You go to work every day and do your job without complaint. You know that if you’re injured while on the job, workers’ compensation is supposed to be there to cover you with no questions asked.
Except that’s not totally true. Employers often try to deny liability for a worker’s injuries because they don’t want their insurance prices to rise. For the most part, workers’ compensation is a no-fault system, but there are exceptions to the rules. Three times your claim can be denied include situations when:
You deceived your employer about your condition when you were hired
If you purposefully and knowingly misrepresented your physical condition to your employer to induce them to hire you and that lie can be directly tied to your injury, that can be a cause for denial. For example, that might include saying “Oh, I have no back trouble!” knowing full well that you have had surgery on your back in the past. If you subsequently injure your back lifting boxes in the warehouse, your employer may contest your claim.
You were using alcohol or drugs while on the job
Your employer isn’t going to take responsibility for your injuries if you were drunk or high while working, and your intoxication led to your injuries. (The only exception to this rule is if your employer gave you the intoxicating substances. For example, if your employer bought a case of beer as a reward for the roofing workers and you got tipsy and fell, your employer would still be liable.)
You intentionally injured yourself or got hurt while trying to injure another
If you got hurt in a fight with another co-worker and you were found to have instigated the fight, you can expect your employer to fight your worker’s compensation claim. Similarly, if you injured yourself in a moment of despair after a bad breakup with your romantic partner, your employer isn’t going to accept responsibility.
There are all kinds of reasons workers’ comp claims get denied, but not all of them are clear-cut. If you’re having problems with your claim, get experienced legal guidance.