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When does an injury qualify for workers’ compensation?

When injuries or illnesses occur because of an occupation, the grievance may qualify for workers’ compensation.

Workplace accidents can take place in construction zones, offices, schools and factories across New York. According to the Bureau of Labor Statistics, there were about 2.9 million nonfatal accidents and illnesses that occurred at or because of work across the United States in 2015. Many of these injured workers likely qualified for workers’ compensation, which is an insurance that provides medical care, and in some cases, cash benefits.

When injuries take place at work

A wound likely qualifies for workers’ compensation when it takes place at work. For example, if an employee’s back goes out while he or she is carrying a bundle of shingles on a construction site, the benefits from this insurance may help cover lost time at work and medical bills. However, if the injuries took place while the employee was working on his or her own roof, the grievance would not be covered.

A person’s fault does not impact whether the accident is covered or not. If the employer did not provide the proper personal safety equipment, and that lapse led to the employee being wounded, the employee would not qualify for any more benefits than if he or she had misused the provided safety equipment. There are exceptions to the no-fault rule, however. If the employee intended to hurt him- or herself, or was intoxicated while on the job, the injury may not qualify for benefits.

When illnesses develop because of the occupation

Some diseases may also be work-related. A worker at an industrial factory may be subjected to loud noises on a daily basis. Those loud noises could result in occupational hearing loss, and may qualify for workers’ compensation. An illness does not have to lead to lost time from work to qualify for this coverage.

When workers are covered

Not all workers have to be covered by workers’ compensation. Many volunteers, independent contractors and clergy members, for example, may not receive benefits from this insurance. An employer has to provide this compensation for many employees, including the following:

  • Domestic workers with 40 or more hours per week
  • Part-time employees at a for-profit organization
  • City or county workers in hazardous conditions
  • Farm workers with a salary of $1200 or more in previous year
  • Public school teachers
  • New York state employees and select volunteers

If an employee who is not covered gets hurt on the job, he or she would not receive any compensation through the insurance.

In New York, most employees are covered by workers’ compensation. If an injury takes place, or an illness is developed at or because of work, it may be beneficial to talk with a knowledgeable attorney to learn more about the role workers’ compensation may play.