What is Considered a Work Injury?
A work injury that you can pursue payment for through a worker’s compensation claim needs to occur on the job and within the scope of an employee’s duties. Severe injuries suffered intentionally, while intoxicated, or due to the foregoing of mandatory safety equipment are usually exempt from coverage.
The good news is that workers comp is available to injured employees regardless of fault in pretty much any other case. Negligence is not a deciding factor like in car accident lawsuit or slip and fall. You are afforded coverage for things like medical bills, lost wages, and disability benefits through workers comp but this comes at the expense of employer immunity from lawsuits over the injury.
When You Can File a Workers’ Compensation Lawsuit
In order to file a lawsuit over a workplace injury you would have to either sue a third party, you would sue over an injury intentionally caused by an employer, you could sue an employer if they impeded your ability to seek workers’ compensation benefits by doing something like failing to report your claim to the insurance company, or you could sue your employer if they do not have any workers’ comp insurance to provide.
The workers’ comp system is streamlined this way so that employees can get the coverage they need while employers and the courts are spared many lawsuits. this does not mean that workers’ compensation claims can always be filed without issue.
Many workers make mistakes that prevent them from collecting compensation that could pay for their workplace damages. Here are the top five mistakes people make after suffering a work injury and their subsequent workers’ compensation case.
#1: Not Reporting Your Job Injury in a Timely Manner
The most common mistake is not reporting your accident to your employer immediately. In the state of Florida, worker’s compensation laws require that an injured employee report any accident involving injury within 30 days to their employer or supervisor. If the injury is the result of an occupational disease, the employee has 90 days from the first sign of illness.
While some exceptions exist, it isn’t worth suffering the injury and having to fight for compensation and defend your delayed report. Given the large number of claims that arise at the workplace, employers are already suspicious of any work-related injury claim. By waiting longer than you should to report your injury, you risk having your injury’s integrity called into question.
Don’t think that reporting your job injury will immediately get you fired, or that you might feel better in the morning. Even if an accident seems minor, reporting it immediately will help in the event that your condition worsens over time. It also can help with the claims process, as you can have a paper trail for the timeline of your injury.
#2: Not Disclosing Any Previous Workplace Injuries
The second most common mistake made by injured workers is failing to disclose any previous work injuries. Even if the previous accident seemed minor or you didn’t report the previous injury out of concern for losing your job, any failure to report a past incident could result in losing your compensation completely.
In fact, if you don’t file a report on previous injuries, it can be considered fraud. In cases of this nature, it’s entirely possible to not only lose your compensation, but you may even face repayment of worker’s compensation finances already received.
When it comes to filling out medical history forms for a doctor’s visit or speaking with an insurance adjuster or case manager, be transparent about any history of being hurt on the job. This obligation exists even when disclosing information regarding a condition that had nothing to do with your previous injury.
The employer’s insurance company will use this information against your claim by saying that your injury was a pre-existing condition rather than the result of the current work injury. This is referred to as a major contributing cause (MCC), and it is a common objection. However, arguing about an MCC and whether or not it was work-related is much easier than fighting worker’s compensation fraud.
What is Major Contributing Cause?
According to Florida Statute 440.09, a major contributing cause refers to a cause that is considered responsible for at least 50% of the damages. In the context of a worker’s comp claim, an employer is liable to pay for the damages of a workplace injury if their negligence is the major contributing cause of the injury.
There are likely many different causes for an injury, as many facets can go into how an injury occurs. However, you can file a worker’s comp claim with them if they have contributed over half of the blame for the workplace injury. For you to receive compensation, your worker’s compensation lawyer must prove your employer’s negligence was the major contributing cause by providing substantial evidence.