Workers’ compensation benefits are designed to balance the needs of the injured worker against the needs of the employer and society as a whole. It’s generally to everybody’s benefit if a worker can get the medical care they need for their injuries and return to productive labor as soon as possible.
If injured workers had to litigate every claim, that would be disastrous for them and the court system. With that in mind, workers’ compensation was designed to be a “no-fault” system. That means it doesn’t matter if the employer was negligent or the employee tripped over their own shoelaces. If they were injured in a workplace accident, they’re typically covered.
However, there are exceptions.
When does fault matter in a worker’s compensation claim?
There are a few times when fault matters. An employer may deny liability when the worker was injured because:
- They were engaged in “horseplay.” If you were joking around with someone and a few playful shoves were exchanged leading to a fall, your employer may contest your right to benefits.
- They were intoxicated at the time of the accident, whether by drugs or alcohol, so long as the substance causing intoxication wasn’t provided by the employer.
- They intentionally injured themselves for some reason or tried to kill themselves.
- They were engaged in an intentional fight with another (meaning they started the altercation) and attempted to injure or kill the other person.
Perhaps it’s most accurate to say that worker’s compensation is almost a no-fault system. Your claim can still be denied for the reasons above.
Employers often dispute whether an injury is work-related or not, and they often dispute the severity of a workers’ injuries. If your workers’ compensation claim has been denied, it’s wise to seek experienced legal guidance.