Workman's Comp is a benefit system that was established decades ago to safeguard workers in the event they became hurt on the job. Fundamentally, the system works like this: when a worker becomes injured, rather than sue their employer (which around the turn of the century was the only option available to an injured worker), an employee can file a claim that provides for the following:
1. Protection of the worker's job (an employer cannot fire an employee simply because they are injured)
2. Continuation of the worker's pay while the worker is injured.
3. Payment of medical expenses (usually including the cost of emergency care, necessary surgery, and rehabilitative services).
Workman's comp essentially relies on the concept of employer liability for job injuries and work related illness but with no fault. In other words, the way the workman's comp system is setup (regardless of the state in which a worker lives), the benefits flow in two ways.
On the one hand, an employer will provide an injured or sick worker certain benefits that are normally covered under workers comp (which normally includes medical care, payment of a certain percentage of a worker's wages, and, in many cases, the continuation of certain benefits); on the other hand, the employer will not normally face litigation for work related injuries or illness.
In many unfortunate situations where a workplace accident or injury has occurred, workman's comp can ideally provide an injured worker with necessary medical care and replacement income during the time for which the worker is unable to work. However, not all situations are ideal. In such instances, a worker may have difficulty with an employer or the employer's insurance carrier (for all intents and purposes, the two entities are, in a workman's comp claim, one and the same). And the rational for this is, sadly enough, fairly clear. Each time an employer's insurance carrier is forced to “payout" on a claim, the cost of the employer's insurance premium rises. In other words, the interests of the employer and the injured worker are sometimes, if not often, at odds.
What should you do when you've been injured on the job and learned that your workman's comp insurance is reluctant to pay? Get a consultation with an attorney who specializes in this type of labor law. Because when an insurance company's financial interests are in opposition to your own, it makes perfect sense to be fully armed, in a legal sense.
The author of this article is Timothy Moore, who, in addition to being a former food stamp caseworker, medicaid caseworker and AFDC caseworker, is a former disability claims examiner. He publishes information at Social Security Disability Tips and Secrets which features a fairly helpful and informative Social Security Disability faq .