May 19, 2012
Workers' Compensation, Compensation benefit, Medical benefits
How Workers’ Compensation Works
by Jim Abernathy
The purpose of Alabama’s Workers’ Compensation Act is to provide benefits to employees who suffer occupational health and injury problems. However, a recovery under the Alabama Workers’ Compensation Act is very different from a recovery in an automobile accident case or similar types of case.
In an automobile accident case (or other "liability" case), the injured person must prove "liability." Or, in other words, the injured person must show that someone else was at fault in causing the accident and the injured person was not at fault. Then, the injured person must prove "damages," which refers to things the injured person lost as a result of the accident. "Damages" include monetary recovery for pain, suffering, mental anguish, actual lost income, medical charges, punitive damages (if applicable), loss of enjoyment of life, permanent disability, as well as a recovery for the spouse for loss of consortium.
In a workers’ compensation case, fault is not the issue, and is often irrelevant. For a person to receive workers’ compensation benefits under the Alabama Workers’ Compensation Act, he must prove that he was injured by an accident arising out of and in the course of his employment. Once this is proven, then the injured worker receives benefits, not damages, as in a car accident case. The benefits recoverable by statute under the Alabama workers’ compensation law are as follows:
- Medical benefit - a lifetime benefit as long as the medical care is provided by an authorized treating physician, and the authorized treating physician relates this medical care, either in whole or in part, to the injured person’s on-the-job injury.
- Compensation benefits - This represents the monetary recovery to the injured worker, and consists of the injured workers’ percent of impairment or disability. In a workers’ compensation case, the injured worker does not receive any monetary damages for pain, suffering, mental anguish, actual lost income, medical charges, punitive damages, loss of enjoyment of life, loss of consortium, etc. If the case is tried before a judge (a jury is not allowed in determining a workers’ compensation case except for one narrow circumstance), the judge determines the percent of impairment or disability, and then the formulas that are contained in the Act dictate the amount of the monetary recovery. Compensation benefits consist of temporary total disability, temporary partial disability, permanent partial disability, and permanent total disability.
- Vocational rehabilitation or retraining - If the injured worker is not able to return to his prior job, and if he is a candidate to be retrained, then the workers’ compensation carrier may pay to retrain the injured worker. Of course, in this event, the percent of disability would be reduced in that the injured worker, after retraining, has access to more jobs.
As the recovery in a workers’ compensation case is governed by statute, there are many potential pitfalls for the person who is unaware of Alabama law. Therefore, it is advisable for any injured worker who is not very familiar with the Alabama Workers’ Compensation Act to contact an attorney who regularly practices in this area.