D.C. Workers’ Compensation Basics
First time dealing with an occupational injury or illness? Find out what workers’ comp is and whether you’re covered by it.
What is workers’ compensation?
Workers’ comp is a no-fault insurance system that compensates employees for injuries or illnesses sustained on the job. Employers carry this insurance for the protection of their employees.
Can I sue my employer for an injury caused by work?
If your injuries were caused by your employer or a coworker, workers’ comp is generally the sole legal remedy. However, when the injuries are caused by the negligence of someone employed by another company, you may have grounds for a personal injury lawsuit against that party. This is known as a third-party claim. While the benefits of a third-party claim include being able to seek compensation for pain and suffering, you’ll have to prove that the defendant was negligent. For that, you’ll need an experienced injury attorney. At May Lightfoot, PLLC, our knowledgeable legal team would be happy to review your case and discuss your options.
💡Pro Tip: If you’ve been injured at work, you must follow specific procedures to handle your claim; you can’t rely on your employer to manage the process for you. You have to notify your employer of your injury or illness and file a claim with the Office of Workers’ Compensation within specified time frames. Even if you’re on top of your paperwork, that doesn’t mean that your employer will be equally diligent—and there’s always the chance that the insurance company or OWC will decide to fight your claim. Don’t risk missing out on much-needed benefits; hire a skilled attorney to handle your claim.
How do I know if my employer has workers’ comp insurance?
Washington, D.C. requires all employers with one or more employees to carry workers’ compensation insurance. This requirement applies to all businesses—from coffee kiosks to large consulting firms and everything in between. Even homeowners are required to carry a workers’ comp insurance policy if they employ one or more domestic workers for 240 hours or more in a calendar quarter.
What if my employer doesn’t carry workers’ compensation insurance?
You may be able to receive compensation for medical care or lost wages from the Office of Workers’ Compensation’s Special Fund Unit. Additionally, you may have grounds to file a personal injury lawsuit against your employer. Injured or ill employs are generally prohibited from suing their employers directly. However, by failing to carry the required workers’ comp insurance, employers open themselves to personal liability for injuries and damages.
At May Lightfoot, PLLC, our exceptional attorneys can help you understand your rights and explore all of your options for compensation.
Does D.C. workers’ compensation only cover full-time employees?
No. D.C.’s workers’ comp law covers all employees who are injured or develop a serious illness due to their job, regardless of whether they work full or part time or are a temp or seasonal worker.
Do I have to be 18 to collect workers’ comp benefits in D.C.?
No. The workers’ compensation law also protects minor teen employees. Was your teen hurt on the job or diagnosed with a work-related illness? Find out how the knowledgeable legal team at May Lightfoot, PLLC can help.
How long do I have to work in a job before I’m covered by my employer’s workers’ compensation policy?
Coverage begins immediately. Even if you’re injured on your first day on the job, within the first few minutes of your shift, you’re protected by D.C.’s workers’ comp law.
Can I still receive benefits if the accident and injury were my fault?
Yes! Workers’ compensation is a “no-fault” insurance system, which means that employees are typically eligible for benefits, even if they were responsible for their injuries. However, there are exceptions. Think you may be to blame for your workplace accident and injury? Contact us to discuss your case and options.
💡Pro Tip: Even if you have reasonable expectations, the insurance company may not compensate you fairly. When it comes to workplace injuries or illnesses, trusting your employer’s workers’ compensation insurer to act in your best interest can cost you. Insurance companies are profit-driven businesses intent on maintaining their bottom line, and adjusters have a wide range of tactics they use to try to reduce the financial obligation to claimants. From fishing for information that could hurt your claim to withholding information that could help it, insurance adjusters are anything but an ally in your quest for fair compensation. Fortunately, with the representation of an adept D.C. injury and workers’ comp attorney, you have a much better chance of overcoming the barriers standing between you and the benefits you deserve.
Injuries and Conditions Covered by D.C. Workers’ Comp
Is your on-the-job injury or illness compensable? Here’s a look at the types of injuries and conditions D.C. workers’ comp usually covers, as well as those it typically does not.
What injuries and conditions does workers’ compensation cover?
In Washington, D.C., workers’ comp recognizes three categories of compensable workplace-related medical conditions:
- Physical injuries resulting from on-the-job accidents or repetitive stress
- Occupational diseases developed as a result of workplace exposure to asbestos, mold, dangerous chemicals, and other hazards
- Mental health issues, such as post-traumatic stress disorder (PTSD), depression, or severe anxiety, arising from an on-the-job trauma or event
Can I collect workers’ comp benefits if I contracted COVID-19 in the workplace?
The coronavirus pandemic is a rapidly evolving situation. However, at May Lightfoot, PLLC, our knowledgeable and experienced injury attorneys anticipate that cases involving essential employees who were diagnosed with COVID-19 after regularly interacting with the public will fall under D.C.’s workers’ compensation law.
Were you or a loved one diagnosed with the novel coronavirus after presumed exposure in the workplace? Contact us for a complimentary review of your case to discuss your legal rights and options.
Are there any types of injuries that generally aren’t covered by D.C. workers’ compensation?
Yes. While most on-the-job injuries are compensable by workers’ comp, there are exceptions. For example, though injuries that occur when actively carrying out your work-related duties are covered, those sustained while commuting to or from work—or on your lunch break—usually are not. There are other exceptions, so you should speak to an attorney about your case. May Lightfoot, PLLC, offers free, no-obligation consultations. Contact us today.
Other workplace injuries typically not covered by workers’ compensation include those that are intentionally self inflicted or sustained during a physical altercation with another employee that you started over non-work-related personal matters (such as fights over romantic partners or sports team wins or losses). However, you may be entitled to benefits if you were the victim of workplace violence.
Still not sure if the circumstances of your work injury make you eligible for workers’ comp benefits? Let us help!
💡Pro Tip: The workers’ compensation claims process is complicated, and unless your injuries are minor, you’ll need an experienced workers’ compensation attorney to look out for your best interests. D.C. workers’ comp statutes are dense and often unclear, particularly to those without a legal background. With your energy rightfully focused on your health and physical recovery, it’s far too easy to miss key claims deadlines or run afoul of other bureaucratic rules. And if your claim is challenged or denied, you’ll need a fierce legal advocate in your corner.
D.C. Workers’ Compensation Benefits
Hurt on the job and wondering what benefits may be available through workers’ comp? Here’s what you should know about the various types of workers’ compensation benefits, including when they start, what they include, and how long they last.
What kinds of benefits does workers’ comp pay?
The insurance system provides medical treatment for workplace injuries and occupational diseases. You may also be eligible for temporary disability payments, a permanent partial disability award, vocational rehabilitation, and death benefits.
What do medical treatment benefits include?
Workers’ compensation covers all reasonable and medically-necessary treatments related to your work injury or occupational disease, including the cost of emergency transportation and care, visits with doctors and specialists, hospitalizations, surgical procedures, physical therapy, prescriptions, prosthetic and assistive devices, prescription drugs, and reasonable vehicle or home modifications. You’ll also be reimbursed for mileage incurred traveling to and from medical appointments.
When do workers’ compensation medical benefits begin, and how long do they last?
Workers’ comp will cover all reasonable and necessary medical care associated with your on-the-job injury or occupational illness, including emergency treatment following a workplace accident. Medical treatment benefits essentially begin immediately. However, they are not automatic; you’ll need to notify your employer and complete paperwork to start the claims process. Medical care can continue indefinitely, as long as the treatment is related to the accident.
What are temporary total disability benefits, when are they appropriate, and how much can I receive?
D.C. workers’ compensation temporary total disability (TTD) benefits are wage replacement payments paid to employees who are unable to work as the result of a workplace injury, but are expected to return to the workforce once they’ve recovered. TTD payments are equal to two-thirds of your average weekly wage, subject to minimum and maximum payment amounts. These benefits can last for up to 500 weeks and end when your doctor determines that you’ve reached maximum medical improvement (MMI), which indicates that your condition is unlikely to improve any further, and you’re released to work without restrictions.
What are temporary partial disability benefits, and what should I know about them?
Like TTD benefits, temporary partial disability (TPD) benefits are wage replacement payments. However, unlike TTD benefits, which are paid to workers who are completely unable to work due to an on-the-job injury, TPD benefits are paid to those who are only partially disabled by their injury and choose to work part-time or in a light-duty job while they recover.
If you find yourself in this position after a workplace accident, you may be entitled to TPD benefits totaling two-thirds of the difference between what you were making before your injury and what you’re making now. These benefits are available for a maximum of 260 weeks.
What if I suffered a permanent injury but am able to return to work?
If your on-the-job accident caused a disability that your doctor says is “partial in nature, but permanent in quality,” you may be entitled to permanent partial disability (PPD) benefits consisting of two-thirds of your average weekly wage. This payment is made after you reach maximum medical improvement (MMI), and the amount varies depending on your level of disability. Contact us today for a free consultation to discuss your D.C. workers’ comp claim and find out what benefits you may be entitled to collect.
What’s the difference between schedule and non-schedule permanent partial disabilities, and how do these categorizations affect how long I can receive PPD benefits?
The law categorizes permanent partial disabilities as either schedule or non-schedule. Schedule disabilities are those involving the loss (or loss of use) of a specific body part, for which you’re entitled to benefits for a specified number of weeks. For example, the complete loss of use of a hand makes you eligible for 244 weeks of PPD payments. However, if you haven’t lost full use of your hand, your doctor will assign an impairment rating that determines how long you can collect these benefits. Thus, a 50 percent impairment rating for your hand would make you eligible to receive PPD benefit payments for 122 weeks. Injury to other body parts, such as legs, arms, eyes, toes, and fingers also qualify for payment after a return to work.
Non-schedule permanent partial disabilities don’t correspond to a specific number of weeks of PPD benefits. You may be entitled to two-thirds of the difference between your average weekly wage and the reduced wages you’re earning after being diagnosed with a permanent impairment.
If you believe that you suffered a permanent injury on the job, you should consult with an attorney because the law is complicated.
What if I can never return to the workforce in any capacity as a result of my injuries?
If you suffered catastrophic injuries on the job and are found to be totally and permanently disabled, you may be entitled to permanent total disability (PTD) benefits indefinitely. However, these benefits are only available for workers with disabling conditions who are unable to find suitable alternative employment. PTD benefits are paid at the same weekly amount as TTD benefits.
When do my benefit payments start?
There is a three-day waiting period before D.C. workers’ comp benefit payments begin. If you’re out of work for 14 days or longer due to your workplace injury, you can recover compensation from the date of the accident and receive payment for the first three days you were absent.
What if my injury results in disfigurement?
If your injury causes serious disfigurement to your face or another exposed part of the body, you may be eligible for a lump sum award of up to $7,500.
Does D.C. workers’ compensation include rehabilitation benefits?
Yes. Both physical therapy and vocational rehabilitation benefits are available to injured employees through workers’ comp. Contact our skillful D.C. injury attorneys to discuss your options.
What death benefits does workers’ comp provide, and who can collect them?
In D.C., if an on-the-job injury or occupational disease results in death, the deceased worker’s surviving dependents may be entitled to funeral expenses and partial wage replacement payments. Eligible dependents include surviving spouses or domestic partners, children under 18 (or those unable to support themselves due to a physical or mental disability), and full-time students under age 23. In the absence of such dependents, alternative beneficiaries may include siblings, parents, grandparents, or grandchildren.
Do workers’ comp benefits include compensation for pain and suffering?
D.C. workers’ compensation benefits are limited to medical treatment, wage replacement payments, scheduled loss awards, vocational rehabilitation, and death benefits.
What is my case worth?
Every workers’ comp case is unique. With so many variables at play, it’s difficult—if not impossible—to accurately estimate the value of your claim without having thoroughly reviewed it. Contact us today to schedule a free consultation to discuss your case and potential benefits.
💡Pro Tip: Filing a workers’ compensation claim isn’t the same as suing your employer. It’s important to note that you’re not filing a lawsuit against your employer; you’re filing a claim against their workers’ comp insurance policy. In fact, the workers’ compensation insurance system is specifically set up to protect injured workers while shielding employers from personal liability.