Most are familiar with the workers’ compensation system. You suffer an injury on the job that prevents you from working and your employer’s workers’ compensation insurance pays for your medical bills and a portion of your wages until you can recover. Despite the theoretical simplicity of this program, in practice, it is quite a bit more complicated. The finer points of law in the workers’ compensation system give rise to a number of myths that can have harmful effects, especially if they prevent injured workers from taking advantage of the program. Our Suffolk County workers’ compensation lawyers have heard quite a few of these myths over the years, and we want to correct the record.
Myth #1: You Can’t Get Workers’ Compensation if You Were at Fault for Your Injury
This is (almost entirely) untrue. Unlike traditional tort law (i.e., personal injury claims), the workers’ compensation system is a no-fault system. That means that you are entitled to workers’ compensation benefits even if you were mostly or even entirely at fault for your accident. There are only a few situations in which you may not be entitled to workers’ compensation benefits, such as:
- You intentionally injured yourself
- You were under the influence of alcohol or drugs and your intoxication was the sole cause of your accident
- You were injured in a fight that you started
- You were injured during the commission of a crime for which you were convicted
The no-fault scheme comes at a price, however. In exchange for being able to collect workers’ compensation benefits even if you were at fault for your accident, you give up your right to sue your employer for damages. But even with that limitation, workers’ compensation overall is a good deal for workers. While you may be able to obtain more money in a personal injury suit, you would also risk obtaining nothing if you did not successfully prove fault on the part of your employer. And without the worker’s compensation program, the court system would be overwhelmed with employer/employee personal injury suits, which would significantly delay the administration of justice.
Myth #2: You Can Only Get Workers’ Compensation for Injuries that Occur at Work
There is some truth to this claim. The workers’ compensation program is indeed limited to accidents and injuries that are work-related. However, such accidents or injuries do not necessarily have to occur on the premises of your workplace. The key inquiry is whether the accident occurred “within the scope” of the worker’s employment, not whether it occurred at a specific location. Some examples of off-site injuries that could nonetheless be considered work-related include injuries sustained while:
- Running an errand at your employer’s request
- Work-related travel (truck drivers, traveling salesmen, construction site managers, etc.)
- Working at a client’s property
- Attending an employer-required event off the premises
- Attending an off-site meeting
- Driving a company car
- Taking a business trip
It’s not always clear whether a particular injury is work-related, and reasonable minds may differ. If you are not sure whether your accident or injury is work-related, consider speaking to our Suffolk County and Nassau County workers compensation lawyers who can help you identify the relevant facts and build your case.
Myth #3: You Can Only Get Workers’ Compensation on Long Island if You Are Injured While You Are Actually Working
As mentioned above, workers’ compensation benefits are available for work-related injuries. But the term “work-related” encompasses much more than merely actively performing your job duties. You are generally eligible for workers’ compensation benefits if the injury occurs while you are working or engaged in incidental, non-work activities. For example, if you slip and fall in the bathroom while on a bathroom break, that injury would be considered work-related even though you weren’t actually performing work duties at the time. Commuting, however, is not considered work-related. Individuals injured while commuting to and from work are not eligible for workers’ compensation benefits in the vast majority of cases.
Myth #4: You Can Be Fired for Filing for Workers’ Compensation
It is illegal to fire or otherwise retaliates against an employee merely because he or she filed a workers’ compensation claim, as well as firing or retaliating against an employee who testifies as a witness in someone else’s workers’ compensation claim. Retaliation could take the form of a demotion, pay decrease, assignment to less desirable work duties, harassment, etc. These types of actions are considered to be discrimination and could give rise to a claim for wrongful termination.
Myth #5: Workers’ Compensation Covers all of Your Work Injury-Related Losses
The workers’ compensation program provides generous medical benefits and a portion of the workers’ wages in cash benefits, but it does not cover all work injury-related benefits. While there is generally no cap on the amount of medical benefits a claimant may receive, cash benefits are capped at ⅔ of the worker’s average weekly wage multiplied by the percent he or she is disabled. It also does not cover all of the types of losses that would otherwise be available in a traditional personal injury lawsuit, including:
- Pain and suffering
- Loss of consortium
- Loss of enjoyment of life
Also, keep in mind that there are strict deadlines by which you must file a workers’ compensation claim after your accident. Failure to do so may result in forfeiture of your eligibility to collect workers’ compensation benefits.
Myth #6: You Have to See the Doctor Your Employer Wants You to See
Some states require workers to see a doctor of their employer’s choosing, but that is not the case in New York. Injured workers in New York can generally see any doctor they wish who is authorized to treat injured workers by the New York Workers’ Compensation Board. However, if your employer’s workers’ compensation insurance carrier has a preferred provider organization (PPO), you will need to select a doctor within that organization within the first 30 days of your accident. After 30 days, you may see any Board-authorized doctor.
More Questions? Talk to Our Long Island Workers’ Compensation Lawyers
For more information about any topic presented herein, please contact the Long Island worker’s compensation lawyers at Turley, Redmond, Rosasco & Rosasco by using our online form or calling any of our Suffolk County locations: 631-582-3700 (Ronkonkoma) or 631-399-0400 (Shirley/Riverhead).