Workers' compensation covers most, but not all, on-the-job injuries. The workers' compensation system is designed to provide benefits to injured workers, even if an injury is caused by the employer's or employee's carelessness. But there are some limits. Generally, injuries that happen because an employee is intoxicated or using illegal drugs are not covered by workers' compensation. Coverage may also be denied in situations involving:
- self-inflicted injuries (including those caused by a person who starts a fight)
- injuries suffered while a worker was committing a serious crime
- injuries suffered while an employee was not on the job, and
- injuries suffered when an employee's conduct violated company policy.
In most states, employers are required to purchase insurance for their employees from a workers' compensation insurance company (also called an insurance carrier). In some states, however, very small companies (with fewer than three or four employees) are not required to carry workers' ompensation insurance. In some states, larger companies that are clearly financially stable are allowed to act as their own workers' compensation insurance companies (also called self-insuring).
When a worker is injured, his or her claim is filed with the insurance company or self-insuring employer, which pays medical and disability benefits according to a state-approved formula.
Workers' compensation is a state-mandated insurance program that provides compensation to employees who suffer job-related injuries and illnesses. While the federal government administers a workers' comp program for federal and certain other types of employees, each state has its own laws and programs for workers' compensation. For up-to-date information on workers' comp in your state, contact your state's workers' compensation office. (You can find links to the appropriate office in your state on the State Workers' Compensation Officials page of the U.S. Department of Labor's website.
In general, an employee with a work-related illness or injury can get workers' compensation benefits regardless of who was at fault -- the employee, the employer, a coworker, a customer, or some other third party. In exchange for these guaranteed benefits, employees usually do not have the right to sue the employer in court for damages for those injuries.