What Is Not Covered by Workers’ Comp?

by Josh Biggs in Tips on 8th June 2021

Workers’ compensation is a vital component of any workplace because it provides benefits and protections to any employees who get injured on the job. Those benefits include medical care and temporary disability assistance if the employee is unable to work and earn any wages while they are recovering from their injury. All states require businesses of a certain size to carry workers’ comp insurance and that insurance covers a wide variety of different scenarios where a worker could get injured while on the job. 

However, there are some situations where an injured worker is not eligible for compensation, for instance, in certain professions because of the inherent danger involved. One example of this is those serving in the military, though in this case, they have their own compensation scheme which you can find out more about here. Employees should be aware of these situations before they attempt to seek compensation because they could be denied. In cases where workers believe that they are owed compensation but the employer refuses to provide it, then they should get an employment attorney to help them. The attorney can help to sort out the situation and give the worker a chance of getting the compensation that they are owed. You can click personalinjuryattorney-fresno.com if you want to learn more about how an employment attorney can help you.

Exceptions For Workers’ Compensation

The following types of employee injuries are not covered by workers’ compensation insurance:

Commuting To or From Work – When a worker is traveling to or from work, they are not considered to be in the scope of their employment. That means they are not covered by workers’ comp insurance and will have to rely on other means, such as a personal injury claim or lawsuit, to get the compensation that they need.

Worker Intoxication – If an employee was under the influence of drugs or alcohol when they got injured and their intoxication was a direct cause of their injury, then they will not be covered by workers’ compensation.

Horseplay – This is described as general fooling around or playing in the workplace. If an employee gets injured while they were engaged in horseplay, then they are not eligible for workers’ comp because they were not working when the injury happened. Only activities that are in the course of the employee’s job are eligible for compensation. However, if an employee that was doing their job gets injured as a result of the horseplay of other employees, then they are eligible for compensation.

Intentional Acts – When an employee intentionally hurts another through an act of violence or sabotage, then that is not covered by workers’ compensation. However, the injured worker can get compensation by filing a personal injury claim or lawsuit against the person who injured them.

Illegal Acts – If an employee is injured while performing an illegal act at the workplace, such as stealing for example, then they will not be covered by workers’ compensation.

Workplace Policy Violations – There are rules in every workplace and if an employee breaks any of those rules and gets injured in the process, then they will not be covered by their employee’s workers’ comp policy.

Fired Employees – Any terminated employee is no longer eligible for any workers’ compensation benefits provided by their former employer.

Contact an Employment Attorney If You Have a Workers’ Compensation Dispute

If you are being denied workers’ comp even though your situation does not fall into any of the listed categories, then you should contact an employment attorney to help you with your case.

Categories: Tips