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Who is Eligible for Workers’ Compensation?

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The rules vary from state to state, but generally you are eligible for workers’ compensation if you’ve been injured on the job or if a job-related condition made you sick. Though this rule sounds simple enough, each case is a different set of facts, so it isn’t always easy to determine eligibility.

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Sometimes the facts are in dispute or fall into a gray area. You have the burden of proving that your injury was work-related, and not all work-related duties make this clear. If you were away from your office when the accident occurred, it would be a very good idea to contact a workers’ compensation law firm before filing a claim.

For instance, let’s say you get hit by another car while making a lunch run. You were going to the restaurant anyway, and others at your job, including your office manager, asked you to pick up food for them. It could be disputed whether you were performing a job-related duty.

Some facts that could weigh in your favor are that, because you had to take the time to collect orders from other employees, you were at the intersection at the time when the accident occurred and not earlier as you would have been if you simply went to get food for yourself. A workers’ compensation attorney would know how best to present your claim or appeal to prove the facts that are favorable to your case.

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What Employees Are Not Covered by Workers’ Comp?

The rules differ from state to state, but generally workers who are not eligible for workers’ comp include:

  • Domestic workers
  • Self-employed
  • Independent contractors
  • Maritime workers
  • Federal employees (with some exceptions)
  • Undocumented workers
  • Agricultural workers
  • Temporary workers
  • Small businesses (three or fewer workers)

Also, if your boss didn’t pay the insurance premiums, you won’t be eligible but you can sue.

Injuries and Illnesses Covered Under Workers’ Compensation

Generally speaking, any accidental injury you suffer while working is covered by workers’ comp. If a third party such as a co-worker caused your injury, you could file a workers’ compensation claim. Workers’ comp bars you from suing your employer in most cases, and a co-worker is an agent of your employer. However, there are some situations where you could sue your employer.

If you do the same motion repetitively in your job and develop a long-term disability such as carpal tunnel, you are eligible for workers’ comp. In Kentucky, where miners contract what is known as black lung, you can receive permanent disability payments from workers’ compensation insurance. Many states now recognize illness caused by work-related stress and cover those work-related conditions.

Work-Related Injuries That Are Not Covered by Workers’ Compensation

Anything can happen on a job. However, there are a couple of exceptions where you could be barred from compensation if you are injured while working. One exception that would bar your claim is if you were impaired by alcohol or another substance at the time of your accident while on the job. Another exception is if you purposely injured yourself. Finally, if you were breaking the law or a company rule at the time you were injured, it could bar your claim.

Call Isaacs & Isaacs Now for Help With Your Workers’ Comp Claim

Like other insurance adjusters, workers’ compensation adjusters are going to try to deny or reduce your claim. They do not care that you are injured, cannot work, and have bills coming in and a family to support. Because the rules are complicated and different in each state, it will be extremely difficult for you to receive a fair deal from your employer’s insurance company without help from somebody who knows the rules where you live and work. The best thing you can do is to call Isaacs & Isaacs for a free consultation and case evaluation with an experienced workers’ compensation lawyer.

We understand the strict deadlines for filing a claim or appeal, and we are on call 24/7 to help you to win the compensation you need to recover and go forward. Call 800-800-888 without delay for immediate help with your claim.

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