4 Injuries that May Not be Covered Under Workers’ Comp

The scope of worker’s compensation is very broad and covers nearly every type of workplace injury that can occur. While many injured workers have claims denied, this is rarely because of the type of injury. More often, the circumstances surrounding the injury are the stated cause of the denial.

If you’re an employee and you’ve been injured on the job, you’re probably eligible for worker’s compensation. But there are some exceptions:

  • You were fighting or engaging in horseplay. Injuries resulting from workplace violence are not covered under worker’s compensation, and injuries resulting from horseplay are commonly excluded as well. However, courts are divided on the issue of horseplay, and circumstances may determine whether you are eligible or not. If horseplay is a common occurrence at your place of work, you’re more likely to be eligible.
  • You were intoxicated. Most states will not award worker’s compensation claims if the injury was caused by the employee’s drug or alcohol use. However, employees have some defenses here. If a drug test is delayed, it may not prove that you were intoxicated at the time of the accident. And even if you were clearly drunk or high, you may still have a case if the accident was caused by someone else.
  • You broke the rules. Honest mistakes or sloppiness won’t automatically disqualify you, but deliberately violating company policy is different. While worker’s compensation is generally a no-fault system, workers who push the limits will suffer as a result.
  • You weren’t at work. While worker’s compensation technically covers you when performing job-related duties, this probably doesn’t include your commute. Exceptions are sometimes made for people whose job includes driving, or people without a fixed workplace. However, injuries occurring while you’re off the job are not covered.

There are very few hard and fast rules involving worker’s compensation eligibility. The system is intended to reduce disputes and simplify the process of remedying workplace injuries. Too many restrictions would defeat the purpose, but too few would allow negligent employees to game the system.

If you’ve been injured at work and you aren’t sure if your injury is covered or not, we can help you. Contact our offices by phone, email, or text message, and we’ll help you navigate worker’s compensation law. Schedule a free consultation today!