Every business depends on its workforce to function properly. If an employee is injured while working, it is vital that they receive the workers’ compensation benefits they are entitled to cover the costs of their medical treatment and lost wages. However, there are some exceptions to workers’ compensation benefits that employers should be aware of. These exceptions can vary from state to state, so it is important to check with your state’s workers’ compensation board to see what applies in your case. Some general exceptions to workers’ compensation benefits include:
1. Intentional self-inflicted injuries
The workers’ compensation policy does not cover injuries intentionally or deliberately caused by the employee. For example, if an employee gets into a fight with another coworker and is injured as a result, they would not be eligible for workers’ compensation benefits. This is because the injury was not sustained in the course and scope of their employment.
2. Injuries sustained while the employee was intoxicated
This is because it is assumed that the employee acted recklessly and put themselves in a dangerous situation. When an employee is intoxicated, they are also more likely to be involved in an accident that could seriously injure or kill them. Their judgment is also impaired, which could lead to them taking unnecessary risks.
3. Injuries sustained while the employee was breaking the law
Every business must conform to the government’s laws and regulations. It is the responsibility of the employer to ensure that their employees are aware of these laws and regulations. When an employee breaks the law, they are not acting in the company’s best interest and are therefore not covered by workers’ compensation. For example, if an employee is injured while robbing a store, they would not be eligible for workers’ compensation benefits.
4. Injuries sustained while the employee was not working
The injury must have occurred while the employee was working to receive workers’ compensation benefits. This means that they will not be covered if an employee is injured while they are not on the clock. The time spent traveling to and from work is generally not considered to be working time, so injuries that occur during this time are usually not covered by workers’ compensation.
5. Injuries sustained while the employee was not on the premises of their employment.
The workers’ compensation policy exclusively covers accidents and injuries that occur while the employee is on duty. If the employee is injured while not at the workplace, the workers’ compensation policy will not cover them.
If you need legal representation to help you file a workers’ compensation claim or appeal a denial of benefits, the attorneys at cwilc.com can help. We have over ten years of experience fighting for the rights of injured workers, and we will do everything we can to get you the benefits you deserve.