Are You Eligible For Worker’s Compensation? Here’s How to Know

When a worker gets injured during work, their treatment is covered by their employer. Simple, right? However, the worker’s compensation laws are not as simple as they look. There are many grey areas and loopholes that can be used against the injured employee if the employer doesn’t want to pay for the coverage. 

In most states, to file for worker’s compensation, the injured person has to be eligible according to some criteria. Here are the criteria that will make you eligible for a worker’s compensation in case of a workplace injury; 

The employer must be insured 

If a business is operating with employees, the employer must be insured for worker’s compensation. It is a mandatory law requirement according to a 70-year-old Federal law. As organizations and companies purchase insurance and pay the premiums, the benefits are handled by a private insurance company or the worker’s compensation fund run by the state. 

While joining work, make sure that your employer is insured. If they do not have any insurance for worker’s compensation, beware that there might be more problems in the management of the company. Incase it does occur that your employer isn’t insured, you can still sue them for a worker’s compensation lawsuit. 

However, when your employer is indeed insured and you get into a situation where you should be compensated, make sure that you do not sign any document you don’t understand. If you have already settled with your worker’s compensation, you lose the rights to sue your employer incase the payment you receive is not enough. So, make sure you get your self a catastrophic injury attorney before any dealings. 

The injured worker must be an Employee 

The first criteria to claim a worker’s compensation is that the injured worker must be an employee. The definition of an employee might change based on the state you are in which is why this criteria becomes a bit sticky in the first place. Simply said, one state’s employee might be another state’s contract worker. If you are a contract worker by definition of the employment law in the specific state, chances are you might not be eligible for a worker’s compensation. 

Part time and full time employees of a company become easily eligible for worker’s compensation. But think of a scenario where a worker is working on a construction site under a subcontractor based on a temporary work contract. If the worker gets injured, who will be responsible for the compensation? In such a murky situation, the injured worker might not be eligible for worker’s compensation. However, the most common definition used to decide the status of employment is, if a worker is assigned to work at one specific location for a certain period every day, they qualify as an employee. 

The injury must be work-related 

To be eligible for a worker’s compensation it is more than necessary that your injury is work-related only. The worker’s compensation covers all kinds of accidents at work that leave a worker injured enough to be diagnosed and treated. However, the insurance only covers accidents that are not a result of the employee’s misconduct. 

Illnesses that are caused by the working conditions of your workplace are also covered in the insurance. For example, any kind of disease or allergies that can get triggered by exposure to some specific chemical, Mesothelioma caused by inhaling asbestos, etc. 

However, if you get injured while commuting to work, or when you are out for lunch, you may not be eligible for a worker’s compensation. 

The injury must be reported on time

Always report your injury as soon as possible. And the best way to do so is to do it in writing than just telling verbally. The first deadline for getting worker’s compensation is to report the injury. Many states have 30 days for this reporting. However, some states offer only as little as three days to report the injury and some others even offer a period as long as 2 years. Whatever your state laws mandate, it is always advisable to report as soon as possible, in writing, with the date and location mentioned in it. 

You can then file a claim for worker’s compensation in a specific period offered by your state legal system. If the injured worker isn’t in a condition to do it themselves, family members and dependents can do it for them. 

The injured worker must have attended all necessary medical procedures 

Lastly, and most importantly, it is important to attend the medical procedure after getting injured to be eligible for worker’s compensation. This law is to prevent fraudsters and fakers from taking undue advantage of the system. Skipping your medical procedures can indicate that you are not actually in pain. So, if you want to claim your worker’s compensation, make sure you attend every scheduled appointment with your doctor, physician, or therapist. 


Worker’s compensation claims are a tricky business. Many employers even trick their severely injured employees settle for less than enough money. So, it is important to make sure that if you are in a similar situation, do not rush things while handling legal dealings with your employee. Report your injury as soon as possible and attend your treatment procedure and then count on your attorney to help you with the technical side of it for a better outcome. 

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