subject: Why Do I Have To Have Workers Compensation? [print this page] Workers compensation is an American system of state laws to pay workers hurt on the job. Before the system was developed, a worker had to sue their employer and show that the employer negligently caused the worker's injury. If a court was persuaded, the worker would be paid by the employer for the injury. That payment, called "make whole", would restore the worker to their uninjured financial state. The purpose of workers compensation is to improve this legal structure.
This system could provide very fluid and inequitable monetary damages to workers, including paying them for the remainder of their lives. And, as noted, it was challenging for employees to file suits that involved proving employer fault.
With these considerations in mind, states created workers compensation laws to ease resolution of injury disputes. One central element of workers compensation is that these programs are often the only way that an employee can recover for a workplace injury.
Each state wrote its own workers compensation law, causing some variability across the country. Most laws share five common requirements. The first requirement is that the worker and employer are covered by the statute. Second, there must have been an employee injury. Third, the injury resulted from an accident. Fourth, that accident must have arisen out of the worker's relationship with the employer. And fifth, that accident must have taken place in the course of the worker's relationship with the employer.
These laws cover many employees and employers, but there are some significant exceptions that vary widely from state to state. Some exceptions include very small employers; certain industries are excluded, such as state and local government or agriculture; and certain occupations might be excluded, like household employees.
The injury element in the laws generally requires a physical injury. Physical being the point.
A one-time event or accident must have caused the injury. Recent changes in the workplace have led to discussions of this element, and how it should be adapted. Some states have broadened the requirement to include repetitive stress injuries like carpal tunnel and ergonomics. Other jurisdictions have looked at the role of diseases developed at work, and included them in their workers compensation coverage. (For example, some states cover a hospital worker's accidental HIV exposure.)
The "arisen out of" requirement addresses the underlying injury risks of an occupation. If there is a high risk of a specific injury, there is a higher likelihood that type of injury would arise out of the employment. An illustration is useful. A physician being hit on the head by a falling tree branch at work has a lower likelihood of occurring than a lumberjack in the same situation. The lumberjack's injury probably has a greater likelihood of having arisen out of his/her employment.
And for the injury to have happened in the course of employment, usually the employee has to have been at work when it happened. This is evidenced by being clocked-in, and when and where the injury occurred. But courts will look broadly at all the evidence if the accident took place during a nontraditional employment setting or activity.
If a worker can show that his injury meets all five of the above elements, he will recover monetary damages based on a preset rate included in the workers compensation law.
These the purpose of workers compensation systems was to eliminate court battles, but those battles continue over the various issues involved. For those seeking information related to their own or their employees' work site injuries, they are encouraged to meet with a workers compensation lawyer licensed to practice in their jurisdiction.
