What is Workers’ Compensation?
Workers’ compensation pays for medical expenses resulting from an industrial injury or occupational disease. Workers’ compensation may also provide monetary benefits to supplement income lost as the result of an injury or occupational disease. Employees do not have to prove negligence on behalf of the employer to receive benefits. Additionally, employers are protected from lawsuits stemming from work related accidents or conditions. If the disability is permanent or results in death, additional benefits may be available to the employee and/or their spouse and/or children. In Washington State, Workers Compensation is governed by Title 51 of the RCW and Title 296 of the Washington Administrative Code.
Filing a claim
Filing a workers’ compensation claim in Washington State involves completing the single page Report of Accident (or Self-Insured Accident Report if your employer is self-insured). In many cases, the physician that initially treats your injury will report the injury to the Department of Labor and Industries. However, it is ultimately the responsibility of the injured worker to report the injury to Labor and Industries. In the event of a catastrophic injury that results in hospitalization, the physician and/or employer are required to report the injury to the department immediately.
Do I qualify?
Employees injured during the course of employment are covered by workers’ compensation. The system is designed to provide benefits to injured workers, even if an injury is caused by the employee’s negligence.
There are some notable exceptions including, but not limited to, when the injury occurs while an employee is on lunch, the worker was injured during the commission of a felony, the employee was deemed to not be injured during the course of employment, or the injury is self-inflicted.
Is there a time limit to file a claim?
Washington State law requires that an injury claim be filed within one year of the date of accident. In the case of an occupational disease, an injured worker has two years from the date of diagnoses to file a claim.
What is the difference between an injury and an occupational disease?
An injury is a sudden and traumatic event producing an immediate result to the worker. An occupational disease is a medical condition that arises naturally and proximately out of employment.
Example: Falling off a ladder and breaking an arm would be an injury. Constant use of a jack hammer resulting in carpal tunnel syndrome may be considered an occupational disease.
Pre-existing conditions that are aggravated by an injury or occupational disease are also covered.
What if my injury was caused by a third-party, such as an auto accident?
Washington State law generally defines a work-related injury to encompass any injury sustained while on the job. This includes errand duties. If an employee is injured in an automobile accident while in the course of employment, they would be entitled to workers’ compensation benefits, regardless of who is at fault for the accident.
If an injury was caused by the negligence of a third-party (someone other than the employer or a coworker), an injured worker may have additional remedies under the law.
Example 1: Someone runs a red light and hits the company truck you are driving while making deliveries for the floral shop, causing you to be injured. You would be eligible for workers’ compensation, and you may have the right to file a suit against the person who caused the auto accident.
Example 2: Equipment owned by another company fails as the result of the manufacturer defect, causing your injury. You would be eligible to file a workers’ compensation claim and may have the right to file suit against the manufacturer.
In the event an injured worker is awarded damages from the suit, the department (or self-insured employer) will have a right to be reimbursed for some, or all, of the benefits they paid. The calculations are often complex, and the advice of an attorney knowledgeable in work-related third-party claims may be necessary.
What if I am injured in a parking lot?
Work related injuries that occur in a parking lot are not normally allowable. However, an exception is made if the employee’s presence in a parking lot is required as part of their job duties.
Example 1: You arrive at 7:50am to start your day at 8:00am and you slip and fall while walking to the building, your injury would likely not be covered because you were not injured during the course of employment.
Example 2: You are assisting a customer to their car and you slip and fall. Any injury resulting from this fall is likely to be allowed because the injury occurred during the course of your employment.
Example 3: You are employed as a parking lot attendant and you are injured while performing your job duties in the parking lot. Your claim for injury is likely to be allowed.