What Is Injury at Work Compensation and How to File a Claim?
Workplace injuries are an unfortunate reality across all industries. In 2023, the Bureau of Labor Statistics (BLS) reported 2.6 million nonfatal workplace injuries and illnesses and 5,283 fatalities across the United States.
To address such incidents, federal law and various state laws provide injury at work compensation to support affected employees and their families. This guide explains injury at work compensation meaning, how it works, how to file a claim, and answers common questions.
What is workers' compensation?
Workers' compensation, or injury at work compensation, is a program that provides benefits to employees who suffer work-related injuries or illnesses. It covers medical expenses, lost wages, and rehabilitation, which provides financial support to injured workers during their recovery.
Federal and state laws govern workers' compensation, which helps employees receive prompt financial and medical support while protecting employers from costly lawsuits.
For example, in California, workers' compensation laws require employers to provide benefits such as medical care, temporary or permanent partial disability benefits, and supplemental job displacement benefits in case the employee does not fully recover and cannot return to their previous role.
Organizations need to consider how their workers' compensation programs align with legal requirements and organizational goals to better support employees. A thorough benefits program evaluation can help identify opportunities for improvement and ensure compliance with relevant laws.
How does workers' compensation work?
Generally, the process starts when an employee reports an injury to their employer, who files a claim. If approved, the employee gets benefits like medical bill payments or wage replacement based on the injury's severity. In some states, like California, if a claim is filed and the employer does not deny it within a certain time frame, the injury is presumed to be covered.
Under federal law, injury at work compensation covers specific groups like federal employees, maritime workers, and miners through laws like the Longshore and Harbor Workers' Compensation Program (LHWCA) and the Black Lung Benefits Act.
For example, the Federal Employees' Compensation Act (FECA) provides federal employees with medical care, temporary disability benefits, and vocational rehabilitation for work-related injuries. Unlike state programs, federal laws focus on jobs linked to federal operations.
Moreover, workers' compensation laws differ by state, with different rules for coverage, benefits, and processes. Most states require employers to have workers' compensation insurance, but the details vary.
Coverage requirements: In Alabama, businesses with five or more employees are required to have workers' compensation insurance through a workers' compensation insurance carrier. Conversely, in Virginia, the requirement applies to employers with two or more employees.
Reporting deadline: In Georgia, workers must report an injury within 30 days. In Wyoming, however, injuries must be reported to a supervisor immediately, but no later than 72 hours after the incident.
Waiting periods: The waiting period for workers' benefits also differs. In California, it is three days and becomes retroactive if the disability lasts over 14 days. In Alaska, it is also three days but retroactive after 28 days.
Injury at work compensation is a required part of your organization's benefits program. Salary experts can help design a Compensation and Benefits Program to ensure compliance and clarity.
Common types of injuries covered by workers' compensation
As mentioned, injury at work compensation covers injuries and illnesses sustained during work-related duties. It includes medical care, temporary total disability benefits during recovery, and permanent total disability benefits for severe cases. Examples include:
Exposure-related injuries, like breathing in toxic chemicals, extreme temperatures, or infectious diseases such as COVID-19.
Overexertion injuries, caused by lifting, carrying, pushing, or repetitive motions.
Slip, trip, and fall injuries, whether from slipping on a surface, tripping over hazards, or falling from heights like ladders.
Impact injuries, such as being hit by falling objects, caught in equipment, or involved in workplace vehicle accidents.
Trauma or stress injuries, including mental health issues or injuries from violent incidents at work.
According to the National Safety Council (NSC), the top 3 workplace injuries causing days away from work in 2021 to 2022 were exposure to harmful substances or environments, overexertion, and falls.
How to file an injury at work compensation claim
The steps for filing a workers' compensation case for a workplace injury differ for federal and non-federal employees. Below is a clear guide for each:
For federal employees
If you are a federal employee injured on the job, the U.S. Department of Labor recommends following these steps:
Register for an ECOMP account: Create an account on the Employees’ Compensation Operations and Management Portal (ECOMP) at www.ecomp.dol.gov.
Choose the correct form: Use Form CA-1 ("Notice of Traumatic Injury") for injuries caused by a specific event, such as a fall or accident. Use Form CA-2 ("Notice of Occupational Disease") for injuries caused by repeated exposure, such as repetitive stress or prolonged hazardous conditions.
No pre-approval required: You do not need permission from your supervisor or agency to initiate your claim. Once registered in ECOMP, you can directly submit your form.
For non-federal employees
Different states have their own workers' compensation laws and processes. For instance, California follows a system with the following steps:
Report your injury: Tell your employer about your injury or illness as soon as it happens. If it is an emergency, get medical help first. Reporting quickly helps avoid delays in your claim.
Fill out the claim form: Get a Workers’ Compensation Claim Form (DWC 1) from your employer. If they do not provide it, call 1-800-736-7401 to request one. Complete the form, describing your injury, and give it back to your employer.
Get medical care: Visit a doctor who specializes in workplace injuries. They will treat you, guide your recovery, and write reports for your claim. Share all details about your symptoms and work environment.
Employer’s role: Your employer will complete their part of the claim form and send it to the claims administrator. They must also give you a copy of the completed form within one working day.
Claims decision: The claims administrator will decide if your claim is approved or denied. If approved, you will receive medical care and possibly wage benefits. If denied, you can appeal within the given deadlines.
FAQs
Now that you know the process for filing a workers' compensation claim, let's address some common questions surrounding the topic:
If I get injured at work, do I get paid?
If you get injured at work, you may not receive your full pay while recovering. However, workers' compensation benefits can partially replace your lost wages and cover medical costs, depending on state laws and the severity of your injury.
How long do you have to file a workers' comp claim in California?
According to California labor laws, an individual has one year from the date of an injury or illness to file a claim, and the workplace injury must be reported within 30 days of the incident.
What to do if an employee is injured outside of work?
If an employee is injured outside of work, they should inform their employer and seek medical treatment promptly. They can use sick or vacation leave to recover. However, they cannot receive workers' compensation benefits, as the injury did not happen during work-related activities.
Can I lose my job due to workers' compensation?
No, you cannot lose your job just by filing a workers' compensation claim. Most jurisdictions have laws protecting employees from retaliation, including termination, for filing such claims. Employers are also required to provide workers' compensation benefits to eligible employees.
The law also protects employees who are hurt on the job, even if the employer is uninsured. In California, employers without workers' compensation can face fines up to $10,000, penalties up to $100,000, or up to one year in jail, or both.
If you’re an employer, your compensation philosophy plays a key role in promoting fairness, supporting employee well-being, and ensuring legal compliance. Salary.com provides tools and resources to help align your pay practices with these goals.
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