aptitude.title 🇺🇸 United States · State WC + federal programs
Workers' Compensation Claim
Routes to the applicable program (state WC or a federal program — FECA, FELA, Jones Act, Black Lung, EEOICPA, WTCHP), applies the "arising out of and in the course of employment" dual test, flags presumption laws and lists actions. Framework orientation — not a claim determination.
⚠ State-variable: workers' comp differs across 50 states + DC + territories. State-specific rules (deadlines, benefit %, presumption laws) require your state's workers' comp board or a workers' comp attorney.
Under the physician's clinical judgement
- The OH physician documents medical facts and work-relatedness; the WC board — not the physician — determines claim validity.
- "Working / not working" for WC differs from a fitness-for-duty judgement; coordinate return-to-work with the treating physician.
- Independent Medical Examiners (IME) may be requested — a distinct role from treating/OH physician.
- WC records are often exempt from HIPAA covered-entity rules; state privacy overlays apply. No patient data stored.
- ACOEM Position Statement on IMEs. Cross-ref: ADA · OSHA 300.