Workers’ compensation insurance provides financial compensation and other benefits to employees who are injured or become ill while on the job. Benefits most often include payment for medical expenses, compensation for lost income, and death benefits.
It also covers injuries that happen over time, like carpal tunnel syndrome. If you think you may have a workers’ compensation claim, the first thing you should do is notify your employer. They will then file a claim with their insurance company. You will need to give the insurance company your medical records and other information about your injury so the insurance company can make a decision about your claim. Typically, if your injury or illness occurred while you were performing job duties, you will be approved. However, there are some exceptions.
Workers’ Compensation Does Not Cover Injuries If You Were Intoxicated
Under workers’ compensation law, employees who are injured while intoxicated are not eligible for benefits. This is considered to be a voluntary decision to engage in willful misconduct before or during work hours. As a result, the insurance company is not liable for any injuries that occur as a result of the employee’s intoxication.
Workers’ Compensation Does Not Cover Injuries That Occur Because of Fighting or Horseplay
Fighting and horseplay are not considered to be accidental injuries, even if they were not intended to result in an injury. For example, if you’re working in an office and you start playfully wrestling with another employee and you end up getting hurt, your injuries would not be covered by workers’ compensation because they occurred because of fighting or horseplay.
However, if you were defending yourself, the fight was provoked by another employee, and it happened during the course of employment, your injuries may be covered.
Workers’ Compensation Does Not Cover Injuries That Occur While Commuting
If your injury occurs while you are commuting to or from work, you will usually not be eligible for workers’ compensation benefits. This is because the workers’ compensation system is designed to cover injuries that occur during the course of one’s employment.
There are exceptions, though. For example, if your employer requires you to use a specific mode of transportation, such as a company car, and you are injured while using that transportation, you might be eligible for workers’ compensation benefits.
Workers’ Compensation Does Not Cover Injuries That Occur on Meal Breaks
When it comes to meal breaks, the general rule is that if you are injured while taking a break from work, you are not eligible for workers’ comp benefits. However, if your employer requires you to take your meals in a certain area and you are injured in that area, you may be eligible for benefits. Or if you are on call during your meal break and you are injured while responding to a call, you could also be eligible for benefits.
Workers’ Compensation Does Not Cover Injuries That Occur During Recreational Activities
If you’re hurt while doing something that’s not part of your job—like playing softball at a company-sponsored event—you probably won’t be covered. If your employer requires you to participate in the activity or the activity takes place on company property during work hours, then you might be covered.
If you were injured and need help determining if you’re covered by workers’ compensation, contact our Washington D.C. workers’ compensation lawyers today to schedule a free consultation.