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What are the Typical Workers' Compensation Requirements?

By Felicia Dye
Updated May 17, 2024
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Workers’ compensation programs can be very beneficial to those who are injured at work or who develop diseases because of their work. To obtain those benefits, it is generally necessary for an individual to meet numerous workers’ compensation requirements. First and foremost, she needs to be hurt in the course of duty and while in a sober condition. It is also usually required that an individual notify her employer, that she file a claim within a certain time period, and that she visit approved health care providers.

One of the primary workers’ compensation requirements is that a person must be hurt in the course of his occupational duties. A person will usually meet this requirement if he is involved in an incident while he is at his workplace. He may meet this requirement if he is off-site but engaged in tasks required by his position or by his employer. A person can also be eligible for coverage if he develops a disease or condition as a result of his occupation.

To receive benefits, a person is required to prove that the problem she endures is caused by work. For example, an industrial worker who develops lung cancer must prove that his condition resulted from his exposure to chemicals and not from smoking cigarettes. When a case involves an injury that results from an accident, it can be easier to prove the connection. The individual in this case, however, has additional workers’ compensation requirements, which are to prove that she was sober at the time of the incident. Injuries resulting while a person is under the influence of drugs or alcohol generally eliminate the possibility of benefits.

A person who wants workers' compensation is generally required to notify the employer of his condition. The employer should then request him to complete an incident report of some sort. This document will likely be required with the workers' compensation application. An application for benefits must be filed within a certain time frame.

Although the injured employee may have the right to choose her initial health care provider, she is generally limited to choosing from a list that is either provided by her employer or by the workers’ compensation agency. After her initial visit, she will need to strictly adhere to the physician’s orders to meet the workers' compensation requirements. This means that when she is referred to a specific specialist, she will usually be required to allow that individual to serve her. If she is ordered not to work, she must stop working even if it creates financial hardship.

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