Which Illnesses Qualify For Workers’ Compensation?


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Author: Mike Lewis, Esq., Mike Lewis Attorneys

Workers’ compensation is an essential system that allows workers who are injured on the job to recover without having to worry about crippling medical costs and loss of wages. Qualifying for workers’ compensation isn’t always so easy, however, especially since employers and insurance companies benefit from offering you as little support as possible.

To make sure you get the support you need, it’s important to understand which illnesses qualify for workers’ compensation. Navigating the complex appeals process if your workers’ comp claim is denied can be difficult, which is why it’s always a good idea to hire a lawyer for the job. Learn which illnesses qualify you for workers’ comp, and discover how a workers’ compensation lawyer can help.

Basic Requirements

To understand workers’ compensation qualifications, you have to understand the most basic requirements for any claim. There are essentially three aspects every claim must contain. The first is that your employer must either carry or be legally required to carry workers’ comp insurance. New Jersey makes it easy to figure this out. If you’re not working for someone covered by a federal program, they must have workers’ comp insurance. If they claim otherwise, get your workers’ compensation lawyer to find the truth.

The second requirement is that you have to be employed by the person or company who owed you workers’ comp. While this may seem obvious to some, it’s important to note that not every worker is an actual employee. Independent contractors, for example aren’t eligible. Most volunteers don’t qualify either. Employers may try to label you as an independent contractor if they don’t want to pay your workers’ comp, so make sure they’re not misclassifying you.

Finally, your illness has to be work related. The employer is not responsible for any injuries or illness you suffer if they weren’t directly caused by a working environment that’s supposed to be safe. If you cannot draw the direct causal link from your work to your illness, you won’t have much of a case should your claim get denied.

Types of Qualifying Illnesses

Workers’ compensation is designed to cover any kind of illness that occurs while on the job. It doesn’t have to be a sudden, accidental injury like breaking your leg after falling off a faulty ladder. In fact, the most common injuries at the workplace are repetitive motion injuries or cumulative trauma disorders. For example, if you spend a lot of time stacking heavy boxes, you could be subject to chronic back pain. Office workers, on the other hand, may suffer from Carpal Tunnel Syndrome. All of these kinds of illnesses would be covered by workers’ compensation if they originated in the workplace.

Occupational illnesses can also be covered by workers’ comp. These illnesses develop after being repeatedly subjected to a harmful working environment for long periods of time. Technically speaking, not all potential occupational illnesses actually qualify, but the most common ones have made it to the occupational disease list, which is what the law goes by. Even if your disease isn’t on the list, you could still be eligible, but you’ll probably have to prove in court that it was caused by environmental hazards in the workplace.

More recently, emotional and mental stress disorders and injuries have been recognized for workers’ comp. Conditions as serious as heart problems and cancer can be caused by stress in the workplace, so it’s only fitting that the employer cover those costs. Proving the causal link between stress and your injuries, however, is very difficult. You’ll need the help of a workers’ compensation lawyer if you take this path.

How to Appeal a Workers’ Comp Denial

If your workers’ comp claim has been denied, you can appeal to get the coverage you’re owed. Interestingly enough, most workers’ comp claim denials are the result of clerical errors and paperwork mixups. Always check to see if that’s the problem first. If it is, getting a fix is easy, and you don’t have to worry about the long appeals process.

When you are forced to appeal, there are quite a few steps to go through. Navigating this process can be tough. First, you have to make sure you don’t miss any important deadlines. In the state of New Jersey, you have two years from the date of the incident to file your claim. It’s always a good idea to file as early as possible, however, as your recovery costs can add up quickly.

To make your appeal, you’ll have to appear in front of an administrative law judge. Once there, you’ll have to present your case and prove that your illness was caused by unsafe conditions at your workplace. This part can be particularly hard to handle alone, so make sure you have a workers’ compensation lawyer in your corner.

New Jersey Workers’ Compensation Lawyer

For a workers’ compensation lawyer you can count on, look no further than Peter Davis & Associates. We have the skills and resources necessary to offer the best chances of you winning your case, and we have a long history of successes to prove it. Contact us today, and we’ll get you started with a free consultation.

About The Author

Mike Lewis is a worker’s compensation lawyer in Winston-Salem, North Carolina, and an AV-rated attorney by Martindale-Hubbell. Mike is the senior partner at Mike Lewis Attorneys and is a graduate of Wake Forest Law School. Mike Lewis Attorneys also welcomes cases related to car accidents, truck accidents, eminent domain, and social security.

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