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Workers’ compensation is for injuries and illnesses

On Behalf of | Aug 7, 2018 | Firm News

Injuries at work can lead to disastrous impacts on a person’s personal life and professional life. Depending on the severity of the issue, there is a chance that the individual can’t return to work right away. Between this and the incoming medical bills, this can lead to dire straits. This is where workers’ compensation coverage might prove beneficial.

One question that many people have about workers’ compensation is whether the injuries are compensable. There are a few different factors that come into the picture:

Must be work related

The tasks you were doing when you were injured must be related to work or while you were on the clock. You can’t claim workers’ compensation benefits for an injury that occurred at home while you weren’t working for your employer.

It is possible that you can receive workers’ compensation for an injury that occurs at a work function. An example of this would be if you were involved in an accident at a restaurant while you were having dinner with clients. The same is true at a celebratory dinner for something that happened at work.

Injuries and illnesses

Many people think that only injuries are compensable under workers’ compensation. This isn’t the case. You can be compensated for injuries and illnesses. Even cumulative trauma injuries like carpal tunnel syndrome are compensable under workers’ compensation. The key is that you have to be able to tie in your medical issue to work.

There are some individuals who can obtain benefits for mental health issues. First responders, for example, might be able to get workers’ compensation for post-traumatic stress disorder due to the nature of their work.

Even some pre-existing conditions can qualify. In these cases, you must show that the issue has been made worse by the conditions at work or the duties you have to do. This can be challenging but it might come down to having a doctor clearly state what conditions caused the issue and note that you need avoid those actions in the future.

Appeals might be necessary

There are specific conditions that must be present when you seek the benefits of this program. Once you apply, you will receive a determination letter. If you don’t think that you are getting the benefits that you are entitled to, you may need to appeal. Read the notices you get carefully because they will give you deadlines and let you know what you need to do if you don’t agree with certain aspects of your case.


FindLaw Network

Verdicts & Settlements

36-year-old laborer for landscaping company fractured wrist when fellow employee hit him with truck. Claimant received in excess of $30,000 in workers’ compensation benefits for total disability and medical expenses and settled with automobile insurance company for fellow employee for $95,000.

1989 workers’ compensation claim settled for $125,000. Claimant originally sustained a low back injury when she slipped and fell at local grocery store resulting in low back surgery in 1989. Several years later, claimant exacerbated her low back injury. Claim was reopened and settled with carrier for $125,000 in 2006.

47-year-old deli clerk sustained low back injuries at work for local supermarket. Carrier originally denied claim on the grounds that the injury was pre-existing. After formal workers’ compensation hearing carrier accepted claim and paid all total disability benefits and medical expenses in excess of $100,000. Case then settled for an additional $100,000 after injured person received a permanent disability rating.

34-year-old male roofer sustained multiple injuries to his shoulder, neck, back and hip when he fell from roof during work. Claimant was provided workers’ compensation benefits in excess of $100,000 and settled remaining claims for an additional $55,000.

40-year-old male working for cleaning company sustained neck and low back injuries when he fell on defective staircase while cleaning local museum. Claimant recovered over $95,000 in workers’ compensation benefits and resolved claim against museum for $85,000.

26-year-old laborer sustained fractured foot when a cast iron pipe was dropped on his foot. Employer and workers’ compensation carrier denied claim on basis that injured worker was an independent contractor. After a series of informal and formal workers’ compensation hearings, carrier conceded that claimant was an employee and settled case for $85,000.

24-year-old waitress sustained back injury while working at Outback Steak House. Workers’ compensation insurance company initially denied the claim. After a series of informal hearings, carrier accepted claim paying medical expenses and total disability benefits. In addition to those benefits paid, claim settled for an additional $75,000.

Delivery truck driver sustained right wrist fracture in rear-end motor vehicle accident while in the course of his employment. Claimant recovered in excess of $40,000 in workers’ compensation benefits for medical expenses and total disability benefits. Claimant settled case against at-fault driver for $105,000.

22-year-old male working as stocking clerk at “big box” retailer sustained herniated disc in low back. Workers’ compensation carrier refused to accept the claim. After formal workers’ compensation, hearing commissioner ordered carrier to pay over $35,000 in past total disability benefits and pay for surgery and all related medical expenses. Case settled for an additional $35,000 for a total recovery in excess of $100,000.

Rear-end collision on entrance ramp to Merritt Parkway resulting in 49-year-old woman sustaining mid-back injury. Case settled at mediation after filing suit for $300,000.

28-year-old passenger sustained multiple herniated discs in automobile accident in New York state. New York no-fault carrier paid for extended period of disability from work and medical expenses, including expenses for surgery. Case settled against driver of vehicle for $300,000 policy limits shortly after filing suit.

54-year-old man sustains shoulder injury when hit from behind by uninsured motorist on New Jersey Turnpike. Case settled for $135,000 prior to trial.

CT Transit bus driver sustained torn meniscus in collision with another vehicle. Claims made against at-fault driver, workers’ compensation carrier and client’s underinsured motorist policy. All claims settle for a recovery in excess of $100,000.

68-year-old woman sustained neck and back injuries in rear-end collision and required extended course physical therapy, but was not a surgical candidate. Case settled for $100,000 prior to filing suit.

34-year-old woman sustained concussion and neck and back injuries in hit-and-run accident on a New York highway. Claimant settled uninsured motorist claim for her $100,000 policy limits.

80-year-old woman sustained right foot fracture when her foot was run over in a parking lot. Case settled for at-fault driver’s policy limit of $100,000 prior to filing suit.

38-year-old nanny sustained right femur fracture when she fell down defective stairs in home of her employer’s neighbor. All medical expenses and lost wages reimbursed and case settled for an additional $150,000.

Claim against landlord for defective staircase in multi-family rental house. Claimant sustained a right femur fracture. Case settled for $125,000 prior to filing suit.

$95,000 judgment obtained against bar and nightclub for assault by one of its patrons against another patron.

47-year-old woman sustained a broken left wrist when she fell from porch stairs at house she was renting. Case settled for $95,000 shortly before trial.

26-year-old male bitten on leg by German shepherd. Claim against dog owner settled for $65,000 plus payment of all medical expenses.