Am I Entitled to Workers' Compensation Benefits?

To be eligible for workers' compensation benefits (sometimes called workman's comp), there are two basic requirements:

• You must be an employee of a company that has (or was supposed to have) workers’ comp insurance.
• You must have been injured at work or as a result of job-related duties.

Let’s look at these requirements in more detail.

Am I an Employee for Workers' Comp Purposes?

Only employees are entitled to receive workers’ comp benefits. It doesn’t matter whether you're a seasonal or part-time employee, you’re still eligible for benefits. Generally, you don’t need to be used for a particular amount of your time before claiming workers’ comp benefits.

If, on the other hand, you’re an independent contractor, freelancer, or consultant, you aren’t eligible for workers’ comp benefits. If you work a lot of hours for your employer, under the close direction of the employer, and/or you work at the employer’s place of business, you are more likely to be an employee vs. an independent contractor.

If you're a “casual worker” or “temp,” whether you're covered by workers' comp depends on whether you're technically an employee or an independent contractor. If you're a salesperson, you'll be an independent contractor or an employee, counting on how independent you're from your employer. If your employer is withholding taxes from your pay, it's treating you as an employee.

If your employer tries to treat you as an independent contractor to deny you workers’ comp benefits, and you think you may technically be an employee, you may want to contact a workers' comp attorney. Volunteers generally aren't covered by workers' comp insurance policies. While some organizations do opt to cover their volunteers with workers’ comp insurance, if you were injured while volunteering, it’s not likely you’ll be covered by workers’ comp.

Is My Illness or Injury Covered by Workers' Comp?

Almost any injury or illness qualifies for workers' comp, as long as it’s job-related. You can be injured in an accident on the job; for instance, straining your back by lifting, getting a finger caught during a machine, falling on a slippery floor, or getting hit by another driver. You can also become sick from unhealthy conditions on the job; for instance, from contact with a hazardous substance or exposure to toxic fumes. If you become ill over a period of months or years, you'll still qualify for workers’ comp. 

For instance, if you are doing repetitive work like typing at a keypad or operating a register, over time you'll get a repetitive stress injury (RSI), such as carpal tunnel syndrome. Chronic illnesses like these, also called cumulative trauma disorders (CTDs), are fully compensable by workers’ compensation. Mental illness also can be covered by workers' comp if it’s a result of something that happened at work (although it is often quite difficult to prove stress-related injuries).

Does an Injury Have to Happen at Work?

Any time you're doing work for your employer, you're entitled to workers’ compensation benefits, whether you're at work or not. You are eligible for workers’ comp in any of the subsequent sorts of circumstances:

• You leave work to select up office supplies and you get in an accident.
• You are telecommuting from home and obtain injured on your computer.
• You attend the office holiday party and subside a flight of stairs.

However, you aren’t eligible for workers’ comp for injuries that occur getting to or from work or once you leave the office for lunch.

What If the Injury Was My Fault?

There is no requirement that the company you work for was at fault because workers' comp is a no-fault system. Even if you did something to cause the injury -- for instance, you always type with your feet up on the desk and you get carpal tunnel syndrome as a result -- you're still eligible for workers’ comp. However, if you caused the injury by intentionally hurting yourself, or because you were using drugs or alcohol, your injury will not be covered.

There is a grey area around other situations where your misbehavior causes or contributes to your injury. If your injury is the result of goofing off, your injury may not be covered by workers' comp -- unless your employer has condoned this kind of behavior. And if your injury is the result of the fight between you and another employee, the main instigator of the fight will not be eligible for workers' comp. The above sorts of situations are decided differently by different workers' comp judges in several states, counting on the precise facts of things. If your injury is the result of horseplay or violence and your workers’ comp claim gets denied, you should contact a workers' comp lawyer for advice.

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