Who Is Covered?
Employers with five or more employees must provide workers' compensation insurance for their employees. This includes agencies of the state and its political subdivisions. Subcontractors are included, but the prime contractor is ultimately liable if the subcontractor is uninsured. Only the following categories of employment are excluded:
• Individuals engaged as independent contractors
• Newspaper and magazine vendors
• Domestic servants
• Employees of any nonprofit, charitable, fraternal, cultural, or religious corporation or association
• Farm laborers (not to include workers at commercial food processing concerns)
• Sole proprietors and partners, unless they elect coverage
Employers that are not legally obligated to provide workers' compensation coverage may do so voluntarily. An employer electing to provide coverage gains the same immunity to lawsuits arising out of work-related accidents as is enjoyed by employers who are required to provide coverage. What Is Covered?
"No-fault" system. Workers' compensation is a "no-fault" system. Employees receive compensation without having to prove that the employer was at fault for the injury. They need only show that the injury arose "out of and in the course of employment." This no-fault aspect distinguishes workers' compensation from ordinary "tort" law, which provides for the compensation of injured people in most other circumstances. Under tort law, a person receives compensation only if the injury was caused by someone else's carelessness. The operative legal term is "negligence," which is simply the failure to use due care. In most cases, an injured party is compensated only if he or she can prove that the injury was caused by some other party's negligence.
Workers' compensation makes it easier for employees to collect because they don't have to show that the employer was negligent. All they have to show is that they were at work and were injured. It doesn't matter that they (or a co-worker) were partly at fault; nor does it matter that they knew the job was risky. Even injuries sustained as a result of "personal" behavior on the job, such as horseplay, are compensable if the behavior could reasonably be expected to occur. "Contributory negligence," "assumption of risk," and other defenses normally used by defendants in an accident case do not apply to on-the-job injuries. There are only a few limited circumstances in which compensation is not available: