Workers' Compensation: Injuries up and payouts down - hmm, something doesn't sound right.

Megan Roth

Contributor

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Middle of the night and I’m wide-awake – go figure. I was just surfing the internet when, at random, an article popped up that grabbed my interest.

“Construction Up, Injuries Up but Workers’ Comp Payouts Down” couldn’t have appeared at a more fitting time, especially considering I just posted an introductory article to this topic on Thursday.

Basically, the article provides an example of a specific claim that was not eligible for workers’ compensation and continues on with an overview of Florida’s construction-related injuries and the drastically decreased rates at which they’ve actually compensated the injured parties.

Reading the article, I couldn’t help but wonder, “Is this just a Florida situation or does it occur across the board?”

Turns out this ordeal occurs frequently in Florida due to revisions (in 2003) to their state workers’ comp law. Unfortunately, however, this doesn’t mean it’s solely limited to Florida (far from it).

Workers’ compensation is offered to workers who are injured on the job as a means of preventing a lawsuit by said employee against employer. It’s almost always the employers’ responsibility to make sure such a policy, which is generally arranged through insurance companies, is in place. As with all insurance policies, the employer pays the premium and the insurance company is expected to evaluate and fork over the dough in the event that a claim occurs.

In reality, however, such policies generally aren’t so cut-and-dry. Workers’ comp claims are often questioned and investigated to extremes, which is easy for me to understand (considering the large amounts of money at risk).

What I fail to understand, however, is how cases involving employees who sustain injuries on the job are often bypassed completely; under workers’ comp laws, those employees are entitled to this monetary benefit. Yet, many don’t receive it (even those who do often receive only enough to make up for a small portion of work-time lost).

It’s important to know this is the only aspect of expenses workers’ comp is expected to cover – the worker should not expect to receive compensation for physical or emotional pain and suffering as the basis for such policies are to avoid suits seeking such coverage.

Yet, gone are the days when a worker can state: “In the event I am injured on the job, I will receive compensation for the time for which I am unable to work.”

Though such policies are in place, their implementation doesn’t seem to be. Thus, it’s sometimes necessary for an injured employee to seek outside legal representation in an attempt to claim the compensation to which they are entitled.

Depending on the circumstances, the plaintiff may actually be entitled to damages for pain and suffering (assuming they are able to prove negligence on the part of a third party).

Regardless of how such cases are determined, they never paint a pretty picture of the insurance company, the employer or the policy itself. However, when it comes right down to it it’s a dog-eat-dog world and sometimes it’s necessary to fight for that which you’re entitled.