Am I Eligible for Workers' Comp in Washington, D.C.?
If you were hurt or became ill on the job in D.C., you are likely eligible for workers’ compensation benefits to help with the financial losses that often accompany these injuries. But just because you are eligible for benefits doesn’t mean that you will have an easy time getting them. Many employees run into obstacles on the path to workers’ compensation in D.C.
Meeting the criteria for a successful workers’ compensation claim can be tricky. Discuss your case with a skilled Washington, D.C. workers’ compensation lawyer at Trollinger Law, LLC today. For years, our legal team has fought for the rights of hardworking employees just like you.
Schedule your free consultation by calling or filling out our simple online contact form now.
Who Is Eligible for Workers’ Comp in D.C.?
In the District of Columbia, you must meet three basic criteria to be eligible for workers’ compensation under the law:
- You must be a regular employee: Not all workers are considered employees. If you’re an independent contractor, gig worker, consultant, volunteer, or “casual” worker, you’re likely not entitled to workers’ compensation benefits. Further, you must be an employee of a private-sector employer.
- Your employer must be required to provide workers’ compensation: Most employers in D.C. with one or more employees are required to carry workers’ compensation insurance. However, if your employer is a government entity, a railroad, a maritime entity, or a real estate broker that mostly pays you on a commission basis, it may not have to meet this requirement. Public employees generally have workplace accident insurance that is similar to but separate from workers’ compensation.
- Your injury or illness must be work-related: To qualify for workers’ compensation benefits, your injury or illness must have occurred while you were performing job-related tasks. Injuries sustained during meal breaks and commutes are not always covered by workers’ compensation coverage. However, if you were performing some job-related task when the accident happened, you have a better chance of receiving compensation.
Requirements for Workers’ Comp Eligibility
In addition to meeting the eligibility criteria listed above, injured workers must also fulfill requirements when it comes to reporting the accident.
The requirements outlined by the D.C. Office of Workers’ Compensation for filing an eligible claim include:
- Promptly reporting your job-related injury or illness to your employer within 30 days.
- Reporting your workplace injury or illness to the Office of Workers’ Compensation in writing within 30 days of becoming aware of the condition.
- Completing a DCWC Form 7, which serves as a formal notice of injury or illness, and then sending it to the Office of Workers’ Compensation and your employer.
- Completing a DCWC Form 7A within one year, if you decide to claim workers’ compensation benefits for your injury or illness.
It’s important to understand that the D.C. workers’ compensation program is a no-fault system. That means you don’t need to prove that someone is to blame for your illness or injury in order to be compensated. But in exchange for that guarantee, you also lose your right to sue your employer for negligence through a personal injury claim.
There is one possible exception to the no-fault rule. If someone else — not your employer — is responsible for your injury, you may have a valid negligence claim against that person or party.
A knowledgeable workers’ compensation lawyer can investigate whether this is a possibility in your case. If so, you could be entitled to additional compensation for pain and suffering, something that is not possible in a workers’ comp claim.
What Injuries Are Eligible?
Injuries in a workers’ compensation claim are eligible as long as the injury was work-related. Specifically, the District of Columbia Workers’ Compensation Act states that the injury must “arise out of and in the course of employment.”
Once you establish that your injury or illness is job-related, the law places no financial limit on the value of benefits that can be administered to cover your relevant medical expenses. There may also be no limit to the length of time over which you can receive medical benefits, depending on the severity of the condition.
In D.C., the injured employee has the right to choose his or her own doctor. However, if he or she is unable to at the time of their injury, the employer may select a physician so that the employee gets emergency care.
Examples of common workplace illnesses and injuries that may be eligible for workers’ compensation include:
- Injuries from stress or overexertion, such as pulled muscles, joint sprains, and slipped discs in the spine.
- Slip, trip, and fall accidents, which can happen on wet surfaces, loose carpeting, and unstable ladders.
- Repetitive strain injuries like carpal tunnel syndrome, bursitis, or tennis elbow.
- Electrocution and machinery accidents, which are common in construction and factory jobs, but may also happen in an office setting.
- Striking or being struck by an object, which may occur if you fall onto an object or get struck by a falling or dropped item.
- Transportation accident injuries, such as car accidents that happen while making deliveries or running errands for work.
- Injuries from workplace violence, such as assault by co-workers, customers, clients, or patients. These injuries are common in healthcare professions.
- Illnesses or injuries from hazardous substances like dangerous chemicals, acids, cleaning solvents, pesticides, or asbestos.
- Burns from hot surfaces, fires, or explosions, which may be present in workplaces like kitchens, chemical warehouses, or construction sites.
If your workplace injury or illness leaves you unable to do your normal job but still able to do some work, you may be eligible for temporary or permanent partial disability benefits. If you’re can’t work at all for a limited period, you could be eligible for temporary total disability benefits.
If your injury or illness is so severe that you become permanently unable to return to work, you may be able to claim permanent total disability. Permanent disability benefits are rarely granted, and eligibility in these cases is usually much more difficult to prove.
How to Prove a Workplace Injury
Proving that you are sick or hurt is often relatively straightforward, but establishing that your injury or illness was sustained on the job isn’t always so easy. Regardless, it is one of the most important elements of a successful workers’ compensation claim.
If you’re uncertain about what you can use as evidence in your workers’ comp claim, a dedicated workers’ compensation lawyer in D.C. can help you build a solid case.
Examples of useful evidence that can support your workers’ comp claim include:
- Photographs of your injuries and the accident scene
- Video footage, if your workplace is equipped with security cameras
- Statements from co-workers or other eyewitnesses
- Attendance reports showing when you were on the clock
- Maintenance and inspection reports, if any equipment was involved
- Documentation and medical records from your physician
- Employment records and pay stubs, to prove lost wages
- Medical bills and receipts from related treatment expenses
If you already filed for workers’ compensation and were denied, the denial letter should have explained the reason you were turned down for benefits. Sometimes it’s that the claim was not filed within the time limits. Other times, the employer may be disputing the claim. Before accepting the denial and giving up, check in with a workers’ comp lawyer. You may have a valid reason to appeal the decision.
What If the Injury Was My Fault?
In most cases, the D.C. workers’ compensation system does not consider fault when determining eligibility in workers’ comp claims. As long as an injury or illness was sustained during the regular, lawful duties of an employee’s job, it is generally covered by workers’ compensation insurance. It should make no difference whether you were partially or entirely at fault for your injury, as long as it happened on the job.
There are a few exceptions to this broad eligibility. If you sustained an injury while you were at your workplace but not actually on the job, such as during an assigned lunch break or while walking into work from the parking lot, that injury may not be covered.
If you were breaking company policy in some way that caused you to be injured, such as engaging in horseplay or misusing company machinery, your injury also may not be eligible for workers’ comp. Finally, if you were drunk or intoxicated and got injured on the job, your injury is unlikely to be covered.
Contact a D.C. Workers’ Comp Lawyer Now
Injured at work? Suffering from an occupational illness? Let a DC workers’ compensation lawyer at Trollinger Law LLC help you pursue the full and fair benefits you are entitled to. We are proud to have been providing compassionate, customized legal services to clients in the D.C. metro region for years.
When you work with us, you’ll be working directly with firm founder Matt Trollinger. He’ll investigate your case, collect the evidence you need to build a strong and solid legal claim, and represent you aggressively in disputes with the insurance company and on appeal.
At Trollinger Law LLC, we put you first. Call us today to get started. The first consultation is free.