Workers’ compensation is a safety net designed to protect employees who suffer job-related injuries or illnesses. It provides financial assistance and medical benefits to individuals facing challenges due to work-related incidents.
However, not everyone automatically qualifies for workers’ compensation. Knowing the criteria for a workers’ compensation claim helps you know what to expect if you get sick or injured on the job.
To be eligible for workers’ compensation, you must be an employee. Independent contractors, freelancers and volunteers typically do not fall under the umbrella of workers’ compensation coverage. Employers are responsible for providing this protection to their employees, making it important to establish an official employer-employee relationship.
Work-related injury or illness
The heart of workers’ compensation eligibility lies in the connection between the injury or illness and the workplace. To qualify, the injury or illness must have occurred while performing job duties. This criterion ensures that individuals seeking compensation have genuinely suffered due to work-related activities.
Prompt reporting of the injury or illness is important. Employees must inform their employers about the incident as soon as possible. Delayed reporting may raise doubts about the authenticity of the claim. Timely reporting helps establish a clear timeline of events, making it easier for the employer and insurance provider to process the workers’ compensation claim efficiently.
Employers play a large role in the workers’ compensation process. They must have workers’ compensation insurance coverage in place. Failing to provide this coverage not only puts the employer at legal risk but also jeopardizes the financial well-being of injured employees. A lack of insurance does not absolve the employer from their responsibility; injured employees can still seek compensation through other avenues.
Exclusions and exceptions
While workers’ compensation covers a broad range of injuries and illnesses, there are certain exclusions. Injuries resulting from intoxication, willful misconduct or self-inflicted harm are generally not eligible for compensation.
Being aware of workers’ compensation eligibility criteria ensures that those in need can access the support they rightfully deserve in times of difficulty.