In a perfect world, workers' compensation would cover everyone who was injured on the job. Unfortunately, this is not the case. There are circumstances when people may not be eligible for benefits through this insurance policy, though they may qualify for similar benefits under different programs. Here are three instances when you may not be covered by workers' compensation insurance.
Your Job or Position Doesn't Qualify
One of the primary reasons you may not be able to collect workers' comp is that your job or position is not covered. Perhaps the most well-known example of this is independent contractors. People in this category are not considered employees of the companies they work for. Therefore, employers not are required to obtain coverage for them.
However, you may be surprised to learn that business owners, and sole proprietors, and partners are typically also not covered by workers' comp. This exclusion is usually the result of state laws that dictate who can file claims against the policy. In New York, for instance, sole proprietors, partners, and certain corporate officers are not eligible for workers' compensation. Sometimes, though, people in this category have to manually opt in to be covered by the insurance policy. For example, qualified sole proprietors in Washington can purchase workers' comp to cover themselves.
Volunteers also aren't eligible for workers' comp benefits, even if they receive food, lodging, and/or transportation as payment for their services. This is because the organizations they work for aren't required to purchase the insurance for them. Some places do buy workers' comp insurance to cover volunteers, and the people who worked for them could file claims for benefits after they're injured. Volunteer firefighters and police officers are another exception to this rule as they are covered by the city's policy. As a general rule, though, volunteers have no rights to workers' compensation.
Part-time domestic workers (e.g. nannies), maintenance workers, gardeners, taxi drivers, and some agricultural workers are also typically excluded from being eligible for workers' compensation benefits. This exclusion is usually rooted in state laws. For example, in New York, employers are not required to buy workers' comp for domestic employees who work less than 40 hours per week and who don't live on the property.
Lastly, longshoremen, railroad employees, and federal employees aren't eligible for workers' compensation because they are covered by alternative programs. For instance, the Longshore and Harbor Workers' Compensation Act covers people who work on boats and piers. The Federal Employee's Compensation Act covers employees who work for the federal government, and railroad employees can file claims for compensation under the Federal Employers' Liability Act.
You Are Considered Casual Worker
In many states, people who only work for a company on a sporadic or intermittent basis may not be covered by workers' compensation insurance. This is because the state may not consider the person to be an official employee of the business.
For example, Pennsylvania requires there to be an employer/employee relationship between the parties in the claim before the injured worker can be considered eligible to be covered by workers' compensation. A high school kid who is hired to pick up trash in the parking lot once or twice a year by a company may be viewed as an independent contractor rather than an employee. As noted previously, independent contractors are not eligible for workers' comp benefits.
Your Company Doesn't Have Enough Employees
A third reason you may be ineligible for workers' compensation is your company isn't required to provide coverage because it doesn't employ enough people. In Tennessee, for example, only employers who have 5 or more workers are required to buy workers' compensation insurance. The only exceptions are construction and coal mining companies who must purchase coverage starting with the first person they hire.
Many other states have similar minimum employee requirements, though the exact number varies. You would need to contact the appropriate workers' compensation agency to determine if this is the case in your area.
Being ineligible for workers' compensation doesn't mean you have to give up all hope for receiving payment for your workplace injury. It just means you may have to pursue other legal measures of obtaining compensation, such as suing in civil court. Contact a workers compensation attorney for advice and assistance.