Who Is Eligible for Workers’ Comp?

Workers’ compensation is a valuable resource that is available to most workers who have been injured on the job. However, one of the most frustrating challenges that many workers face when applying for workers’ compensation is determining eligibility.

Below are the general guidelines you’ll need to meet to ensure that you meet these eligibility requirements and that you’re able to receive these benefits without issue. If you have additional questions about workers’ compensation or if you’re facing pushback from insurance companies or the Workers’ Compensation Board regarding your eligibility, we encourage you to contact Pond Lehocky for a free consultation to review your options.

What Is Workers’ Compensation?

Workers’ compensation is a resource provided to most workers that primarily offers financial compensation to address workplace injuries. At minimum, this entails compensation for medical bills, treatment, medication, and rehabilitation. But beyond this, workers who successfully apply may also be entitled to additional compensation for:

• A portion of their wages, if they are unable to work for an extended period of time due to their injury
• Disability benefits and vocational rehabilitation to those who are unable to work in the same capacity as their former job
• Funeral and burial expenses on behalf of the family in the event of a tragic workplace death

General Workers’ Compensation Eligibility Requirements

The primary eligibility requirements to receive workers’ comp require that applicants are employees (not contract workers), and that they were injured on the job while performing duties that are typical of their position.

Who Is Typically Covered by Workers’ Comp?

While workers’ compensation is available to most types of workers, there are exceptions. Below are a few examples of the types of workers that may or may not be eligible for workers’ compensation depending on their occupational status and role. Keep in mind, however, that these guidelines may differ from state to state.

Part-Time Employees

The same eligibility requirements generally apply to both part-time workers and full-time workers. However, depending on the state, there may be additional paperwork that you’re required to file to apply. It’s also worth noting that if your goal is to acquire wage replacement as part of your benefits, this is generally calculated based on how many hours per week you were working and your hourly rate on the day you were injured. 

Temporary and Seasonal Workers

In general, most seasonal and temporary workers are eligible for workers’ comp, but again, it can differ from state to state. For example, in some states, employers are only required to provide workers’ compensation insurance if they employ a certain number of people, while other states don’t enforce any additional stipulations.

Federal Employees

Most federal employees are eligible for workers’ compensation; however, there are slightly different guidelines for filing. Instead of submitting paperwork to the state workers’ compensation board (as most employees do), federal employees must apply for workers’ compensation through the U.S. Department of Labor’s Office of Workers’ Compensation Programs (OWCP).

Additionally, some types of federal occupations (such as railroad employees and certain coal miners) may be disqualified from filing. However, instead, these groups may be able to file a personal injury suit to receive compensation for their injuries.

Who Is Not Covered by Workers’ Comp?

One of the primary requirements for receiving workers’ compensation is employee status. If you are not categorized as an employee, you will generally not be eligible to apply. Below are the types of workers that will likely not be covered by workers’ compensation; however, they may be eligible to pursue other options.

Independent Contractors and Freelancers

Independent contractors and freelancers (who file taxes under a 1099) are not considered employees and are therefore not entitled to workers’ compensation. Independent contractors and freelancers generally maintain their health insurance to address any workplace injuries that occur on the job; however, if their injury resulted from the negligence of their client or another worker, they may be able to pursue damages through a personal injury claim.

Volunteers

Volunteers, who are not paid employees, are typically not eligible for workers’ compensation, but some states make exceptions depending on their specific role. There are also exceptions when it comes to federal volunteers, such as members of the Peace Corps or AmeriCorps. If you do not fall into this category, there may be additional options available through the organization you volunteer with or through a personal injury claim.

Agricultural or Domestic Workers

You may be surprised to learn that most states do not offer full workers’ compensation benefits to agricultural workers, an occupation that sees a large number of occupational injuries and diseases every year. There are currently only fourteen states that offer full coverage to agricultural workers. Other states may offer limited benefits, depending on the number of workers employed. 

The same alternatives mentioned apply here as well; if you are a farm worker who is not eligible for workers’ compensation, you may still be able to pursue compensation for your injuries through a personal injury claim.

Can You Get Workers’ Compensation if You Work Remote?

The same eligibility requirements that apply to in-person employees also typically apply to remote workers. If you’re considered an employee (and not a contract worker or freelancer), and you suffer an injury while working, you are likely still eligible for workers’ comp. However, you may have additional filing requirements depending on your state’s laws or if you work in a different state than your employer.

Can You Get Workers’ Compensation if You Have a Pre-Existing Condition?

Generally, yes, but it can complicate things. If the pre-existing condition is unrelated to the injury you sustain at work, there should be no issue. But in cases where the pre-existing condition contributed to the second injury, or was made worse by the second injury, the insurance company assigned to your case may try to deny or reduce your benefits, even if they have no right to do so. 

This is why it’s always good to consult with a workers’ compensation lawyer immediately after you’ve notified your employer of your injury, as they will be able to determine if you are still eligible and can communicate with both the insurance company and your employer on your behalf, and advocate for your rights.

Talk to a Workers’ Compensation Attorney if You’re Having Trouble Getting Benefits

While most employees are eligible for workers’ compensation, the system is often complicated, and there are unfortunately many things that can go wrong throughout the filing process. If you’re facing resistance from your employer, the workers’ compensation board, or the insurance company assigned to your case, contact Pond Lehocky for a free consultation to confirm your eligibility. Our workers’ compensation attorneys have over 250 years of combined experience and have offered assistance in workers’ compensation cases for over 15 years.