documentation you need to provide to the statute of limitations for when you can file a claim. Because your claim is being made against the employer’s workers compensation insurance provider, they have lawyers on their side, so there is no guarantee that you will get the benefits you need.”

Most states have a statute of limitations of one to two years from the date of the accident, but in some states, workers must submit a claim within 6 months. In Alaska, the timeframe is a mere 30 days.

However, regardless of the statute of limitations for filing a workers compensation claim, you must inform your employer of the accident within 30 days of the incident taking place. Failure to inform your employer in a timely manner could negate your ability to file a claim.

To file a workers compensation claim, you must provide documented proof that the injury or illness stems directly from a workplace accident or exposure. This claim can be supplemented by medical records, witness testimonies and diagnostic testing. The physicians who provide the medical documentation must be approved by state or federal workers compensation boards. Specific forms must be used for the state where you are filing a claim.

“Getting a claim submitted — or even informing your employer — when you are trying to recover from an injury isn’t always possible,” Napoli notes. “In New York, the majority of claims are denied when they are first submitted, often because of simple mistakes like missing documentation or information. While denials can be disputed and appealed, you’re better off working with a trusted legal advisor who can help you avoid these mistakes in the first place.”

Making Workers Compensation Work For You

Whether you work in an office job or on a construction site, there is always potential for a work-related illness or injury. Your employer’s workers compensation coverage is designed to provide the financial recompense you deserve when a work-related incident causes you to be unable to do your job or to experience significant hardship.

By getting the help you need to file a claim, you can ensure a more secure financial future for you and your family.