Workers' Compensation
Josh Wienman | September 7, 2022

The Loopholes in the Workers Compensation Act that You Should Know

When you think of workers’ compensation, what springs to mind is that it is a program meant to protect employees from any negligence or accident at work. In every system, some loopholes need to be filled so that the benefits reach those who genuinely require them.

Workers’ compensation is mandatory insurance that almost all employers must carry for their employees. It may seem like an unkind move by the state government against the working class, but there are good reasons why these laws have been implemented. These benefits include medical treatment and wage replacement payments in case of disability.

Fraudulent Claims

Workers Compensation claim

Fraudulent claims are one of the most significant issues with workers’ compensation. In most cases, the claims are paid by one insurance company that may be very large and spread across multiple states. This means the system has an error rate of about 1%. But workers’ compensation has an error rate of about 25% because the claims are paid out of the state’s general treasury. The problem is that only a handful of states have fraud units devoted to workers’ compensation claims, and most are understaffed.

The Statute Of Limitations

The workers’ compensation statute of limitations is a time limit for filing a claim. The timeframe might vary from state to state. The workers’ compensation act usually provides a time limit for filing a compensation claim. If the employee fails to file a claim within the set time, they cannot get the compensation. Some states have a workers’ compensation statute of limitations that is as short as 90 days. Therefore, it is essential to be well-informed about the workers’ compensation statute of limitations and act on it accordingly.

Employees Disciplined Or Terminated From Employment

Wrongful Termination

Some employers may try to eliminate employees who have filed a workers’ compensation claim against them. This can happen both in the public sector and in the private sector. If an employee files a workers’ compensation claim and gets disciplined or terminated, they can file a grievance against their employer. However, the employee must file a workers’ compensation claim before being disciplined or terminated.

Once an employee is disciplined or terminated, they cannot file a workers’ compensation claim. If they file one, it would be considered an act of fraud. Therefore, employees disciplined or terminated can file a grievance and claim their rights have been violated.

Employees Who Cause The Injury Or Loss

It is usual for people to assume that they will not get workers’ compensation benefits if the employee is responsible for the injury or loss. However, the truth is that the workers’ compensation act does not mention anything about the employee’s involvement in an accident.

The employer can still file a workers’ compensation claim if the accident is due to an employee’s negligence or carelessness. However, the employees can file a workers’ compensation claim if the employer’s negligence is at fault. These claims can be filed by injured workers, their dependents, or their legal representatives.

Common Types Of Construction Accidents

Construction Accidents

Various types of accidents can happen on construction sites. All of these accidents can lead to workers’ compensation claims. Construction accidents are common in busy cities like San Antonio. High-profile cities are prone to construction accidents since they invest in improving the infrastructure of the city. Some of the most common types of San Antonio construction accidents are:

  • Falls from heights – can occur when installing scaffolding, on roofs, or in other high-rise buildings.
  • Falling objects – Falling objects are every day during demolition, roofing, and demolition sites.
  • Electrocution – is caused when workers come in contact with live wires, tools, or other sources of electricity.
  • Being struck by a thing – can happen during any construction site activity.
  • Automobile accidents – are common in the field.

Conclusion

This article covered the loopholes in workers’ compensation that you should know about. One of the most significant issues is fraudulent claims, which is why the workers’ compensation system is so expensive. It can also be challenging to access in some cases as the system has many rules. Many different types of accidents can happen on construction sites, and there are many ways for workers to get injured. Allowing workers on construction sites access workers’ compensation can help them get the benefits they need to heal and move on with their lives.

Josh Wienman

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