Eligibility to Make a Claim for Worker’s Compensation

One of the most common misconceptions regarding worker’s compensation claims is that it is a lawsuit brought against the employer. However, worker’s comp is in place to avoid this, giving injured employees the opportunity to receive the financial support they need to recover and restore their quality of life regardless of who was at fault. Knowing the basic eligibility requirements is the first step in determining if a worker can pursue a compensation claim. There are three common eligibility criteria that claimants must meet:

The Employer Must Carry Worker’s Compensation Insurance

To qualify for worker’s compensation benefits, the organization or person whom an employee works for must have current worker’s compensation insurance. The exception to this would be if the employer is legally required to have coverage, but has chosen not to do so. Staff size, geographical location, and the nature of the business are all factors that determine whether a company must carry worker’s compensation insurance by law.

The Injured Party Must Be an Active Employee

There are some instances wherein a worker may not necessarily be considered, by law, to be an employee. Independent contractors are one such example. They are not employed by the company, but work on a freelance basis. To be eligible for worker’s compensation, the injured individual must be a current employee who is not working as a volunteer or contractor. Two other instances where employees are not eligible for worker’s comp benefits are interstate railroad workers and crewmembers on vessels. If injured on the job, federal law requires these employees to sue their employer instead of collecting worker’s comp.

The Injury or Illness Must Have Occurred on the Job or Be Work-related

Generally, the injury must have taken place while an employee was at work or carrying out a job-related task that benefits the employer. For example, driving a company vehicle at the behest of the employer may qualify as work related duty. Repetitive motions injuries, exposure to hazardous materials, and slip and fall accidents are also examples of injuries that may fall under the purview of worker’s compensation insurance.

Certain employee groups, such as farm workers, domestic employees, and seasonal workers, may not qualify for worker’s compensation under any circumstances. Injured employees who believe they have been unjustly placed into one of these exempt statuses can speak with a qualified attorney to determine if they may still be eligible to receive benefits.