Workers’ Compensation
Workers’ compensation is a state program whose rules vary substantially by state. The basic structure of these programs guarantees compensation for work- related injuries and illness without the need to prove fault on the employer’s part. The amount of compensation is fixed for each injury, and the employee has a very limited right to sue the employer for additional compensation. Because this compensation is much lower than the employee might recover in the courts, workers’ compensation laws are often criticized for not creating a sufficient incentive to protect workers. The courts have allowed this limitation of liability because all injured workers receive medical care and some compensation. In contrast, private civil litigation is generally not available.
All physicians who treat work- related injuries and illnesses should understand their state workers’ compensation system. Failing to comply with reporting requirements and claims filing procedures can deny the patient needed care and delay payment of physician charges. Physicians should be prepared to provide reports to workers’ compensation hearing examiners. They should also realize that workers’ compensation laws have not eliminated litigation over workplace injuries. Employees must still litigate whether their injury was workplace related and the extent of their incapacitation. Physicians should contact the agency that regulates workers’ compensation in their state for specific information about complying with its claims procedures.