Learn What Is Not Covered By Workers’ Comp

Rispoli & Borneo P.C.

Workers’ Compensation Lawyers

One of the biggest benefits of workers’ compensation is that it is considered a “no-fault” system. This means that even if the person who got injured while working is responsible for their injuries, their employer will almost always still cover them under workers’ compensation if the employee provides evidence of injuries that are related to their job. While this is good news for anyone who may have accidentally caused their own accident, there are still exceptions to this rule and certain times when an employer will not cover your injuries. 

When will I not be covered by workers’ compensation? 

There are times when workers’ compensation will not cover you. For example, if you do not file your claim on time, never report your injuries to your employer, did not get injured during the scope of your employment, or did not seek medical care, you will likely not be able to get workers’ compensation benefits for your injuries. 

Other Exceptions

There are a few other major exceptions that you should keep in mind when filing for workers’ compensation benefits, and speaking with lawyers, like workers’ compensation lawyers from a law firm like Cohen & Cohen P.C. can help you determine if your situation calls for filing a workers’ compensation claim. 

  • Injured on a break. This can be a tricky situation because it can depend on the details regarding your break. For example, if you are eating in your employer’s cafeteria or out to a work lunch, you may be covered under workers’ compensation. However, if you went out to get lunch on your break, workers’ compensation likely will not cover your injuries. 
  • You were injured away from work. Unless you were performing work-related tasks while away from the office, it is unlikely they will provide you with workers’ compensation. 
  • You were under the influence. If you were under the influence of drugs or alcohol while you were working and were injured because of it, you may not be able to get your workers’ compensation benefits. Though it will depend on the state you are in, you should speak with a lawyer if this describes your situation. 
  • You were fighting. In the event that you were fighting with another employee or were horsing around, you will likely be considered not working (under the scope of your employment) during that time and it is less likely that your employer will provide you with workers’ compensation benefits. 

When it comes to workers’ compensation benefits, the truth is that there is never a clear answer on what falls under these benefits or not depending on the work circumstances or the state. One of the best things you can do is speak with your lawyer to help you when you have questions about filing your claim.