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What does workers’ compensation not cover?

Workers’ compensation can provide you with help if you suffer an on-the-job injury. It can be quite helpful when you cannot return to work due to your injury, and it will pay your medical expenses related to the incident.

It is a no-fault system, which means that you do not have to prove your employer was at fault. However, this does not mean that your employer’s insurer will pay out in every situation.

When you are at fault

The Hartford explains that if your actions led to your injury and your employer had no ability to prevent it even with safety precautions, then the insurer may not pay. A good example of this type of situation is if you were goofing around and not following safety rules and you hurt yourself. The injury was the direct result of your actions and decisions.

When you were acting outside your job duties

Workers’ compensation only has to cover you for injuries you incur while on the job and doing your assigned job duties. If you were, for example, fixing your vehicle while on your lunch break and suffered an injury, then workers’ compensation would not be liable for that injury.

When something illegal occurs

If you do something illegal and suffer an injury, then you will not receive compensation under workers’ compensation.

When you intentional injure yourself

If the insurer finds that your injury was intentional, you will not get coverage. There will be an investigation to discover what happened and how it happened, so if you try to injure yourself just for the benefits, it will not work.

When you were on drugs or alcohol

After your accident, you will likely have to undergo drug and alcohol testing. If you have any drugs or alcohol in your system, the insurer can deny your claim.

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