Am I Entitled to Workers' Compensation Benefits?

To qualify for workers' compensation benefits, you must be an employee of a company with workers’ comp insurance and you must have suffered a work-related injury or illness.

Updated by , J.D. · University of Missouri School of Law
Updated 3/27/2024

To be eligible for workers' compensation benefits (sometimes called workman's comp), there are two basic requirements:

  • You must be an employee of a company who has (or was supposed to have) workers' comp insurance.
  • You must have been injured at work or as a result of job-related duties.

Let's look at these requirements in more detail.

Am I an Employee for Workers' Comp Purposes?

Only employees are entitled to receive workers' comp benefits. It doesn't matter whether you are a seasonal or part-time employee, you're still eligible for benefits. Generally, you don't have to be employed for a certain amount of time before claiming workers' comp benefits.

If, on the other hand, you're an independent contractor, freelancer, or consultant, you aren't eligible for workers' comp benefits. If you work a lot of hours for your employer, under the close direction of the employer, and/or you work at the employer's place of business, you are more likely to be an employee, not an independent contractor.

If you are a "casual worker" or "temp," whether you are covered by workers' comp depends on whether you are technically an employee or an independent contractor. If you are a sales person, you could be an independent contractor or an employee, depending on how independent you are from your employer.

If your employer is withholding taxes from your pay, it is treating you as an employee. If your employer tries to treat you as an independent contractor to deny you workers' comp benefits, and you think you may technically be an employee, you may want to contact a workers' comp attorney.

Volunteers generally aren't covered by workers' comp insurance policies. While some organizations do opt to cover their volunteers with workers' comp insurance, if you were injured while volunteering, it's not likely you'll be covered by workers' comp.

Is My Illness or Injury Covered by Workers' Comp?

Almost any injury or illness qualifies for workers' comp, as long as it's job-related. You can be injured in an accident on the job; for example, straining your back by lifting, getting a finger caught in a machine, falling on a slippery floor, or getting hit by another driver.

You can also become sick from unhealthy conditions on the job; for example, from contact with a hazardous substance or exposure to toxic fumes. If you become ill over a period of months or years, you can still qualify for workers' comp. For instance, if you do repetitive work such as typing at a computer keyboard or operating a cash register, over time you may get a repetitive stress injury (RSI), such as carpel tunnel syndrome.

Chronic illnesses like these, also called cumulative trauma disorders (CTDs), are fully compensable by workers' compensation. Mental illness can also be covered by workers' comp if it's a result of something that happened at work (although it can be quite difficult to prove stress-related injuries).

Does an Injury Have to Happen at Work?

Any time you are doing work for your employer, you are entitled to workers' compensation benefits, whether you are at work or not. You are eligible for workers' comp in any of the following types of circumstances:

  • You leave work to pick up office supplies and you get in an accident.
  • You are telecommuting from home and get injured on your computer.
  • You attend the office holiday party and fall down a flight of stairs.

However, you aren't eligible for workers' comp for injuries that occur going to or from work or when you leave the office for lunch.

What If the Injury Was My Fault?

There is no requirement that the company you work for was at fault, because workers' comp is a no-fault system. Even if you did something to cause the injury -- for instance, you always type with your feet up on the desk and you get carpal tunnel syndrome as a result -- you are still eligible for workers' comp. However, if you caused the injury by intentionally hurting yourself, or because you were using drugs or alcohol, your injury will not be covered.

There is a gray area around other situations where your misbehavior causes or contributes to your injury. If your injury is the result of goofing off, your injury may not be covered by workers' comp -- unless your employer has condoned this kind of behavior. And if your injury is the result of the fight between you and another employee, the main instigator of the fight will not be eligible for workers' comp.

The above types of situations have been decided differently by different workers' comp judges in different states, depending on the specific facts of the situation. If your injury is the result of horseplay or violence and your workers' comp claim gets denied, you should contact a workers' comp lawyer for advice.

How Do I Start the Workers' Comp Process?

Though workers' comp laws differ by state, most jurisdictions require a, injured or sick worker to notify their employer of an injury within 30 to 45 days of an accident or injury becoming known. Failure to do so can potentially result in a denial of benefits.

Providing notification to an employer of a workers' compensation compensable injury is typically done by giving notice to someone in a managerial position. However, in cases where a worker is unable to provide such notification (perhaps due to hospitalization), the requirement of formal notice is generally excused if the employer learns of, or should have known of, the worker's injury.

Once notification has been made to the employer, the employer should submit a report to the state worker's compensation board (or industrial commission) and notify the workers' comp insurance carrier. At that point, the workers' comp carrier will be in the position to begin paying an injured or sick worker's medical bills, as well as a percentage of the worker's average weekly income (usually 66%), through the payment of temporary disability checks.

Sometimes the process happens differently. A worker may go see the doctor, and when the doctor discovers the injury or illness is work-related, the doctor may ask the worker to fill out a workers' comp claim form, which will advise the employer and its insurance company that the worker has suffered a workplace illness or injury. In this case, when you return to work after seeing the doctor, it's still a good idea to tell your supervisor what happened.

A workers' compensation carrier can also reject your worker's claim. You can always appeal the rejection of a claim with the state workers' compensation board or industrial commission. In such cases, you'd be wise to seek the assistance of an attorney who specializes in workers' compensation claims.

Contact a Workers' Comp Lawyer

If you need help applying for workers' comp or appealing a denial of benefits, contact an experienced workers' comp attorney. Most workers' comp lawyers don't charge a fee up-front, and instead receive a percentage of your benefits if you win your claim.

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