Workers comp benefits provide comprehensive coverage for on-the-job injuries and liability insurance for employee lawsuits. However, this mandatory insurance has its limits. Workers Compensation law prevents business owners from being on the hook for incidents beyond their control or unrelated to the job.
When Workers Comp Benefits may be Denied
Workers Compensation is not a blanket insurance coverage. It is primarily for work-related injuries and illnesses that prevent an employee from doing their job. In order to protect themselves, employers should be aware of five common disqualifying situations.
1) Outside of Work Injuries
Although workers are covered if they get hurt at work, once they leave the job site you are not held liable for anything that may happen to them. To protect themselves, some employers use security cameras to document when injuries do or do not occur.
2) Under the Influence Incidents
Regardless of company policies, employees who are under the influence at the time of their injury may be ineligible to claim workers comp benefits. This includes alcohol and illicit substances, like marijuana or cocaine, which impair motor skills.
3) Self-Inflicted Injuries
Although workers comp does not typically take fault into account when declaring benefits, self-inflicted injuries are sometimes different. You may be able to deny compensation if an employee’s injuries are self-inflicted.
4) Violations of Company Policy
Employees who are injured while violating company policy may also be ineligible for Workers Compensation insurance. For example, if an electrician is hurt while not following company safety guidelines, the employee may be ineligible to collect workers comp.
5) Violations of the Law
If one of your employees is injured while breaking the law, they may be denied workers comp. While it may seem obvious, this rule does actually come into play on occasion.
If one of your employees is injured at work, it’s best to immediately document exactly what happened before, during and after the incident. You may be required to report the injury to your insurance carrier and submit paperwork to begin the claims process.
Worker comp benefits will generally cover medical bills, lost wages or other related expenses if none of these exceptions apply.