Workers Compensation Newsletters
Like an injury, an employee's accidental illness is generally compensable if it is contracted in the course of employment. An "accidental" disease is one known as resulting from an unanticipated or unique exposure. To obtain workers' compensation for an infectious disease, the employee is usually required to show that contraction of the disease was unforeseen and that the exposure and the disease are causally linked through the employee's job. Many state statutes address diseases in relation to workers' compensation with some denying compensation outright for specified illnesses and others allowing compensation only for diseases contracted after an occupational injury.
In order to avoid the effects of the workers' compensation system, some employers will deliberately categorize a person as an individual contractor instead of an employee. Some individuals may even categorize themselves as individual contractors, preferring to reject the compensation system. Whether this categorization is successful, however, turns not just on the name given to the employment relationship. Rather, each relationship is examined on its own facts and will be decided based on the conduct exhibited between the parties as well as the work contract entered into between them.
"Injury From Usual Exertion or Exposure" Concept)
When determining workers' compensation coverage, most states condition benefits on the worker receiving a "personal injury" in the course of his employment. The remainder of states just use "injury." For workers' compensation purposes, a "personal injury" or "injury" includes not only harm to the person from a trauma, such as a cut from a sharp piece of equipment, but also occupational diseases. Further, a "personal injury" can be either a physical or mental condition.
As a general rule, if an injured employee fails to either provide timely notice of his injury or file a timely claim for workers' compensation, he will be denied benefits. However, in some instances, the employer or its insurance carrier may waive the limitations periods. For example, if an employer has actual knowledge of the employee's accident and resulting injury, the employer may be said to have waived formal notice of the injury. Likewise, if the employer voluntarily makes compensation payments to the employer, he may be deemed to have waived the requirement that the employee file a claim.