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Workers Compensation Law: Your Rights And Benefits

  • Legal Editor

If you were seriously injured on the job or suffered from a job-related medical condition, you might be entitled to workers’ compensation benefits. These may include medical benefits and monthly income payments until you can return to work.

Construction work is by far one of the most dangerous occupations. Construction site accidents kill and injure thousands of American workers every year. 

In 1970, in response to these conditions, Congress enacted the Occupational Safety and Health Act, which legally mandated safe working conditions for all workers – especially those in the high-risk construction industry.

Worker’s Compensation Accidents And Injuries

What is the Workers’ Compensations Act?

The Workers Compensation Act was enacted to ensure that employees who are injured or rendered disabled on the job are provided with adequate compensation, eliminating, in most circumstances, the need for expensive and protracted litigation through the court system.

The Workers Compensations Act requires companies to purchase Worker’s Compensation insurance for the benefit of their employees should they be injured on the job. If the employer fails to purchase such coverage, the employer will not be shielded from legal liability. 

The injured construction worker will be able to sue the employer for all injuries, not just those covered by Worker’s Compensation, and will include allegations for payment of pain and suffering.

Under Worker’s Compensation laws, an employee with a work-related injury can apply for Worker’s Compensation benefits regardless of whether the employer or its agent was at fault. 

In exchange, an employee will be legally barred from having the right to sue the employer for work injuries under the system of Workers’ Compensation.

General Contractor Must Keep Work Conditions Safe

The general contractor is required by state law to provide a reasonably safe construction site, warn of hazards inherent at the site, hire employees with good safety records, coordinate job safety, and supervise and ensure safety compliance throughout the job site.

Given the peculiar risks and dangers associated with construction job sites and the unchecked discretion of general contractors to control and manage the pace and manner of work, state law imposes on general contractors what is known as a non-delegable duty to maintain a safe workplace free from unreasonable risks of injury.

It is called a non-delegable duty because the general contractor may not legally delegate the responsibility to any other person or worker, including other businesses and subcontractors. 

Even if the general contractor delegates project safety to someone other than himself, the general contractor will still be held liable for the injuries and damages sustained by the worker, even if the general contractor did not cause them.

OSHA Requirements

Under OSHA, the general contractor must ensure the safety and protection of all workers on a construction project, irrespective of whether they are the general contractor’s employees. Said another way, the general contractor is the single source of responsibility for the safety of all employees on the job site. As such, the general contractor bears full legal responsibility for all OSHA violations.

Construction Accidents Caused By Defective Products

Construction sites usually use dangerous tools and machinery such as scaffolding, tractors and cranes, power tools, hoists, woodworking tools, ladders, winches, cement mixers, bulldozers, graders, scrapers, forklifts, pressure vessels, gas detectors, and other types of standard construction equipment.

In most situations, injured workers receive Worker’s Compensation insurance benefits regardless of fault. Because Worker’s Compensation benefits act as a type of insurance, it precludes the employee from suing the employer for the injuries and disabilities sustained at work. 

Most states require employers to purchase Worker’s Compensation insurance for their employees. Specifically, Worker’s Compensation insurance companies specialize in covering construction work accidents and fatalities.

Third-Party Liability Claims – Construction Cases

Even though employers are liable for employee work accidents occurring during their employment, the worker can still legally pursue injury claims against a non-employer third party. 

For example, suppose a construction worker was working on the employer’s job site using a defective jackhammer and was injured as a result of the defect. In that case, the worker may still pursue his legal claims against the manufacturer and supplier of the defective product and the employer under Worker’s Compensation. 

Where applicable, the employer’s insurance company will likely claim a set-off from the responsible third-party manufacturer. In this context, the employer insurance company becomes an intervening party against the manufacturer or supplier.

Examples of Covered And Noncovered Claims 

The following examples of compensation covered in most construction injury cases include total compensation for past and future medical care and treatment, drug therapy, replacement income, vocational rehabilitation, and job search assistance.

Types of Claims That Qualify or Dont Qualify Under Worker’s Compensation 

  • Covered: If you are working on a construction site and a coworker accidentally breaks your arm with a 2 x 4, this is obviously an on-the-job injury, and it’s covered.
  • Not Covered: Any injury you sustain should be covered if you deliver work packages and get in a traffic accident.
  • Not Covered: If you are delivering packages, but you take a three-hour break from work to go and visit your grandma and take her shopping in your employer’s van – and then get into a traffic accident – you probably will not be covered by worker’s compensation because the accident did not occur within the scope of your employment.
  • Not Covered: If you take a break from your job every hour to smoke a cigarette and it develops into lung cancer, you will not be covered by worker’s compensation since the “injury to your lungs” had nothing to do with your work.
  • Probably Not Covered: If your boss yells at you every day and your job becomes so stressful, you are forced to seek medical treatment and miss work. Stress is usually not a work-related injury unless you can prove it is a psychological injury that was caused by a work-related traumatic event. The defense will usually try to prove that other psychological problems in your life were the primary cause of your stress, not work.

Pain And Suffering are Generally Not Covered

The most significant disadvantage of the Worker’s Compensation system in construction cases is that injured workers are not entitled to collect for pain and suffering, which is normally a large part of most personal injury cases. 

This is not true in third-party cases outside of worker’s compensation. For example, a worker is injured because he used a defective tool. The worker can sue under worker’s comp and the manufacturer of the defective device under a theory of strict liability and negligence in the design and manufacture of the product.

Wage replacement usually comes out to about three-quarters of the worker’s average yearly wage. Workers’ compensation insurance is not limited to present and immediate accidents. Worker’s Compensation also covers construction injuries and illnesses developed over long periods relating to the work environment, and particularly where the worker has been injured due to repetitive physical activity.

Lump-Sum Benefits – Permanent Work Injuries

If the worker is rendered permanently disabled from a previous construction job, the worker will probably still be eligible for long-term disability or lump sum benefit. 

However, permanent disability benefits usually are aggressively prosecuted by the insurance company and can be very complex, highly contentious, and time-consuming. 

It is recommended that a worker consults with an experienced Worker’s Compensation lawyer to help them develop the right litigation strategy for their case.

Denial Resulting From Drug Use 

Most states can impose mandatory drug testing of injured employees. Consequently, the state can deny the injured employee Worker’s Compensation benefits if the drug tests reveal the employee was under the influence of drugs or alcohol at the time of the injury. 

Compensation may also be denied if the employee violated the law or express company policy.

It is not unusual to see the employer challenge the claim because the accident did not happen on the job or because the injury was not severe enough to qualify as a compensable injury.

Right To Appeal Denial Of Your Claim

The rules and appeals process will be based on your state’s Workers’ Compensation laws. The first phase of the appeal process will likely be a hearing before an administrative law judge at your state’s Board of Workers Compensation. Additional appeals levels vary depending on your state’s Worker’s Compensation Administrative Rules and Appeals Process.

Ensure that your appeal is filed before the statutory deadline and that you are entirely prepared to present your case, including offering expert medical opinions (usually in the form of current medical reports), which will support the nature and extent of your work injury claims. 

Again, if your claim involves a severe injury, at this phase in the administrative process, it is strongly advised that you have a skilled worker’s compensation attorney representing you.

Worker Not In The Course Of Employment Not Covered

Your employer’s Worker’s Compensation insurance would not cover you if you were not working within the course of your employment when you were injured. This includes workers who run offsite non-related job errands. 

For example, if a construction worker was supposed to be delivering supplies to another job site but instead went with a friend to do something unrelated to his job and, on his way back from his friend’s house, was involved in an auto accident, the worker will not likely be covered if the accident did not happen while he was in the course of the worker’s employment. 

Driving to and from the place of work is generally considered to be in the system and scope of a career. Moving to or from extraneous non-work relater personal or social visits are usually not covered.

Must Timely File Your Workers Compensation Claim  

The law is very strict about filing and reporting your claim promptly. The single most common reason a claim is denied is that the work accident was not written or filed on time. The law requires that a worker report the claim immediately.

If you submit a workers’ compensation claim and it is denied, you must receive a letter stating expressly why it was denied. You still have a right to appeal the decision, and you are strongly advised to retain an experienced worker’s compensation attorney to handle the appeal for you.

Worker’s Compensation Plus Social Security Disability Benefits

Disabilities can take many different forms. Illnesses, physical and mental limitations, extreme pain, and depression or anxiety all qualify as disabilities. Consequently, in addition to Worker’s Compensation, you may also be eligible to recover Social Security Disability Benefits. 

Workers Compensation Attorney

If you have specific questions or require additional information about your legal rights and obligations, consult a verified Worker’s Compensation Lawyer as soon as possible.

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