Workers' Compensation and Workplace Injury
This domain tests the no-fault compensation bargain: what injuries are covered, what benefits follow, and when the exclusive remedy yields.
Coverage
A compensable injury arises out of and in the course of employment. Courts apply positional-risk and increased-risk analyses, reject idiopathic injuries, and apply the coming-and-going rule with its premises, special-mission, and travel exceptions. Aggravation of a pre-existing condition is compensable, and occupational disease is assigned to the last injurious exposure. Fault and employee negligence are irrelevant.
Benefits
- Medical treatment, generally without a dollar cap under state statutes.
- Temporary total disability, typically two-thirds of average weekly wage subject to a state maximum, after a three-to-seven-day waiting period that is often retroactive.
- Permanent partial (impairment rating) and permanent total disability.
- Death benefits to dependents plus burial expenses; vocational rehabilitation.
Exclusive remedy and its exceptions
Negligence suits against the employer are barred, but claims survive for intentional torts, failure to secure coverage, dual capacity, and third-party liability. The carrier holds a subrogation lien on third-party recoveries. Most states also bar retaliation for filing a claim.
Worked example
A delivery driver with degenerative disc disease lifts a 60-pound parcel at a loading dock and herniates a disc. The employer argues the condition was pre-existing. Analysis: the work lifting is a causal aggravation, so the claim is compensable despite the prior condition and no employer fault. She receives medical care plus temporary total disability at the statutory rate after the waiting period. Her negligence suit against the employer is barred by exclusivity, but she may sue a negligent third-party driver, with the carrier asserting its lien. Her termination one week after filing supports a separate retaliation claim.
Traps
- Treating the coming-and-going rule as absolute; premises and special-mission exceptions matter.
- Assuming a pre-existing condition defeats compensability.
- Missing the retaliation claim that rides alongside the injury claim.
- Forgetting that FELA, LHWCA, and the Defense Base Act displace state comp for covered workers.
- Calculating average weekly wage without including overtime and bonuses where the statute requires it.