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Workers’ Compensation Program in the US

Introduction

Workers’ compensation is a program that provides benefits such as treatment, rehabilitation and other benefits to employees who encounter work-related injuries. This compensation saves the employers from being sued by their employees who experience injuries or diseases – some of the injuries may lead to permanent disabilities. The provisions for compensations differ in each employee because some are paid weekly, for example, the disability compensation, and others are paid for the past and future damages. In United States, workers’ compensation laws in every state provide procedures for compensating affected workers through cash assistance, medical care, and rehabilitation services (Thomson, Schimidle, & Burton, 2001). This paper focuses on the history of workers’ compensation program in the US and the various doctrines of workers compensation.

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History of Workers’ Compensation in the U.S.A

According to Thomson, Schimidle, and Burton (2001), compensation started back in 2050 B.C. A king named Ur Nammu laid down rules for compensating workers who were injured in their work places. The Greek, Roman, Arab and Chinese also set laws that protected employees. The amount of compensation depended on the body part lost or injured. For instance, the value of compensation of an ear depended on the size of the part lost. Georgia and Alabama were the first states in the United States to pass laws protecting workers, which was in 1855-1907. Prior to the emergence of compensation laws, the workers could only sue their employers. However, workers faced many challenges when presenting their cases because of many legal doctrines that protected employers.

Workers’ compensation laws later became very essential in many governments because legal proceedings were not satisfactory for both the employers and the employees: employers faced financial risks, and workers faced physical and developmental disabilities because of work-related injuries (Thomson, Schimidle, & Burton, 2001). In early 20th century, employees began movements to campaign on workers rights. Authors like Sinclair Upton also participated by writing a book titled the troubles workers face in their work place (O’Brien & O’Brien, 1990). The laws stressed on the need to formulate acceptable procedures within the state government as opposed to the federal government.

Today, employee’s compensation schemes are organized by the employers. Most of them come from insurance benefits or opening an account. Eighty percent of the workforce is covered by the compensation schemes. There are laws that protect those who are domestic and farm workers and those in the non-governmental organizations. There is an amount which is paid directly to the employee in case of a permanent disability. Furthermore, workers are enrolled in a compensation scheme, but there are groups of workers who have not been subscribed to the compensation system (Schnied, 2010).

Kunreuther (1996) argues that the causes of workers injuries are measured through different dimensions, which include injuries arising out of employment and injuries arising in the course of employment. When an injury arises out of employment, it means that the task given to the employee is the cause of injury or any other condition in the work place. Likewise, when an injury occurs in the course of employment, a test determines when and at what time as well as the task the employee was involved in when an injury occurred. For example, in a case where an employee attacks another employee while enjoying themselves with drinks on a weekend, and may be admitted in hospital, he is not likely to be compensated because the incident occurred outside the work environment.

Workers’ Compensation Legal Doctrines

Since workers are aware of their right to compensation, there are rulings that determine the legal doctrines that are tracked in the jurisdictions. The experts who follow workers’ claims analyze the cases and asses the law that goes along with that case to determine the court rulings. In the process of report analysis with the court rulings, they learn legal doctrines that are the foundation of the laws. These doctrines are set under three elements of the employees’ compensation, which include injuries, compensability and benefits. In injuries, the experts look at the report and tell whether it is an injury and if it requires compensation. In compensability, they check where an injury occurred, any disability causes and whether it falls under workers compensation system. In benefits, the amount of benefits to be paid to the worker is determined, considering the estimation method and time of payments (Diane Publishing Company, 1993).

According to the doctrines, for a worker to be compensated the injury or illness has to be work-related. The following paragraphs discuss these doctrines.

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To and From Work

This doctrine is also called “the coming and going rule”. This rule indicates that an employer cannot compensate a worker when coming or going out of work as long as he is outside the company’s premises, and does not matter whether an injury occurred within a short distance near the Company. Many workers have been caught up in a short distance situation, but there are some exceptions in different jurisdictions, these include in cases where a worker is travelling from one company’s premise to another. Workers may go out between working hours to collect supplies or meetings in different offices. If there is any injury, the employee compensates the worker (Thomson, Schimidle, & Burton, 2001).

There are cases where an employee performs a task on his way home and suffers injury – he is not liable to the compensation. The same case applies to an employee who carries his tasks and performs them at home. In some states like Texas, compensation is paid incase the employer is the one who pays for transport costs or where the means of transport has been provided by the employer, and when the employer controls the employee destinations. The more control an employer has on the destinations and the modes of transport, the more likelihood of employees being compensated in case of accidents (Schnied, 2010).

The Threshold Doctrine

Threshold doctrine relates to the areas covered by the place where employees work. Schnied (2010) argue that these premises include other buildings, which may be far from each other, but owned by the same company. These areas also include parking areas or other spaces that the employer rents. Garages and sidewalks related to the employer are also included in this case. However, this does not apply to the public garage that may be used by the employees and other people. There are many cases of accidents which occur while an employee is either at worker or in between. For example in a typical company, there is one case that occurred which involved an employee who was going home after work, there was lots of rain and he had to ran towards his car, but remembered that he had forgot to turn the office light off and went back. On his way back, he fell down on the stairs and was injured. This case was considered compensable because it was ruled out that when he went back to switch off lights, he went back on employers duty.

Traveling Employees

This doctrine applies to salespersons, marketers, service workers, and drivers such as supplies and truck drivers. Their work involves long travels and this may be extended to different countries since travelling is part of their work. Although is hard to tell whether an employee was injured while at work, the injuries that occurs during their work time are compensable. The employees especially the truckers are continuously covered because they are engaged in employers work during the day and night (PCCP, n.d).

Deviations from Employment

In deviations for employment, employees are not compensable in case an accident occurs when the employee has already left the employers premises. However, in case he left to attend other emergency duties like business, compensation applies, but the law has stated clearly that in case of deviation, it must be significant (Schnied, 2010).

Personal Comfort Doctrine

Thomson, Schimidle, and Burton (2001), argue that personal comfort doctrine entails instances like when employees go out for lunch or coffee. If the lunch was taken within the premises, they are compensable, but if taken “off premises”, they are not compensated. However, if the employees went in a certain restaurant to discuss business matters, they are likely to be compensated. The law also covers executives who travel for long distances on business purpose.

Recreational Activities

During recreation and other activities such as games and Christmas parties, the employees may be injured. Such injuries may be compensable since they occurred within the employer’s premises and it depends on whether the employer is aware of the parties and games. If the employer does not approve such activities, but lets them to take place, it is assumed that he was aware and hence such injuries are considered compensable. In a case where employees are engaged in games such as football and get injuries in the company’s premises and the employer is aware that these activities took place especially during afternoon break, such cases are compensable. Injuries outside the company premises may not be compensable unless the employer approved and participated and gets benefits from such activities. There is no compensation in employees’ involvement of intoxication and drugs, and hence it should be clearly proved that the accidents occurred due to drugs but not another cause (Thomson, Schimidle, and Burton (2001).

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Horseplay Doctrine

In horseplay doctrine, employees are engaged in plays and jokes. These plays and jokes are meant to relieve stress and are believed to benefit the employer because they take place during breaks when most employees are tired or suffer from fatigue. Injuries caused by horseplay are compensable only if the employer was aware that they existed and had accepted them (PCCP, n.d).

Fighting and Assaults

Thomson, Schimidle, and Burton (2001) affirm that fighting and assaults doctrine deals with fights between the employees. In most cases, the person who starts the fight is not compensated. Although, it is difficult to tell the one who starts the fight, but the victim is the one who is covered by the workers compensation. It is usually difficult to deal or to rule out such a case because there has to be a detailed investigation. It is always good to identify the casualty and the attacker earlier to eliminate fabrication of statements from either parties or other employees who might be present during the attack. Self imposed injuries and suicide is not in any way compensable.

Rules Governing Injuries

There are many rules that determine the type of injuries that are subject to compensation and those that are not. These types of injuries include injury caused by accident, which are injuries that occur out of accident due to work assigned. The injuries may also cause a long term disease such as infections which may require surgeries. After surgery, there can be more complications, which may lead to permanent disability and even death. All these expenses and injuries are protected by workers compensation system (Kunreuther, 1996).

An injury caused by a preexisting condition is often compensable as long as the injury is made worse by an injury that occurs during work time. The condition may be worsened by other causes not related to work such as drunkenness. It must be established that the condition is aggravated by work related injuries. However, if the employee’s condition remains the way it was after treatment, compensation is not guaranteed.

Similarly, work compensation system is in most cases focused on the physical injuries and this includes the diseases caused by the injuries. Psychological accidents such as depression and stress are not compensable, but if they occur together with physical injuries, they are compensable. However, there some exceptions in some states such as Florida and California (Diane Publishing Company, 1993).

Schnied (2010) argues that diseases such as heart attack and strokes may be in some cases compensable or not compensable. If the attacks occurred immediately when they were subjected to heavy and strenuous tasks, the employee must be compensated but if the disease is from other external source, they are not compensated because they may be caused by heavy smoking, family history, depression and stress. However, in Texas, the time and place at which an attack occurred is important or when an event within the employees premises cases the attack.

The law recognizes occupational diseases as under workers compensation. Occupational diseases may occur due to being subjected to tasks that may be of repetitive nature and have a likelihood of causing bodily harm. These diseases include the back pains and spinal cord injuries. Ordinary diseases which occur when workers are outside the work environment are not compensable unless they are caused by occupational disease. Occupational disease consists of diseases such as latex sensitivity and pneumoconiosis (PCCP, n.d).

Benefits of Workers Compensation System

Workers compensation system has benefited employees in many ways, including saving medical expense, disability pay, and vocational rehabilitation. The employer’s insurance company pays medical expenses and sometimes the worker is allowed to select the medical provider. Disability is fully paid for either in a permanent or temporal situation, but the amount differs due to the extent of harm. An employee is taken to a vocational rehabilitation if he has been severely injured and is unable do to tasks according to his area of specialization. He is retrained to do other tasks, which are free from further injuries (Thomson, Schimidle, and Burton (2001).

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Schnied (2010) agree that workers compensation also saves employees from filing lawsuits because employers will take care of an injured employee expenses. Dependants may also receive care, especially when death occurs. However, some companies in the US that have not signed their workers in workers compensation system and employees take care of any injuries that may occur while working. Insurance rates have risen and employers are unable to have their employees covered by the workers compensation insurance.

Conclusion

Workers compensation has been of help to many employees in the United States. Some of the employees are aware of their rights about work related injuries, but others are yet to realize those rights. This paper reviewed the history of workers’ compensation in US and analyzed several doctrines that govern compensation programs. In this regard, there are several websites such as workers compensation centre that provides news to the employees and information on types of insurance and Workers Compensation Services. There are laws that protect the employees in both public and private sectors and hence workers should be educated about their rights in the workplace because workers compensation system does not discriminate any worker who is registered so long as his case is genuine.

References

Diane Publishing Company. (1993). Social Security Programs in the United States. Social Security Bulletin, 56 (4).

Kunreuther, H. (1996). Mitigating Disaster Losses through Insurance. Journal of Risk and Uncertainty, 12 (2/3), 171-187.

O’Brien, B.M. & O’Brien, D.W. (2004). Workers’ Compensation Claims and Benefits. Los Angeles: Parker & Son Publications.

Property & Causality Claims Professionals – PCCP. (n.d). Compensability: Legal Doctrines of Workers’ Compensation. Web.

Schnied, T.D. (2010). Legal Liabilities in Safety and Loss Prevention (2nd ed.). Massachusetts: Jones and Bartlett Publishers.

Thomson, T., Schimidle, T.P., & Burton, J.F. (2001). Workers’ Compensation: Benefits, Costs, and Safety under Alternative Insurance Arrangements. Michigan: W.E. Upjohn Institute for Employment Research.

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