Workers’ compensation is probably something you don’t know a whole lot about, until you or a close friend suffers an on-the-job injury. Then it comes at you all too quickly.
What’s the difference between workers’ compensation and personal injury ? (If the word ‘tort’ makes you think of a tasty pastry, it’s worth your while to click around on that site.) For you, it might be a big difference in terms of the number of zeros in your award.
In Iowa , for example, workers’ compensation claims have scheduled injuries. In other words, forget everything you’ve ever been told about not being able to put a price on your life and health. Simply put, in most instances, your mangled hand is worth a specific dollar amount. Same goes for a leg, a foot, an ear, etc. The doctors provide impairment ratings which are then used to determine the value of one’s permanent condition or, the ratings set the boundaries for the value of the case. The who, what, where, when, and why is irrelevant so long as you injured a specific body part on-the-job. (Assuming no other concurrent or pre-existing injuries or conditions, the chess player and the soccer player may well end up receiving the same amount for loss of use of a foot.) However, for injuries affecting the whole body , such as back, neck, internal, neurological, and mental health to name just a few, the limitations of the scheduled injury analysis I have discussed do not apply, as these injuries are not classified as scheduled. Confused yet?
In Illinois , workers’ compensation injuries are not scheduled as they are in Iowa . In establishing case value, Illinois does not apply the American Medical Association Guides to the Evaluation of Permanent Impairment , including the 5th or 6th Editions. The Illinois system is based on precedent ; that is, compensation for permanent disability is based upon what the Illinois Workers’ Compensation Commission has awarded in the past for similarly situated individuals.
With personal injury claims, on the other hand, specifics are very important. Were you in any way at fault? How much were your medical bills? Can you continue to work? How does the injury affect your personal life? You’re the victim and yet you’re left to prove that you deserve compensation. Doesn’t seem fair, but it’s the way the system works. The best thing you can do is be upfront and honest. It’s up to you to report your injury early and seek legal advice regarding how to proceed.
You’d think that determining what constitutes a workers’ compensation claim would be pretty straightforward. Well, you’d think wrong . The injury must arise out of and in the course of employment . Sounds redundant, doesn’t it? But often Employers escape liability by saying that an employee was technically “on-the-job,” but sustained an injury as a result of behavior not related to the job. In other words, injuries are often deemed to be sustained out of—but not in the course of—employment.
So, what about lunch breaks? As with most questions, the legal answer is “it depends.” A recent New York workers’ compensation case provides an interesting example. Like Illinois , New York Workers’ Compensation law requires that the injury arise both out of and in the course of employment. In this case, a cab driver was parked in a parking lot, eating his lunch, when approached by another motorist for assistance in jumping his car. The cab driver graciously agreed, but the battery exploded as he was securing the jumper cables, resulting in the cab driver losing his left eye. He filed for workers’ compensation….but he was on his lunch break when the injury occurred.
The case ended up in the New York Court of Appeals , which agreed with the employer that meal breaks are generally not compensable. They ruled, however, that this case was an exception. Testimony showed that drivers routinely took 15-20 minute breaks with the express permission of the employer at a location convenient for the employer. Reasoning that the general rule doesn’t apply when the nature of the job dictates the time and place of the meal and the employee is still “on-the-job” at the time the break occurs. Thus, the court determined that the cab driver was injured in the course of employment.
But did his injury really arise out of employment? The New York Court of Appeals determined that if an employee is injured while involved in an activity that benefits the employer, while in the course of employment, then that employee has a workers’ compensation claim. But the cab driver here was just being a Good Samaritan , right? Wrong. The court ruled that, because the cab was clearly marked with the employer’s name, the assistance created a good-will benefit to the employer. In other words, the cab driver was providing free advertisement for the employer.
As you can see, the world of workers’ compensation can be very confusing, but a good attorney can help you navigate through the details. Hopefully, you never have to deal with an on-the-job injury; but this should give you some helpful information to digest on your own lunch break today, just in case.