WORKERS’ COMPENSATION LAW – CLAIMANTS DEFINITION
Every state has enacted laws to provide benefits to workers injured in the course and scope of their employment. In exchange for giving up the right to sue, an employee’s injury is compensated according to a benefit schedule adopted by the workers’ compensation law. Generally, workers’ compensation laws require a portion of lost wages and medical expenses be paid in a prompt fashion. The purpose behind the legislation is to ensure that injured workers and employers are not required to resort to the civil justice system in order to obtain compensation. Employers are not faced with payment of claims for pain and suffering and possible punitive damages. Employees, on the other hand, are not required to prove negligence and are not precluded from recovering because of the defenses of contributory negligence and/or assumption of the risk. Because the benefits that are available are limited, workers' compensation legislation generally provides for a “no fault” system.
Workers’ compensation laws have been in existence since the beginning of the 20th century. In Pennsylvania, for example, the first Workers’ Compensation Act was enacted in 1915 and required an amendment to the Pennsylvania Constitution.
The Workers’ Compensation laws differ from state to state. Some programs are state run while others require insurance coverage. Some states provide for a specific program of benefits for lost wages and medical coverage. Other states may limit the amount of benefits available based upon a medically determined degree of impairment.
In any event, despite the fact that workers’ compensation laws are “humanitarian” in nature and the benefits are to be readily available to the injured worker, it is imperative that the injured worker consult with an attorney with special expertise in the area of workers’ compensation law. An attorney can assist the employee in insuring that the benefit rate is properly calculated; that appropriate medical treatment is being provided; and the rights of the injured worker are protected. Counsel also will be invaluable in ensuring that workers’ compensation benefits are coordinated with other available benefit programs. For example, workers’ compensation benefits may be received along with Social Security Disability Insurance benefits; in certain circumstances benefits may be available under the injured worker’s automobile insurance policy; workers’ compensation benefits need to be coordinated with unemployment compensation benefits and various non-workers’ compensation programs that are available through the employer or by law.
Despite the laudatory nature of workers’ compensation programs, employers and insurance carriers avail themselves of the legal means by which to reduce benefits that are otherwise payable. As a result, counsel should be retained as soon as possible during the process to ensure the proper payment of benefits and to avoid litigation. Counsel also can be invaluable in negotiating a compromise of the workers’ compensation claim in the appropriate circumstances. With the assistance of an attorney, the injured worker will be able to obtain all available benefits in an effort to maximize recovery. In this manner, the injured worker and the injured worker’s family will be best protected.
John W. McTiernan
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