Geri E. Diaz
Iriarte Camacho Calvo Law Group LLC
Employers are required to obtain workers compensation insurance. This insurance policy provides benefits to employees for injuries and illnesses arising out of and in the course of their employment.
Workers compensation is a no-fault system, so the employee is entitled to workers compensation benefits even if the injury is his fault. For example, if the employee is at work and slips and falls on a banana peel and injures his back, he is entitled to workers compensation benefits even if he should have seen the banana peel on the ground.
However, there are some limits to the employer’s liability. If the work injury is caused solely as a result of the employee’s intoxication, then the employer is not liable for benefits.
The right to workers compensation benefits is the exclusive remedy for an employee when he is injured on the job. Aside from a few exceptions to this rule, an injured employee may not also assert a civil claim against his employer for the work injury.
When an employee is injured on the job, he is entitled to a number of benefits, including medical treatment, payments for loss of time from work and/or payments for permanent disability caused by the injury.
In order to obtain benefits, the employee must notify the employer of the injury as soon as possible. He should also provide notice of the injury in writing within 30 days and file a claim for benefits within one year of the knowledge that his injury was caused by his workplace activities.
Once notice is provided to the employer, the injured employee is entitled to medical treatment to cure or relieve the effects of his industrial injury. Within 20 days of the first treatment, the injured employee’s physician must provide a report of the injury and treatment plan.
When the injured employee is off work obtaining medical treatment and recovering from the industrial injury, he is entitled to temporary total disability benefits if certified by the physician. These benefits are paid to compensate him for his lost wages. In the private sector, the rate of temporary disability benefits is calculated at 66 2/3 of the injured employee’s average weekly wages. If the treating physician reports that the injured employee can return to work under specific work restrictions and the employer is able to accommodate those restrictions, then the right to temporary disability benefits terminates.
An injured employee may also be entitled to permanent disability benefits if he does not fully recover from his work injury. These benefits are paid if he has a lasting disability that affects his activities of daily living. The injured employee’s physician may provide an estimate of the level of permanent disability. However, if the physician fails to do so, then the Workers Compensation Commissioner may require the employee to be examined by a selected physician who will prepare the report. The injured employee’s permanent disability benefits will be based on his level of permanent disability.
An employee generally recovers from his injury faster when he is back into an active lifestyle and is interacting with others. Too often, an employee who is off work for long periods of time tends to experience a negative impact on his physical and mental health and well-being. Therefore, when an employee sustains a work-related injury, the goal is to get him back to work as soon as medically and reasonably possible as it achieves the best outcome for both the employee and the employer.