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Does fault matter in a workers’ comp claim?

On Behalf of | Aug 7, 2024 | Workers' Compensation |

Workers’ compensation is a kind of insurance that provides employees certain benefits if they are injured while working. Employees eligible for workers’ comp may be able to recover medical coverage for their injuries and lost wage payments. These benefits can help employees recover from their injuries and continue to provide for their families.

Workers’ comp is a no-fault system. What this means is that employers typically do not have to prove negligence to provide injured workers with benefits. There are some exceptions that, if met, could prevent a worker from receiving workers’ comp benefits. Here is what you should know:

Was the injury self-inflicted?

Workers can file for workers’ comp claims if, for example, they are injured because of equipment failures, machinery issues or slip-and-fall accidents. Some employees will injure themselves to try to claim workers’ comp benefits. This attempt to dishonestly take advantage of the system could prevent a worker from receiving benefits.

Was the injured worker inebriated?

An employee may use drugs or alcohol while working. Certain substances can cause workers to act erratically or carelessly. As a result of their substance use, they may injure themselves while, for instance, using machinery or failing to follow workplace protocols. If the employee is discovered to have used substances while working, violating work policies, then they could be denied workers’ comp benefits.

Did the injured worker start a fight?

An employee may instigate a fight with their co-worker. The fight could result in serious injuries. While the injuries happened while on the job, the worker may be denied workers’ comp benefits because they caused the fight.

If you are denied workers’ comp benefits and desperately need them for your medical expenses and family care, then you may need to seek legal guidance to learn what you should do next. 

 

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