Workers' Compensation Laws and Disability Benefits
Workers’ compensation laws differ from state to state. In general, they provide benefits for workers who are injured or become sick because of work. They also provide death benefits to dependent family members of those who are killed on the job. Benefits include medical care, rehabilitation expenses, and partial or total disability coverage in lieu of wages. Although benefits are similar across the states, there are many legal details that vary and can make a substantial difference to a particular claim.
Medical benefits pay for hospital and medical expenses that are necessary to diagnose and treat an injury or illness. Doctors’ visits, medication, and operations are usually covered. In many cases, special equipment, such as a wheelchair, will be covered by workers’ compensation. Emotional injury claims can present a greater challenge to prove than physical injuries, but in states like Massachusetts that recognize emotional or mental health injuries caused by work, workers’ compensation will cover counseling or other mental health services.
Only those medical practices that are generally accepted by the medical community will be covered. It may be challenging to get coverage for experimental treatments. For example, if there is a new or innovative therapy for mesothelioma, it may be difficult to obtain coverage for it.
Rehabilitation benefits provide coverage for medical and therapeutic care that will help a worker recover. For example, if a worker suffered an amputation at the factory where they work and can no longer do jobs that require both hands, rehabilitation benefits would help them get retrained or become qualified to work at a different job.
Disability benefits are those that compensate injured or ill workers who are unable to work. Disabilities can be total or partial, and they can be temporary or permanent. A temporary total disability stops an injured or ill employee from working at all, but the employee may make a full recovery. A temporary partial disability keeps them from doing some aspects of the job for a limited period, but they may be able to do all of their job duties at some point in the future.
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Certain injured workers may be eligible for Social Security disability benefits in addition to workers’ compensation. For more information about Social Security disability benefits, visit Justia’s Social Security Disability Benefits page in the Estate Planning Center.
Permanent disabilities are those that prevent workers from ever returning to full ability to do the same job. A permanent total disability is one that fully prevents someone from working at their job or a similar position. However, they may not be completely incapacitated. A permanent partial disability also entails a permanent injury, but it only partially stops someone from working. For example, if a worker sustains nerve damage in their fingers and they teach painting for a living, they may still be able to teach, but they might lose some of their fine motor skills for purposes of showing students how to accomplish more detailed painting.
Disability benefits are based on how much a worker earned before they were hurt. Some states cap the amount someone may receive in disability benefits. Workers do not have to pay income tax on the benefits.
Death benefits are provided to financially dependent family members, such as a spouse, minor children, parents, or siblings. These may include funeral and burial expenses, but they will also compensate dependents for the loss of the decedent’s income. In some states, partners cannot receive benefits unless they were legally married, and stepchildren or children born outside a marriage cannot recover death benefits.
Can Someone Be Laid Off While Receiving Workers’ Compensation Benefits?
All state workers’ compensation laws prohibit retaliation. Workers cannot be harassed, laid off, fired, or demoted because they are on workers’ compensation leave or because they filed a claim. However, if an employer was already planning a layoff or to fire or demote a worker because of poor performance, filing for workers’ compensation will not prevent an employer from taking that adverse employment action.
Who Is Covered?
In many states, businesses with five or fewer employees are not required to carry workers’ compensation insurance. Check state laws to see what coverage might be available in a specific situation.