Workers’ compensation, or workers’ comp as it is commonly called, is an insurance program that provides benefits to workers who were injured or became ill on the job.
Workers’ comp is designed to make up for medical costs and lost wages while they were out of work and is legally mandated in most states (except for Texas).
While you may be familiar with this program, there are some important details you need to understand if you are considering a workers’ compensation claim.
Will My Illness Or Injury Qualify?
Not every accident or illness that occurs while you are working qualifies to be covered by workers’ compensation.
To qualify for workers’ comp, an injury must meet the following requirements:
- Arise out of employment (AOE)
- Be in the course of employment (COE)
- Be within the scope of employment (SOE)
Translation? If you were doing a task to benefit your employer or within the scope of your job and you become ill or injured as a result, then you can receive benefits.
In Missouri, you must be an employee of a business that has workers’ comp insurance and meet all filing deadlines per Missouri’s labor laws.
However, injuries incurred over lunch breaks or at company events are some of the gray areas that need to be addressed with the AOE/COE rules.
Let’s say you sprained your ankle walking from picking up a sandwich at the deli on your lunch break. That most likely wouldn’t qualify as you were off the work premises and not completing a task to benefit your employer.
However, if you were picking up a sandwich for your boss or a platter for an office lunch, then you may qualify for workers’ comp.
Under what’s known as the “going and coming rule,” workers’ comp usually doesn’t cover injuries sustained during your work commute.
There are exceptions to this rule, however, including when you’re:
- Driving a company vehicle
- Required to bring your own car for business use during the workday
- Doing special errands for your employer
- Traveling on a business trip
- An employee who regularly travels for work or doesn’t have a regular, fixed work site (such as traveling salespeople going to meet customers or health workers going to the homes of care recipients).
Injuries and Illnesses That Qualify
There can never be a comprehensive list of the injuries and illnesses covered. Most often, when someone thinks of a workers’ comp injury, they think of a heavy machinery or vehicle accident – someone losing an appendage or even more severe.
However, below are some of the other more common types covered by workers’ comp insurance:
- Repetitive strain or stress injuries (RSIs) – This injury occurs in many jobs – not just those of us typing away at our computers all day getting carpel tunnel syndrome!
- Occupational Illnesses – Work-related illnesses can range from traditional occupational illnesses like black lung disease (from exposure to coal dust) and asbestosis (caused by exposure to asbestos) to AIDS/HIV contracted when a health worker gets a needle stick.
- Pre-Existing Conditions – Even if you have a pre-existing condition, if a work-related injury aggravated the condition, it would be covered by workers’ comp.
- Hearing Loss – Anyone who works in a noisy environment, such as construction sites or in an engineering facility, will often suffer hearing loss over time. Unless there’s another obvious reason for the condition, this is usually covered by workers’ comp.
- Stress–Related Injuries – The medical profession increasingly recognizes the connection between long-term exposure to stress and a wide range of illnesses, both physical and psychological. In Missouri, you do not need to have a physical injury to file a mental stress claim. Still, it may be difficult or impossible to get workers’ comp benefits for illnesses caused by on-the-job stress, the nature of your illness, and the reason for the stress.
Speaking With A Lawyer
The rules for workers’ comp coverage of injuries and illness can be very complicated to navigate. You may have trouble successfully filing your claim without the help of an attorney if you suffered a cumulative trauma injury, occupational illness, or stress-related physical or emotional problem because of work.
An experienced workers’ comp lawyer, like those at Marler Law Partners, can analyze your case, explain whether your injury or illness is likely to be covered, explain the time limits for filing claims related to cumulative trauma or occupational disease, and help develop the strong evidence needed to support a CT or stress-related claim.
Don’t waste any more of your time – schedule a free consultation with a trusted attorney today to ensure you get what you are owed.
Don’t Pay A Dime Unless You Get A Settlement.