what workers' compensation is

Workers’ Compensation: What Exactly Is It and What Does It Cover?

We see ads for workers’ compensation on TV, radio, and the Internet all the time. These ads only give us snippets of what workers’ compensation law is and does. It protects you if you are injured and affords you get benefits that you are entitled to; you must first understand what workers’ compensation means.

Workers’ compensation is a state-run insurance program that provides compensation to workers injured at work or workers who contracted an illness while on the job.

The monetary compensation covers medical and hospital bills and disability payments while the worker undergoes treatment (the amount usually is two-thirds of your salary). Let’s break down the types of workers’ compensation:

  • Medical – Covers the cost of hospital and medical bills, including doctor’s visits (e.g. co-pays), prescriptions, surgeries and medical equipment (e.g. crutches). It may also cover counseling, pain management, and acupuncture.
  • Rehabilitation – Covers medical and therapeutic care, such as physical and occupational therapies. This type of coverage might pay for retraining, tuition, and other related expenses if you cannot return to your old job.
  • Disability – There are four types of disability.
  1. Temporary Total Disability – The injury prevents you from working for a certain amount of time.
  2. Temporary Partial Disability – The injury prevents you from doing some of your duties at your job for a certain degree of time.
  3. Permanent Total Disability – This injury prevents you from being gainfully employed.
  4. Permanent Partial Disability – This injury caused permanent damage, but it partially impairs your ability to Your employer may have another position for you if you cannot do your old job duties. Keep in mind that your employer is not obligated to create a new position for you.
  • Death – This benefit is provided to the family of the worker who was killed at work. It covers the cost of the funeral as well as compensates family members. The monetary compensation is calculated as a percentage of the deceased worker’s salary.

What Is Not Covered by Worker’s Compensation?

Some work injuries not covered by workers’ compensation are:

  • An injury due to intoxication or illegal drug use.
  • A self-inflicted injury (e.g. a fight at work).
  • An injury obtained while committing a crime (e.g. stealing goods from the warehouse).
  • An injury caused by violating company policy (e.g. not getting the necessary hours of sleep for a trucker driver).

You’re Hurt on the Job, Now What?

When you are injured at work, you need to report the injury to your employer promptly. Many do not report the injury at all because they fear their boss and co-workers will harass them. This type of harassment is illegal. Claims can be denied, especially if you waited too long to file. The approval of your claim depends on:

  • the kind of illness or injury;
  • following the procedures when an accident occurs (i.e. notifying your employer);
  • filling out the documentation correctly;
  • complying with all additional requests for information;
  • attending all of the mandated doctor’s visits; and
  • proving the injury was work related, or dangerous chemicals and substances caused the illness.

Worker’s Compensation doesn’t cover all Workers

There is a group of workers that are not covered by the state-run worker’s compensation insurance program. They are covered under the federal labor laws. These occupations include farmers, coal miners, longshoremen, nuclear energy workers, dock workers and those who work at sea.

Also, some states are not required to have workers’ compensation.

Pennsylvania and New Jersey are required by law to have workers’ compensation insurance. You can learn the latest information on worker’s compensation by state by checking out the State Workers Compensation Office, here is a link to Pennsylvania’s Department of Labor and Industry.

No one wants to get a work injury, yet they happen due to a co-worker’s carelessness or a product defect. Time is important not only for getting treatment but for filing a claim to ensure you get the benefits you readily deserve. And you can receive workers’ compensation if the injury was your fault.


Contact Brett Tessler Forthwith

Need Help?

Brett Tessler & Associates can help you with your worker’s compensation case. If you have eligibility questions or if your employer is disputing your claim, be sure to consult with a workers’ compensation attorney near you. If you would like to speak to one of our highly qualified lawyers for a free consultation, contact us 215-569-9005.