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Occupational Injury or Illness: What You Need To Know On A Legal Perspective

  • January 31, 2020

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Occupational Injury

Occupational injury or illness can be described as any injury or illness that is caused by an event or exposure in the work environment. In case an employee or worker develops an occupational illness or gets injured in the job, they are eligible for a claim via the employer’s business insurance policy. Once the claim is approved, the employee is entitled to wage replacement, medical coverage as well as other benefits. In order to access these benefits, it is essential for the employee and the employer to follow the requisite steps to make sure that the injury is compensable.


As soon as an occupational illness or injury arises, time is of the essence. It is critical to make sure that the incident is reported as soon as possible. Any delay in filing the claim can result in denial of the compensation benefits for the employee. According to the experts in the field, a delay in filing results causes the impression that the claim might not be legitimate.

Related: 8 Ways To Prevent Injury In The Workplace

Some of the conditions that are not covered by most company’s business insurance policy include:

  • Self-inflicted injury
  • Stress
  • Psychiatric disorders
  • Injuries caused by fighting
  • Injuries caused by horseplay
  • Injuries caused during the commute to or from the workplace
  • Injuries caused under the influence of alcohol or drugs
  • Injuries caused while violating company policies
  • Injuries caused while committing a crime

However, if you have a cumulative work injury or illness, the clock starts ticking as soon as the worker takes off time from work because of the same. For example, most employees in the IT industry suffer from carpal tunnel syndrome due to usage of the keyboard and mouse over continuous time periods. Stephen Whiskin from explains that a personal injury attorney can help you know if you are entitled to receive compensation from an illness. This especially holds good if the illness is due to the negligence of the employer or failure to take adequate precautions. The worker needs to be aware of the injury or illness, caused due to work or the workplace and if they are eligible for a claim.

Filing a Claim

Once an employee or worker has an occupational injury or illness, they need to immediately follow the steps mentioned below:

  • Intimate the employer about the work illness or injury. This will include specific details like date, time, how the injury occurred, type of injury and so on.
  • File a formal claim using the information mentioned in the earlier step.

Once the claim has been filed the insurance company will conduct an independent medical examination via a doctor they have chosen beforehand. The doctor will send their findings to the insurance company, based on which the company will decide its compensation offer.

Since each region has its own rules regarding the claim process as well as the statute of limitations, it is a good idea to learn more about what to expect. Being aware of the rules in the place you are working or running a business can always help.

When is Compensation Awarded?

In case the following statements are proved to be true, your employee is considered to be eligible for compensation:

  • The injured employee is on the company’s payroll and not an employee of an independent contractor.
  • The employer has insurance covering its employees.
  • The employee got injured as a result of their job or job-related duties.

Usually, an occupational injury has to be reported within 30-45 days of the incident or illness. It is vital that the employee understands the specific time period within which they can file their claim. In case the deadline passes, there is very little chance that the employee will be able to get any compensation.

According to the law, in case of any occupation injury or illness, the employee is covered. There are specific rules for an extended occupational injury that apply to certain conscripts as well as military personnel. Freelancers and self-employed people need to take out voluntary occupation injury insurance so that they are entitled to workplace injury coverage. Once the claim is approved by the insurance company, the employee is entitled to social security benefits. Employees who have a permanent disability due to occupational injury or illness are entitled to further compensation for permanent injury.


While in some cases there are no doubts about whether the employee is entitled to receive compensation due to an injury or illness that is job-related, some cases might not be so straight forward. In fact, workers are not even aware sometimes of their legal rights. This is why it is a good idea to talk to a personal injury attorney and get their take on the situation before making a decision about filing a claim. After all, work-related illness or injury can even change the way of life of the employee based on the severity of the illness or injury.