Most people know that you may be eligible for workers’ compensation benefits if you’re hurt on the job. But, understanding the scope of what is and is not covered by workers’ compensation may be a bit more complicated. In terms of the type of illness or injury, coverage is broad. For instance, workers’ compensation may cover:
- Sudden injuries, such as a fall, being struck with an object, or getting caught in machinery
- Injuries sustained over time, such as carpal tunnel syndrome and other repetitive stress injuries
- Occupational illnesses, such as cancer resulting from exposure to chemicals or other harmful substances on the job
In Florida, workers who are diagnosed with occupational illnesses are only eligible for workers’ compensation benefits if there is a special risk associated with their job.
What is an On-the-Job Injury?
The key determining factor in whether an injury is covered by Florida workers’ compensation is whether the injury occurred in the course of employment. Most injuries that occur at work during work hours are covered by workers’ compensation, but that’s not a sure thing. For example, an employee who was walking from one floor to another in the employer’s office building to travel from their desk to a meeting in the conference room and slipped on the stairs would almost certainly be found to have been injured in the course of employment. The employee was carrying out the employer’s business at the time of the injury.
However, if that same employee decided to run the stairs for exercise on their lunch break and slipped on the stairs and suffered the exact same injury, the employer and workers’ compensation carrier would likely argue that the injury was outside the scope of work–probably successfully. The employee was on their own time when the injury happened, even though they were still on the premises and in the middle of the work day. And, the employee wasn’t carrying out tasks related to the employer’s business during the lunchtime workout.
Similarly, an employee who is injured while coming and going to and from work generally won’t be eligible for workers’ compensation coverage. But, there is an exception if the employee was on the employer’s premises when the accident occurred and certain other conditions are met.
For example, an employee who is crossing the street in front of the office building where they work on the way in to start the work day and trips generally won’t be covered because the injury occurred while coming and going and they were not on the employer’s premises. However, if the same employee suffered the same injury in the same way while crossing the employer-owner parking lot on the way into the building, the injury might be covered by workers’ comp.
As you can see, it is not always immediately clear whether or not an injury qualifies for workers’ compensation coverage. Most employers aren’t experts in workers’ compensation law. And, some will even misrepresent the situation to avoid claims. So, don’t take your employers’ word that an injury won’t be covered by workers’ compensation. If the employer won’t file a claim or your claim is denied, your next step should be to consult an experienced Florida workers’ compensation attorney.
The Most Common Workers’ Compensation Claims
The U.S. Bureau of Labor Statistics (BLS) provides data on the types of injuries that cause employees to lose work time. In 2020, some of the most common injuries requiring days away from work included:
- Sprains, strains and tears (266,530 injuries)
- Fractures (74,610 injuries)
- Bruises and contusions (68,990)
- Cuts, lacerations and punctures (59,430 injuries)
- Multiple traumatic injuries in one event (20,140 injuries)
- Burns (15,380 injuries)
- Thermal (heat) burns (11,840 injuries)
- Chemical burns (3,540 injuries)
Just as on-the-job injuries can happen in many different ways, any part of the body may be affected by a work injury. But, some are more common than others. In 2020, the body part injuries that most often required time away from work included:
- Body systems (405,590)
- Upper extremities (246,910, with hand and shoulder injuries being most common)
- Lower extremities (192,340, with knee injuries being most common)
- Trunk (175,970, including 128,220 back injuries)
- Head (68,170, including 15,730 eye injuries)
There were also more than 68,000 injuries involving multiple body parts.
Ordinarily, there are more than 100,000 employer-reported occupational illnesses each year. In 2020 that number skyrocketed to more than 540,000. The increase was largely attributable to a dramatic increase in reported respiratory illnesses during the Covid-19 pandemic. In 2020, the rate of reported respiratory illnesses among workers increased from 1.1 per 10,000 full-time or full-time equivalent workers (FTE) to 44 per 10,000 FTE.
When to Consult a Workers’ Compensation Lawyer
The workers’ compensation system is designed in part to give workers easier access to medical care and replacement income after a work injury. But, employers and workers’ compensation carriers can make mistakes. And, sometimes they don’t play fair.
You should seriously consider consulting an experienced Florida workers’ comp attorney if:
- Your claim involves an occupational illness–these claims tend to be more difficult to prove and employers and carriers often fight them
- Your claim is being unnecessarily and unreasonably delayed
- Your employer or carrier tells you that your injury isn’t eligible for workers’ compensation coverage
- Your claim is denied
- Your claim is approved, but your benefits are less than you believe they should be
- You’ve been offered a lump sum settlement–this type of settlement can be to your benefit, but there are pitfalls and you could lose out on compensation
At Harrell & Harrell, we help injured people and people who are unable to work due to illness or injury secure the compensation and benefits they need. We know how stressful it can be when an employer or insurance carrier is standing between you and the coverage you need to take care of your health, pay your bills, and provide for yourself and your family.
If you’re having issues with your workers’ compensation claim, don’t hesitate to reach out and get the help you need. Reliable information and knowledgeable guidance can make all the difference.
Here at Harrell & Harrell, our highly qualified personal injury attorneys specialize in worker’ compensation claims and it’s completely free to talk to us. Call 904-251-1111 right now to schedule your no-obligation consultation.