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What incidents can become ineligible for workers’ compensation?

On Behalf of | Apr 22, 2024 | WORKERS' COMPENSATION - Workplace Accidents, WORKERS' COMPENSATION - Workplace Injuries |

Occupational hazards can become unavoidable conditions in the workplace. For some employees, the risks can be minimal, such as those in administrative and office work that require little manual labor. The dangers are more apparent for others, including workers in warehousing or industrial jobs. These workplaces usually require more stringent safety standards and practices to prevent physical harm.

Still, accidents can happen despite taking preventative measures. Workers prone to sustaining injuries from these incidents can rely on their workers’ compensation insurance to cover necessary expenses. However, this type of insurance might not cover an accident based on its details, such as the following:

  • The incident happened when the employee was not working, which usually includes the employee’s breaks and transit to or from work.
  • The accident occurred from illegal activities or conduct that qualify as felonies.
  • The injured employee was under the influence of alcohol or other substances during the incident.
  • The reported injuries existed before the accident or resulted from self-harm.

Still, these limitations can change according to other details involving the claim, more so if the condition is a mental health issue or disorder. The circumstances surrounding the incident can significantly impact whether the employee can receive workers’ compensation coverage or not, making documentation and other supporting evidence vital.

Determining eligibility for workers’ compensation insurance

Despite having rules for workers’ compensation insurance, other factors can affect eligibility, typically varying on a case-to-case basis. Sometimes, the only way to determine whether these restrictions apply is to seek legal counsel. Having experienced guidance can help address confusion and misunderstandings about the claims process, eligibility standards, and other legal issues that can arise during the process.