What Workers Compensation Covers for Employees

If you’re injured on the job and can’t work, you may be wondering what options you have to recoup your lost wages and cover your medical bills. You may think you have the right to sue your employer, but in most cases, you’ll need to file a workers’ compensation claim.

Workers’ compensation is a no-fault insurance system that gives benefits to employees who are injured while on the job. A workers’ compensation policy can cover a wide range of illnesses and injuries as long as they occurred while on the job and within the scope of employment.

Here are some of the most common illnesses and injuries covered by workers’ compensation.

Occupational Illnesses

Workers’ compensation typically covers illnesses and diseases that employees may develop due to on-the-job exposure. Examples may include:

  • Asbestosis caused by asbestos exposure
  • Black lung disease caused by exposure to coal dust
  • AIDS/HIV contracted when a health worker gets a needle stick

Cases of occupational illnesses are easy to prove when there is a well-established medical link between an occupation and a disease, like in the case of black lung disease.

It can be challenging to prove the work connection when the illness is considered an “ordinary disease of life,” like heart disease or lung cancer. Workers’ compensation may still be available in these cases, but employees must have strong medical evidence that the workplace caused or contributed to the illness.

Overuse and Repetitive Motion Injuries

Overuse and repetitive motion injuries can be painful and debilitating. Repetitive strain or stress injuries (RSIs) can affect a wide range of employees who routinely perform the same physical tasks over and over again.

RSIs can include:

  • Carpal tunnel syndrome
  • Back pain
  • Tendonitis
  • Rotator cuff syndrome
  • Writer’s cramp
  • Ganglion cyst
  • Bursitis

RSIs are typically covered by workers’ compensation, but some states have special restrictions on claims for cumulative trauma. In some cases, employees have to provide greater evidence that the injury is work-related.

Hearing Loss

Employees who work in noisy environments, such as manufacturing plants and construction sites, may suffer hearing loss over time. Workers’ compensation will generally cover hearing loss unless there is an obvious, non-work-related reason for the condition.

Stress-Related Injuries

Stress can lead to a wide range of illnesses, both psychological and physical. Some states will cover stress-related injuries, but many will not.

Generally, states will not recognize claims for physical illnesses caused by emotional stress. For example, heart disease may only be covered if the injury was caused by physical exertion or stress which was extraordinary for the job.

One exception is post-traumatic stress disorder (PTSD). Many states will allow workers’ compensation claims for this condition. Some states will allow for other stress-related psychological conditions as well, but only if they were caused by a sudden, extraordinarily traumatic event in the workplace. This could include a teacher having to deal with a mass school shooting, or a store clerk being held at gunpoint.

The rules are a bit different when employees develop mental or emotional conditions because of work-related physical injuries. Physical injuries can often lead to depression, sleep disorders and anxiety. In this case, these injuries are often considered a “compensable consequence” of the physical injury, and the employee should be able to seek treatment and other benefits for these conditions.

Adam Richards

About Adam Richards

Adam Richards is a semi-retired business professional originally from Bangor, Maine. He spent the majority of his career in sales and marketing where he rose to the marketing lead of a Fortune 1000 company. He then moved on to helping people as a career counselor that specifically helped bring families to self-sufficiency through finding them rewarding careers. He has now returned to Bangor for his retirement and spends his free time writing. This blog will be about everything he learned throughout his career. He'll write on career, workplace, education and technology issues as well as on trends, changes, and advice for the Maine job market and its employers.