What Does and Does Not Count as a Work-Related Injury?
Personal Injury Lawyer
If you’re injured while on the job, you cannot sue your employer or co-worker for causing your injury or illness. You can however file for workers’ compensation, which is a benefits program that pays for your medical bills and potentially pays a portion of your lost wages if you miss work as a result of your illness.
If you’re looking to collect workers’ compensation benefits, you will have to prove that your injury or illness is work related, occurred on the job or as a result of the job.
What injuries make you eligible for workers’ compensation?
This varies greatly and injuries are looked at on a case-to-case basis, but generally if you were performing a task that benefited your employer and were injured or fell ill as a result, your injury is work-related. That means that you should be able to receive benefits so long as you meet the following eligibility requirements:
- You are an employee
- You have a work-related injury or illness
- Your employer carries workers’ compensation insurance
- You met your states’ deadlines and requirements for reporting the injury and filing a claim
There are some instances in which an employee may not be eligible to collect workers’ compensation for their injuries.
- The employee was intoxicated or using illegal drugs at the time of the injury
- The employee was committing a serious crime at the time of the injury
- The employee’s injury was self-inflicted
- The employee was injured because they initiated a fight
- The employee suffered their injury while they were not on the job
- The employee’s injury caused while they were violating company policy.
Sometimes a claim is not so black and white. There are instances in which it may be difficult for an employee to prove that the injury that they sustained was the direct result of their employment. Here are a few examples:
Injuries Sustained While Breaking a Workplace Safety Rule
Injuries are usually covered by workers’ compensation regardless of who is at fault for the injury, but if you were exhibiting misconduct at the time of your injury, you may not be eligible. For example, if the employee was drunk or using drugs at the time of their injury, they may not be eligible to receive compensation. Additionally, if the employee was fooling around, rough housing, breaking a workplace rule or trying to hurt themselves or someone else at the time of the injury, they may no longer be eligible. In these cases, the employee who was injured could potentially argue that the horseplay or rule-breaking that occured was known or condoned by the employer, and that could potentially lead to some benefits.
Injuries Sustained at a Company Party
Injuries sustained at a company party or event are actually covered under workers’ compensation because they are company sponsored events. Employers can find a loophole however, should they not require or expect that employees attend these events.
Injuries Sustained While Traveling for Work
Workers’ compensation generally does not cover injuries that were sustained during an employee’s commute to and from work, but there are exceptions. For example if you were driving a company vehicle while you were injured, if you were driving your car because you were required to do so by the company, if you were doing errands for your employer, or if you were traveling on a business trip.
Injuries Sustained While at Lunch or on Lunch Break
Let’s say you were walking to grab yourself some lunch on your typical lunch break, and you trip and fall, breaking your wrist on the way down. You probably cannot claim workers’ compensation because usually injuries that happen on an employee’s lunch break aren’t work-related.
There are some exceptions, though. If you were running an errand for your superior at the time of the injury, your injury may be covered under workers’ compensation because you were performing a duty for your employer. Additionally, if you were injured in the company cafeteria, it’s possible for you to receive workers’ compensation, but only if you were not breaking any company guidelines or rules at the time of the injury.
Illnesses, Stress-Related Conditions or Repetitive Strain Injuries
Workers’ compensation claims that include these types of injuries or illnesses can be tricky because the employee has to prove that their condition is a direct result of their workplace. Repetitive strain injuries like carpal tunnel can be covered under workers’ comp for employees who work at a desk all day. There are also illnesses that can result from one-the-job exposure, or even psychological illnesses that result from workplace stress. Employees may also claim that a physical injury was caused by workplace stress or that a preexisting injury was made worse by their time on the job.
Remember that workers’ compensation claims vary from person to person and the laws surrounding them vary from state to state; therefore, there are no hard and fast rules to whether or not a person is able to receive workers’ compensation.
Have questions about your workers’ compensation claim? You may want to get in touch with a lawyer experienced in workers comp Milwaukee, WI offers to help you claim the benefits that you are entitled to.
Thank you to our friends and contributors at Hickey & Turim, SC for their insight into workers compensation and what counts as a work-related injury.