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When Workers’ Compensation Won’t Get Approved

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Posted On 01.18.18 by in Blog

Workers’ compensation is a form of insurance. It provides employers with a safety net, so that if one of their employees gets injured on the job, they don’t have to worry about a civil lawsuit. That being said, like any other form of insurance, it would be a mistake to think that you’ll be paid no matter what. Restrictions apply and if you find yourself working outside of them, your compensation is no longer a sure thing.

Working While under the Influence

It should go without saying that working while inebriated or under the influence of some type of drug is never a good idea. If you get injured while on the job and are found to be intoxicated, high, etc. you will not be receiving workers’ compensation. The insurance company will have a pretty easy time blaming the accident on your state of mind and can then justify not paying out. Proving that the alcohol and/or drugs were not responsible is your only hope, and will be an uphill battle, to say the least.

Suicide or Homicide Attempts

Another exception that should be obvious is if you try killing yourself or someone else while on the jobsite. In the case of an attempted suicide, many people have later tried to deny that was their intention. Instead, they insist that the attempt on their own life was an honest accident. If the insurance company can prove otherwise, you’ll be out of luck.

Criminal Behavior

If you were injured while in the process of committing any other crime while on the clock, your compensation will be withheld. Again, some criminals will try to prove that whatever they were doing wasn’t an attempt at theft, for example, but insurance companies have a lot of experience at seeing through these explanations.

Deviation of Duty

Everyone knows what their job entails. They also understand what’s expected of them once they show up for work. Of course, that doesn’t necessarily stop people from deviating from their role. Horseplay may seem harmless enough, but it often gets people hurt. It doesn’t matter how innocent your intentions might have been, if you weren’t performing your role or partaking in acceptable behavior (e.g. walking to the elevator) when you were hurt, you shouldn’t expectation that workers’ compensation will pay out.

Suing Your Employer

Sometimes, your workers’ compensation may get approved just fine, but isn’t the right route to go. Instead, you should be suing the employer in civil court. This would refer to a scenario in which you think your employer intentionally put you in danger or harmed you in some way. This is called an intentional tort. Examples would include situations where you were emotionally traumatized, physically assaulted or denied the ability to leave.

If you’re having problems with your workers’ compensation claim, contact us today and speak to someone in our office. At Ingerman and Horwitz, we have over 25 years of experience helping people in your situation. Whether your claim is being denied or you think you have a legitimate lawsuit, we’re here to help.

 

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