The Eligibility Criteria to Apply for Workers’ Compensation

By Oscarjack 4 Min Read

The eligibility of your workers’ compensation claim is contingent on several key factors. Most worker’s compensation claims are simple and can be resolved through arbitration between the parties involved.

However, the case’s complications can sometimes increase, leading to the need for proper court hearings and legal processes. During this hearing, a specialized judge will hear your case and review all the evidence to deny or award you the compensation you seek. Since there are specific rules about a worker’s compensation case you must be properly prepared for the hearing by hiring a workers’ compensation lawyer.

In this article, we will run you through the eligibility criteria for a worker’s compensation hearing and how you can prepare for one. By familiarizing yourself with these fundamental requirements and special considerations, you can confidently and clearly navigate the workers’ compensation landscape.

Employee Status:

You can only avail worker’s compensation if you are registered as an employee. Independent contractors, such as freelancers or gig economy workers, typically do not fall under this category. Misclassification disputes, often arising in ride-hailing services, underscore the importance of accurately determining your employment status.
Despite signing a 1099 tax form, you might still be deemed an employee for workers’ compensation purposes. Courts generally assess the level of control exerted by the employer over your work and the details of your working relationship to make this determination.

Volunteers, excluding specific exceptions like volunteer firefighters, are generally not entitled to workers’ compensation benefits. However, some states provide organizations with the option to cover their volunteers under workers’ compensation.

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Employer Workers’ Compensation Coverage:

You can be eligible for worker’s compensation benefits if your employer carries workers’ compensation coverage, as mandated by state laws. Most employers must provide coverage however, there may be exceptions depending on factors like employee counts type of business, or the nature of work performed.
Employers voluntarily purchase worker’s compensation insurance so that their employees may access benefits without needing to go through court proceedings against their employers to receive them.

Work-Related Injuries or Illnesses:

Eligibility for worker’s compensation benefits depends upon having experienced an occupational-related injury or illness while performing tasks for your employer, including any injuries sustained while doing tasks for them that qualify as work-related and are eligible for workers’ comp benefits.

Example scenarios could include injuries sustained while performing work-related activities, like loading boxes; developing illness while performing tasks related to their work such as typing; or becoming sick due to working conditions.

Determining the nature of injuries sustained at work may become more complex in certain scenarios, such as lunch breaks, company-sponsored social events, and informal interactions among colleagues.

After an accident occurs, you must collect paystubs to track any lost wages or calculate worker’s compensation benefits you are due.

Conclusion

Now that you understand the eligibility requirements for worker’s compensation benefits, it’s important to keep in mind that even after fulfilling all criteria, your claim could still be denied. In these instances, hiring an experienced workers’ compensation attorney could ensure you receive adequate compensation for losses suffered during an injury incident.

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