When Do New Hires Become Eligible for Workman’s Comp?

Every 15 seconds, 151 workers have an accident. According to the International Labour Organization, that adds up to 317 million non-fatal occupational accidents per year. What’s more, Travelers insurance company reports that 35% of worker injuries happen within their first year on the job. With stats like that, it’s little surprise a new hire would wonder how soon they’ll have access to workman’s comp. In fact, a reader recently wrote in with just such a question asking:

“How long do I have to work at my job before I’m eligible for workman’s comp? I fell off a ladder five days after my hire date, so not sure whether or not I’m covered.”

Ladder fall notwithstanding, the good news is this worker should absolutely have the possibility of workman’s comp coverage. In fact, most workers should have coverage from the first second they clock in on their first day. But for that to hold true, the following five requirements must all be in place.

5 Requirements for New Hires to Qualify for Workman’s Comp Benefits

Requirement #1: Your Employer Must Carry Workman’s Comp Insurance

Believe it or not, this varies by state. Currently, employer’s insurance for workman’s comp is mandatory in all states except Texas. But even within states that require businesses to carry workers’ comp, there are still differences in what they’ll cover.

Be sure to check your employee handbook for explanations. If that’s not available — or if they don’t have one — then look for your state’s guidelines. It is important to ascertain if your employer should have coverage in the state where you work.

Requirement #2: You Must Meet the Definition of “Employee” Under Your State’s Laws

Generally, an “employee” is any person working under an agreement, express or implied, where someone else dictates the activities. Basically, if you have a boss and you’re not self-employed or an independent contractor, you’re probably an employee.

Though some states will consider gig workers as employees eligible for workman’s comp, in most cases, they’re not. But part-time work and seasonal work for an employer will generally garner employee status. 

The easiest way to determine if you’re an employee is to look at how you’re paid. If you receive a W-2, you’re an employee. If you get a 1099, you’re likely considered an independent contractor and will not have workman’s comp coverage.

Related: ¿Cuándo pueden ser elegibles los nuevos empleados para la Compensación de Trabajadores?

Requirement #3: Your Injury or Illness Must Be Work Related

Returning to our reader’s question, we’re assuming this employee fell off the ladder at work, not someplace else. It is not clear from the way the reader wrote the query, but this is important. To claim workman’s comp, an accident must happen while you’re at work.

If our reader fell off the ladder at home while getting ready to go to work, then no. That injury isn’t going to be eligible for workman’s comp coverage. However, if the employee was on the ladder at home as part of their job, it might. “Work from home” (WFH) requirements during the pandemic have muddied claims a bit that way. But in general, an injury must happen at one’s place of employ or while performing their job duties.

Once again, guidelines vary from state to state. If you’re still not sure if you qualify, ask yourself honestly, did this injury happen because of doing your job? And is it now interfering with you doing your job? That is the bottom line.

Requirement #4: You Must Report Your Injury to Your Supervisor in a Timely Manner

If you get hurt, do not suffer in silence. Report it as soon as possible to your supervisor at work.

And don’t be afraid to do it. Your employer cannot fire you if you have legitimately been injured on the job, even if you’re new!

At the very least, you must report your injury to your employer before your state’s deadline expires. Generally, that’s within 10 to 90 days, depending on where you live and work. But again, check your state’s guidelines.

Then you’ll need to file that claim with the state as well. Your employer may be able to complete this step for you, but you should be aware of it. Typically, there’s a one-to-three-year statute of limitations for workman’s comp claims.

Requirement #5: You Must Seek Medical Attention for Your Injury

There must be proof of injury. And that comes from medical records. In order to qualify for a workman’s comp claim, you must see a medical professional.

Sometimes an employer or state will require you to see a doctor they specify to receive treatment. It is important to also ask about that stipulation, so you don’t get stuck with unexpected bills. Additionally, keep all receipts for medical expenses you do accrue as you will likely need to submit those.

Be sure to ask the doctor treating you about your diagnosis, and the best ways to treat this injury. If it’s something that will require ongoing care like physical therapy, you want to prepare for that possibility. And if your injury requires you to take time off work, you should also ask for that in writing. Your best bet is to ask questions and document everything.

If you have all five of these requirements in place, you should qualify for workman’s comp from your new employer. And it’s important to take action right away so you don’t miss critical filing deadlines. Remember, you can always consult a workers’ comp lawyer about your claim for free.

Even new hires have rights. Make sure you know your rights so you can get the help you need to heal and get back to work.

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Kimberly Dawn Neumann is a multi-published NYC-based magazine and book writer whose work has appeared in a wide variety of publications ranging from Forbes to Cosmopolitan. She graduated summa cum laude from the University of Maryland, College of Journalism. For more, visit: www.KDNeumann.com, Instagram @dancerscribe, and Twitter/X @KimberlyNeumann.