Workers' compensation insurance is often touted as a no-fault system that automatically compensates an employee injured in the workplace. Unfortunately, this isn't technically correct; there are a few terms and conditions that may deny you workers' compensation benefits depending on what caused your injury. Here are some cases where workers' compensation may not apply even if you are injured at work.
Your Injuries Were Self-Inflicted
Self-inflicted injuries are not compensated by workers' compensation; those are yours to bear. You shouldn't expect compensation if you cause an injury to yourself at work because you knew what you were doing. The most obvious example of a self-inflicted injury is that which occur in a suicide attempt, but this isn't the only way in which you can incur self-inflicted injuries.
For example, if you engage in an inherently dangerous activity that isn't part of your work, your employer can argue that your injuries are self-inflicted and deny you workers' compensation benefits. An example is jumping off a height instead of using a ladder that is available for your use; don't expect compensation if you break your ankle in the process.
You Were Intoxicated At the Time of the Accident
Intoxication is a common reason for workers' compensation denial. In fact, most employers have policies in place to test injured workers as soon as they have received emergency medical care. If such a test reveals a drug in your system, such as alcohol or other controlled substances, then your employer may use the result to deny you workers' compensation benefits. This is particularly true if your employer doesn't tolerate intoxication at work or has a strict policy of not getting high at work. However, the employer first has to prove that the intoxication contributed to the accident. You may still get your benefits if the intoxication didn't play a part in the injury.
You Were Violating a Company Policy
Lastly, you may also lose your rights to workers' compensation benefits if you were injured while breaking your employer's policy. This is particularly true if the violation caused or contributed to the accident and it is a well-known policy – not some obscure one that only your employer knows about. For example, don't expect compensation if your employer has a strict no-smoking policy and you were injured by a fire started by your discarded cigarette.
As you can see, you should never assume that your workers' compensation claim will be paid, particularly if the issues discussed above apply to your accident. Consult a workers' compensation attorney to help you figure out a way forward after your injury.
Share20 August 2018
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