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Employee Misconduct

Generally, workers' compensation is a no-fault system that provides an employee with benefits for work-related injuries and illnesses without reference to an employee's negligent or wilful misconduct. This is not so, however, when such misconduct occurs outside the course of his employment. Additionally, various jurisdictions have outlined certain instances where an employee's misconduct constitutes a defense to the award of workers' compensation benefits.

Recovery of Costs, Attorney's Fees, and Interest in Workers' Compensation Actions

Generally, parties in workers' compensation actions are responsible for their own attorney's fees and costs. The amount of attorney's fees that can reasonably be charged to a claimant in pursuing his claim for benefits is specifically outlined in many state statutes. For example, some states will cap attorney's fees at a specified dollar amount; others will cap such fees at a designated percentage of the amount recovered as benefits by the claimant.

Fault of Employee

A core principle within the area of workers' compensation is that the question of "fault" is largely irrelevant. It is only when the employee's "fault" in connection with the injury is occasioned by him leaving the course of employment or is a statutory defense in a jurisdiction will the inquiry come into play. The test for workers' compensation is generally not personal such that an employee's misconduct, whether negligent or intentional, will affect the receipt of benefits. Rather, the test is merely whether the injury arose out of and in the course of employment.

Procedure under the Black Lung Benefits Act

To recover benefits under the Black Lung Benefits Act, a miner, his surviving spouse, or his surviving dependents must file a claim with the appropriate government office, usually a Social Security or Labor Department office. From the date that the miner has been made aware of the medical determination that he is totally disabled from pneumoconiosis, he has three years in which to file a claim for benefits. This time limit is subject to exception only for extraordinary circumstances. The miner's surviving spouse and dependents have no time limitations for filing their claims.

Uninsured Contractor

Some employers may seek to avoid workers' compensation liability by using contractors to perform work that would normally be performed by the employer's own employees. The reasoning is that employers are responsible only for the workers' compensation coverage of "employees." However, to preclude employers from evading liability by this method, most jurisdictions will impose liability here if the contractor itself is uninsured for workers' compensation. Thus, if an employer utilizes a contractor's employees to do that which the employer's own employees would normally do, and an employee of the contractor is injured, the employer will be responsible for worker's compensation despite the fact that the injured individual is not an "employee" of the employer. These state statutes basically deem the individual an "employee" to further the goals and purpose of workers' compensation. In order to determine whether the contractor is performing work that would normally be done by the employer's own employees, courts will look to the employer's past practices as well as the practices of other employers in the same industry or trade.