Benefits and Coverage
Workers’ compensation covers a variety of losses, such as medical expenses, lost wages, rehabilitation, and disability benefits. It may also include death benefits for the worker’s dependents.
Workers’ compensation benefits are intended to help cover timely medical care and financial support without needing to prove employer fault, helping the worker recover and return to work as soon as possible.
Temporary disability benefits last until you recover or return to work, generally up to 104 weeks in most states. Permanent disability benefits can extend much longer, including for life.
The duration depends on the progress of your recovery and whether the disability is partial or total, temporary or permanent.
Yes, conditions such as post-traumatic stress disorder may be covered if they are shown to be directly related to work. The cause is typically required to be a traumatic workplace event or accumulated stress.
Each state applies different standards, especially when there is no evident physical injury.
Medical Care
In many states you must first see a doctor designated by your employer or their insurer, although you may request a change afterward. Some states allow you to designate your own doctor in advance.
These rules vary by state, so it is important to verify your rights locally with an attorney in your area.
Legal Process and Claims
You must report your injury to your employer as soon as possible and file a formal claim within 90 days of the accident. However, it is important to get detailed information, as each state has its own specific deadlines.
Delays can affect your eligibility, and your employer must provide you with the forms and guidance needed to continue the process.
If the employer is required to carry insurance and does not, they may face legal penalties, and you could sue them directly. Some states have special funds to cover benefits in these situations.
Suing directly may offer broader compensation, but it is usually a longer process and requires proving negligence.
In most cases you cannot sue your employer because the workers’ compensation system is exclusive, but there are exceptions if there was intentional harm or lack of insurance. Generally you must choose between a lawsuit or workers’ compensation.
These exceptions allow other legal avenues when workers’ compensation is not sufficient.
You can appeal the decision before the state workers’ compensation board and request a hearing. It is advisable to contact an attorney who specializes in these cases.
It is recommended to act quickly, as appeal deadlines are typically 15 to 30 days from the date of the denial notice.