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Opt-out clauses leave workers in some states with fewer benefits

In North Carolina, most employers are still required to provide employees with access to workers’ compensation benefits, but that is not the case in two other states, and more could be following their lead. Both Oklahoma and Texas offer employers “opt-out” clauses in which companies are allowed to replace workers’ compensation with their own plans. Proponents of opting-out say that they are able to offer benefits to workers more quickly and at less cost, but case studies of several injured workers tell a different story.

For example, the family of one Texas worker who fell to his death while painting a communications tower received only $250,000. Under workers’ compensation laws, the survivors might have been eligible for up to $1 million in a lifetime. The claim of a health care worker was denied because she reported the injury three hours past the 24-hour cutoff point. Her supervisor had to step in, and the company agreed to give her benefits.

Another health care worker injured her back and has been unable to work for two years, but she was denied benefits because she did not report the injury prior to the end of her shift. Similar stories proliferate, and even in cases where workers get a decision reversed, they often suffer without needed treatment and medication in the meantime.

Even with workers’ compensation, individuals’ claims may sometimes be denied, or they may face intimidation from employers when they try to file a claim. A person who is injured in a workplace accident may want to speak to an attorney to discuss the best course of action. For example, if the employer is responsible for the injury, the injured victim may want to consider a personal injury lawsuit in lieu of filing a claim for benefits.

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