Workers’ Compensation Matters in Other States

In every state except Texas, employers are required to maintain workers’ compensation insurance for their employees. If an employee is injured at work, they are entitled to compensation regardless of who is at fault.

However, the type of compensation, the amount paid out, and the procedural requirements for workers’ compensation vary from state to state. For example, some states provide additional protections for industries that play a large role in their economy or which are particularly associated with accidents.

There are several types of workers’ compensation benefits, including payments to compensate for missed work and paychecks, medical expenses, damage to a specific body part, rehabilitation programs, and, in the case of a death, funeral expenses.

Wage Loss Benefits
Payments to compensate for loss of wages due to total or partial disability.

Specific Loss Benefits
Payments to compensate for the loss of a body part, the permanent loss of the use of a body part, or for permanent scarring or disfigurement to the neck, face, or head.

Medical Care
Payments for reasonable surgical and medical care required to treat the workplace-related injury or illness.

Death Benefits
Payments to the surviving dependents of a worker who died as the result of a workplace illness or injury.

When a worker is disabled by a workplace injury and unable to work either temporarily or permanently, or unable to perform their prior role, their employer’s coverage may pay for disability benefits.

Temporary Partial
The worker can perform limited duties while they recover.

Temporary Total
The worker is unable to perform any role while they recover.

Permanent Partial
The worker has recovered from their immediate injury to the greatest extent possible but can only perform in a limited role going forward.

Permanent Total
The worker has recovered from their immediate injury to the greatest extent possible but is no longer able to work.

Though the function of workers’ compensation laws is broadly similar across the country in that they ensure workers receive adequate medical care and financial compensation for workplace injuries, there are small but important nuances which are important to account for when filing a claim.

For example, New York and New Jersey differ from Pennsylvania in:

• How they determine eligibility for temporary, permanent, partial, and total disability
• How they calculate death benefits
• The amount of benefits awarded
• The number of medical exams which may be required

New York and New Jersey also have a different appeals process than Pennsylvania. Some states also have stronger protections for workers than others, like New York, which requires employers to carry insurance for workers’ disability which occurs outside of work situations. Other states, such as New Jersey, require out of state employers to carry workers’ compensation coverage for any employees that are working in their state.

Independent Contractors
One major difference in state workers’ compensation laws is in how independent contractors are treated. 27 states, including Pennsylvania and New York but not New Jersey, differentiate between employees and contractors.

In the states which make a distinction between those titles, an employee is someone the employer has direct control and authority over — they choose how and when the employee performs their duties. Independent contractors, which can include freelancers, some construction workers, and seasonal workers, maintain some control over the manner in which the contracted work is being performed.

Reporting and Filing Deadlines
Workers’ compensation reporting and due diligence requirements also vary by state. In Pennsylvania, an employer has 21 days after a workplace injury is reported to investigate it before deciding to inform their insurance carrier. In New Jersey, employers must notify their insurance company immediately.

The statute of limitations for filing a workers’ compensation claim varies slightly between states. Pennsylvania workers have three years from the date of injury to file a claim (or three years from their last day of work if the injury developed later, such as in the case of a repetitive stress injury). In New Jersey, workers only have two years from the date the injury occured, the date of their last medical treatment for it, or the date they received their last compensation payment, whichever is latest, to file a claim.

Healthcare
The specific medical treatment a worker will receive can also differ depending on the state of their employment. In Pennsylvania, workers may choose their own medical provider. In New Jersey, employees have to stick with the physicians selected by the workers’ compensation insurance company covering them or pay out of pocket to see their own doctor.

All employees are entitled to represent themselves when making a workers’ compensation claim, but doing so can put them at a significant disadvantage. The law firms representing workers’ compensation insurance companies vigorously defend their clients and attempt to minimize the benefits paid. Workers need an experienced and well-resourced legal team capable of fighting just as zealously on their behalf.

Even if an employee is already receiving workers’ compensation benefits, a consultation with an experienced attorney can reveal if the current benefit arrangement is appropriate and assist the worker in defending any challenges to their benefits or medical treatment being made by the insurance company.