Although workers' compensation covers employee injuries that occur in the workplace, there are some injuries that it may not cover. Here are some of the injuries you may have trouble claiming from workers' compensation.
You will have a hard time claiming your workers' compensation benefits if you were injured while intoxicated; this is especially true if the intoxication contributed to the accident. Consider a case of a retail employee who slips and falls on the retail floor. If it is discovered that the employee had a few beers before coming to work, it can be argued that they lost their balance and fell because they were intoxicated. In such a case, the retail employee may be denied workers' compensation benefits.
Although workers' compensation is a no-fault system of compensation, it doesn't cover self-inflicted injuries. The no-fault condition only means that you don't have to prove that your employer caused the accident. Therefore, you should not expect to be compensated if you, say, cut your finger while trying to prove to your colleague how tough your gloves are by rubbing the finger over a sharp blade.
Paying workers' compensation benefits for injuries incurred in the course of a criminal act or triggered by a criminal act is tantamount to rewarding crime in the workplace. For this reason, don't expect workers' compensation benefits if you were committing a crime at the time of your injuries. This applies both to crimes against the government and crimes against your employer. For example, if your employer doesn't allow you to engage in personal projects in the workplace, and you are injured while carving a gift for your spouse, you aren't likely to be compensated for the injuries. Similarly, don't expect any compensation if you are injured while trying to break into the storage room to steal merchandise.
Injuries Stemming from Recklessness
Workers' compensation is meant to compensate employees injured in the scope of their work. Therefore, you aren't likely to be compensated for injuries caused by horseplay since horseplay doesn't usually fall within employee's work duties. You might be compensated for the injuries, however, if your employer knew about your routine horseplay and encouraged it or looked the other way.
If you have hit a snag with your workers' compensation claim process, consult a lawyer to help you with the case. Workers' compensation lawyers can help you prove that your injury doesn't fall into any of the excluded categories.