Workers? compensation insurance allows an employee to collect damages from an employer following an on-the-job injury or illness, without the need for a lengthy and potentially messy lawsuit. By relinquishing the ability to sue an employer for negligence, an injured employee is guaranteed wage replacement and medical benefits after suffering injury and/or death in the course of employment.
Workers? compensation is administered on a state-by-state basis.? Each state requires employers to provide some form of workers? compensation insurance to their employees; however, a number of exemptions exist that could potentially leave certain employees without coverage, but still free to sue their employers if they can be held liable for negligence.? Some of these exceptions are explored here.
EXCLUDED INJURIES
While exact laws vary by state, workers? compensation insurers are not required to compensate any injury which fits the following criteria:
??The injury occurred while the employee was intoxicated (either by drugs or alcohol, but not those prescribed by a doctor)
??The injury arose out of a willful attempt by the employee to cause harm to himself or another person
??The injury resulted from the actions of a third party who injures the employee for personal reasons (in this case, the person who caused the injury would be held liable, not the employer)
??The injury was caused by a peril, disease, or act of nature to which the general public is also exposed
??The injury occurred outside the scope of the employee?s job-related duties
EXCLUDED OCCUPATIONS
While exceptions apply in certain states, the following types of occupations are usually ineligible for workers? compensation coverage:
??Farm and agricultural workers
??Volunteer workers
??Employees of charitable organizations
??Domestic employees
??Casual laborers
??Newspaper vendors
Employers are still permitted to provide workers? compensation insurance to these types of employees by adding a voluntary compensation endorsement to a workers? compensation policy. As the name suggests, employers are free to add this endorsement at their own discretions, but they are not required to do so by law.
FEDERAL EXCEPTIONS
In addition, certain occupations are covered by federal workers? compensation laws, meaning any state workers? compensation laws do not apply. Examples of these occupations include:
??Postal workers ? covered by the Federal Employer Liability Act (FELA)
??Railroad workers ? also covered by FELA
??Longshoremen and harbor workers ? covered by the Longshore and Harbor Workers? Compensation Act (LHWCA)
??Sailors ? covered by the Merchant Marine Act of 1920 (also known as the Jones Act)
??Offshore oil rig workers ? covered by the Outer Continental Shelf Lands Act (OCSLA)
??Anyone who works on an overseas military base ? covered by the Defense Base Act (DBA)
Employees who engage in these occupations do, in fact, have workers? compensation coverage; however, they still represent an exception to the normal system of employer-provided workers? compensation insurance under the jurisdiction of state laws.
An employee whose occupation or injury falls under one of these exclusions is not automatically prohibited from seeking restitution if injured while at work. As previously stated, workers? compensation insurance is provided to employees in exchange for their right to sue their employers for negligence; when no such arrangement exists, employees are free to file suit. However, lawsuits related to excluded injuries under workers? compensation (except when caused by third parties for personal reasons) rarely hold up in court.
Ultimately, workers? compensation is a complex subject, as laws can vary greatly depending on the state(s) in which the employer is located and the employees regularly work. For more information about workers? compensation insurance in a particular state, it is recommended to visit the state insurance department in question.
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About The Author: Nathan Rothwell serves as the lead instructor and subject matter for Insurance License Express, a division of Express Schools, LLC. Since 1996, Express Schools has offered online insurance licensing courses and online real estate courses, as well as online real estate exam prep and insurance license exam prep.
Tags: damages, employees, employer, exemptions, Insurance, payment, provide, workers compensation
Source: http://www.insurancelicenseexpress.com/blog/index.php/the-many-exceptions-to-workers-compensation/
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