5 Reasons Your Workers’ Comp Claim Could be Dismissed

If you’re concerned about having your workers’ compensation claim dismissed, rest assured that most workplace injuries are covered. Even if it takes a lot of hard work and patience, you can get the compensation you deserve for a work-related injury. However, you may want to review the following situations where you may be denied coverage:

  1. Your injury isn’t work-related. Workers’ compensation is supposed to cover pretty much any injury you can imagine, as long as it’s work-related. This means that the injury occurred at work or during work-related activities, not during your time off.  If your job involves running errands or traveling, these activities are covered as well. Commuting, however, is generally not covered.
  2. Your injury is caused by a behavioral problem. While workers’ compensation is a no-fault system, your claim may not be covered if you hurt yourself by engaging in prohibited activities, such as: illegal activities, drug or alcohol abuse, horseplay, or deliberately reckless behavior. Horseplay may not disqualify an employee if it was normally tolerated up until the time of the injury.
  3. Your injury is self-inflicted. You can’t collect workers’ compensation if you hurt yourself on purpose, and you certainly can’t collect if you hurt yourself just to get benefits. While this is hardly the most common reason why claims are dismissed, it’s not unheard of. An employee who tries to game the system, whether for either money or for time off, could face consequences beyond a workers’ compensation denial if their motive is discovered.
  4. Your injury is caused by violence. If you start a fight with anyone at your place of work, you can probably count on losing both your job and your right to be compensated for any injuries you sustained. But even if someone else started it, workers’ compensation may not cover you if the motive wasn’t related to work, such as violence resulting from a personal dispute between coworkers, or between an employee and an ex-spouse. If an employee is attacked by an angry client or customer, or is attacked while working alone at night, the employer is more likely to be liable.
  5. You didn’t report your injury in time. In most cases, employees have 30 days from the day of the injury to report it to their employer. For injuries that develop gradually or require testing, the employee has 30 days from whenever they notice, or could reasonably have noticed, the injury and its connection to their job duties. For example, an employee who develops carpal tunnel syndrome would need a doctor to verify that the injury was indeed work-related, which could take weeks or even months. An employee who slips on a wet floor, on the other hand, would have to report within 30 days.

Even in these cases, it can be difficult to rule out that an injury should be covered. Different jobs have different requirements, and the boundaries between a work-related injury and an unrelated injury requires a lot of discernment. Katherine is an experienced workers’ compensation attorney, and she can help you understand the difference. Contact us by phone, email, or text message, and let us schedule a free consultation to get you started!