Avoiding the Employment Relationship

In order to avoid the effects of the workers' compensation system, some employers will deliberately categorize a person as an individual contractor instead of an employee. Some individuals may even categorize themselves as individual contractors, preferring to reject the compensation system. Whether this categorization is successful, however, turns not just on the name given to the employment relationship. Rather, each relationship is examined on its own facts and will be decided based on the conduct exhibited between the parties as well as the work contract entered into between them.

Res Judicata and Reopening of Social Security Decisions

The hallmark of res judicata is finality. Essentially, once a court has entered a final judgment conclusively establishing the rights of the parties on the merits of the dispute, such decision is final and will bar subsequent actions based on the same claim or cause of action. This rule of civil procedure has been adapted and applied to administrative actions, including social security decisions.

Supplemental Security Income Appeals Process

Aggrieved individuals may appeal initial determinations of the Social Security Administration with respect to a variety of issues. A non-exhaustive list of appealable issues includes whether an individual is eligible to receive Supplemental Security Income (SSI) benefits, the amount of an individual's SSI benefit, whether an overpayment has occurred and the amount to be repaid, and whether the individual suffers from a "disability." Though individuals have sixty days to initiate the appeal process, only those individuals who appeal within ten days may have their benefits continued until the appeal is decided. If ultimately, the individual's appeal is unsuccessful, the payments he received in the interim will be considered overpayments. After each decision in the appeal process, the individual has another sixty days in which to appeal to the next level.

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.

Non-Business Exemptions

The workers' compensation system was designed to provide benefits to those employees who are injured in the course of employment. However, not all "employments" are considered to be within the contemplation of the system. By way of contrast, consider the factory worker who cuts his hand while working on an assembly line making car parts for the employer and the teenage boy who cuts his hand trimming hedges for his neighbor. Both the factory worker and the teenage boy were "employed" to perform a service for another. However, workers' compensation would only be applicable to the factory worker's injury. Other examples where resulting injuries would likely not qualify for workers' compensation, even though the individuals were paid for their services, include a housecleaner hired to perform a one-time spring cleaning on your home, a babysitter who cares for a young child on a weekend evening, and a mechanic friend who helps to fix a broken vehicle.