Workers’ compensation is a no-fault system. Any employee who suffers injuries due to a workplace accident is entitled to demand work loss benefits regardless of whether there is any fault on the part of the company. These benefits typically include 2/3rds of the worker’s average weekly wages for the length of time he/she cannot work. It also includes payment of all reasonably necessary medical bills including surgeries, doctor visits, time with therapists, medications, and the cost of medical devices.
According to the Insurance Information Institute, the workers’ compensation industry had the following interesting statistics for the years 2008-20017.
The industries with the most worker’s compensation claims between 2008-2017 were:
- Laborers 64,410 claims
- Truck drivers (tractor-trailer and heavy trucks) 47,860 claims
- Janitors and cleaners 35,580 claims
- Nursing assistants 34,210 workers compensation claims
- General maintenance and repair workers 30,580 work injury claims
- Retail salespersons 25,200 work injury claims
- Registered nurses 24,540 worker claims
- Store clerk and order fillers 23,990 workers’ compensation claims
- Construction laborers 23, 290 work injury claims
- Light truck and delivery service drivers 22, 830 work injury claims
There are some surprises in these numbers for the average work. The first is that construction work is only ninth on the list. Construction workers can be electrocuted, suffer serious burns, can fall from scaffolds and other heights, can be hit by vehicles such as trucks and cranes, can be struck by equipment, and often suffer back and neck injuries due to heavy lifting.
It may seem surprising that the nursing sector is so dangerous. Nurses can easily be infected. They must constantly move and manipulate patients and beds. Some patients may not be able to control their hostility. We represent and have represented numerous nurses and certified nursing assistants (CNA’s) who have been injured when heavy patients suddenly shift their weight and an injury occurs. We have also represented and continue to represent several nurses and other health care workers, particularly in the mental health field, who have been violently attacked by patients and suffered severe injuries.
Leading writers of workers’ compensation insurance policies
The top writers of insurance coverage for workplace injuries were the following companies. Employers are either required to have insurance for worker’s compensation claimants or they are required to self-pay if a workplace accident occurs.
- Travelers Companies Inc.
- Hartford Financial Services
- AmTrust Financial Services
- Zurich Insurance Group
- Berkshire Hathaway Inc.
- Liberty Mutual
- State Insurance Fund Workers’ Comp (NY)
- American International Group
- Old Republic International Corp.
Leading Causes of Workplace Fatalities
The U.S. Department of Labor keeps statistics for workplace deaths. In 2015, logging caused the most workplace deaths – 132.7 deaths per 100,000 full-time employees. The next occupations as to highest workplace death rates were:
- Fishing workers
- Aircraft pilots and flight engineers
On average 3.4 of out of every 100,000 workers died due to a workplace accident or illness.
When a worker dies in a workplace accident or due to an occupational illness, the family (typically the spouse and children, i.e. the dependents of the deceased) is entitled to some benefits. These benefits generally are:
- The reasonable cost of the funeral and burial up to a preset amount.
- A lump sum payment based on the remainder of the Award pertaining to the deceased worker.
The leading causes of work-related deaths for 2015-2016 were as follows:
- Transportation deaths including vehicle crashes 2015. 2,054 2016. 2,083
- Just vehicle crashes 2015. 1,264 2016. 1,252
- Slips and falls 2015. 800 2016. 849
- Assaults and acts of violence 2015. 703 2016. 866
- Contact with equipment and objects 2015. 722 2016. 761
- Exposure to harmful substances and environments 2015. 424 2016. 518
- Fires and explosions 2015. 121 2016. 88
In addition, there were 417 homicides in 2015 and 500 homicides in 2016 that were work-related. The source for this set of data comes from the U.S. Department of Labor, Bureau of Labor Statistics, Census of Fatal Occupational Injuries.
According to employer.com:
- Data from the US Bureau of Labor Statistics confirm the staggering number of workplace accidents. In 2012, for example, there were 3 million nonfatal claims for workers compensation – about 3.5 of every 1,000 full-time workers filed a work injury claim. Statistically, about 19 in 20 of these workers’ compensation claims were for workplace accidents. The other five percent were for occupational illnesses.
- As might be expected, police work was the most dangerous type of work. The risk of a workplace accident for police officers was, on average, five times more than for other job categories.
Workers’ compensation and fraud
There are two types of fraud. Fraud committed by employees and fraud committed by employers
The main types of employee fraud were the following:
- Workers who claimed they were hurt on the job when they were actually hurt away from the job.
- Building up a minor work injury into one that is far more severe than it is – allowing the worker to collect more wage loss benefits and stay home from work for a longer period of time.
- Faking injuries altogether. For example, claiming a soft-tissue injury of the neck or back even though the worker isn’t hurt.
Employers also do things that are fraudulent or dishonest to falsely deny a valid worker’s compensation claim. Common examples include:
- Claiming that a worker actually worked in a less hazardous job in order to pay the worker lower wage loss benefits.
- Trying to claim that a worker was an independent contractor and not an employee. Employees are generally entitled to file a worker’s compensation claim for wage loss and medical expenses. Independent contractors are not entitled to file workers’ compensation claims. That being said, the employer does not have the final say as to a worker’s status. Whether a worker qualifies as an employee or an independent contractor depends on a variety of factors such as who has the right to control how the worker does his/her job and when the job is done. Unfortunately, we see this “misclassification” defense frequently. It is clearly fraudulent and done by employers for many reasons. One is they obviously do not want to pay for workers compensation insurance, but in addition, by classifying workers as independent contractors, they can avoid payroll taxes and paying for health insurance as well.
Additional workers’ compensation findings
According to the Social Security Administration, in 2013 the total amount of worker’s comp benefits nationwide was $63.6 billion. This total was based on the following:
- Payments for medical benefits – $31.5 billion
- Payments for wage loss compensation – $32.0 billion. This sum includes payments to workers who are disabled and to the survivors of deceased workers.
The amount employers pay for workers’ compensation varies depending on the following factors, among others,
- The risk of injury
- The industrial classification
- The experience rating
At the North Carolina and Virginia Law office of workers’ compensation lawyer Joe Miller Esq., we fight to get injured workers all the compensation they deserve. We are strong advocates for injured employees. Our office has helped thousands of injured and ill workers get the compensation they deserve. To speak with an experienced attorney, call 1-(888) 694-1671 or complete my contact form to schedule an appointment.