A Thorough Explanation of Workers Compensation Benefits

Suffering a work-related injury can not only be painful for an employee, but can also be incredibly stressful. The process behind workers compensation can get confusing and a worker may worry about getting approved for benefits coverage. Many employees consider hiring an attorney during this time, just in the rare case their employer mishandles their claim or violates their rights. Here we have provided an explanation about workers compensation including definition, eligibility, doctor preferences, exclusions and more.

What exactly is the intention of a workers compensation program?

Workers compensation is a program that is state-mandated which offers benefits coverage to workers who endure job-related illnesses or injuries. This program is designed to provide financial help for medical treatments and loss of pay due to the job injuries or illness regardless of who was at-fault. However, there are some circumstances in which an employee is not able to receive benefits.

Are all injuries eligible for coverage through workers compensation?

An injured employee may not receive benefits if they were drunk or under the influence of a drug when the injury happened. Other factors that may lead to a denial of benefits can involve:

  • Injuries that were self-inflicted or caused by initiating a fight with a coworker
  • Injuries occurred as a result of a worker committing a crime
  • The employee’s behavior violated a company policy
  • The employee was not on the work property or performing a job-related duty when the injury happened

Can I seek medical treatment from my own doctor?

Which doctor is required to treat your work-related injuries varies depending on which state you live in. Some states permit a worker to see their own preferred doctor. However, other states may necessitate seeing a doctor under your employer’s network, at least initially.

Doctors that are paid by the insurance company of your employer may not have your best interests in mind. Be wary if your employer’s doctor does not take your expressed symptoms, aches or pains seriously. Your personal doctor knows your health history, and can create a more effective and genuine treatment plan for your injuries. Ask your employer if you are able to see your own doctor for a second opinion, after the initial evaluation by the required physician is performed.

What if an injury is long-term?

Long-term conditions such as stress injuries or back problems due to your work may be covered by workers compensation. A few types of diseases or illnesses that can be eligible for coverage may include lung disease, heart conditions and stress-induced digestive issues.

Which employees are excluded from being able to receive benefits?

Whether employees can receive workers compensation benefits depends on the state you live in, how many workers are in the business, the type of company, and the nature of work that is performed. Specific jobs that can be excluded from getting benefits may include seasonal workers, domestic employees and farm laborers. If you have any further questions or concerns about your eligibility for workers compensation benefits, consider talking with your employer or an on the job injury attorney West Palm Beach relies on if needed.


Thanks to our friends and contributors from Workers’ Compensation Lawyer – Palm Beach for their insight into workers’ compensation.