Workers’ compensation is a “No-Fault” remedy created by statute. Negligence on the part of the employer or a co-employee is not an issue. Workers’ compensation statutes and case law have changed the nature of workers’ compensation and have carved out numerous exceptions. There are numerous written materials on the legal issues surrounding workers’ compensation and it’s beyond the scope of this blog post to provide a detailed analysis. However, since knowledge is power, I think it is important for you to know the more common issue to help you understand your workers’ compensation claim. The injured worker has the burden to prove each element of his injury by accident. He must prove that he had an injury by accident that arose out of and in the course of his employment, which resulted in incapacity.
You must prove an injury by accident. This may seem simple but it is probably one of the most common reasons why workers’ compensation claims are denied. To prove an injury by accident, the injured worker must prove a SPECIFIC IDENTIFIABLE INCIDENT that occurred at a reasonably definite time, which is the cause of an obvious sudden mechanical or structural change in the body. This is the legal definition. It basically means that you have to prove that your accident happened suddenly at a specific time while you were performing a specific work-related task. Gradual injuries or injuries sustained at an unknown time are not covered.
Here is an example of a gradual injury: You are a painter and lift ten buckets of paint and put them in the back of your truck. At the end of lifting the buckets, you feel pain in your back and have a herniated disc. THIS WOULD NOT BE COVERED UNDER WORKERS’ COMPENSATION. However, if you were putting the buckets of paint in the truck and, as you were putting the third bucket in the bed of the truck, you felt a pull or pain in your lower back and continued working, it would be covered under workers’ compensation because you would be able to specifically say as you were putting the third bucket in, you felt a sharp pain, pull, pop, etc. Proving an injury by accident is one of the top reasons you may want to hire a workers’ compensation attorney.