What Does Workers’ Compensation Not Cover?

Workers’ compensation is crucial to help make sure that employees receive medical treatment after sustaining a work-related injury.  Workers’ compensation allows an employee to recover medical costs related to the treatment of the injury. It also provides temporary or permanent disability payments to help take the place of lost wages.  Workers’ compensation will cover a wide variety of injuries, ranging from post-traumatic stress disorder, carpal tunnel syndrome, or a broken arm, just to name a few.  While workers’ compensation certainly covers a lot of different injuries, there are definitely some things that workers’ compensation will not cover.

One thing that workers’ compensation will not cover is injuries sustained during a car accident that happened during the employee’s normal commute.  Getting to and from work is not generally included, but there can be some exceptions.  For example, if the employee is driving between two different work sites, or is commuting to a distant work site that is not the employee’s typical workplace, then injuries sustained during that drive could sometimes fall under workers’ compensation.

Another class of injuries that would not be included in workers’ compensation benefits would be injuries that were intentionally inflicted by the employee himself.  An employee cannot recover for injuries if he or she purposefully sustains that injury.  This makes sense, as it is clearly unfair to allow an employee to receive financial benefit for purposefully throwing himself off of scaffolding or slicing her arm with a kitchen knife.

Third, injuries that were sustained during horseplay or fighting are likely not covered.  Even if  the employees are “on the clock” when they were horsing around, if either sustains an injury while this was going on, they likely will not be covered by workers’ compensation.  As with most other issues, there are exceptions to this.  If the employer regularly permitted or even encouraged horseplay, it is conceivable that the injuries would be covered.  Similarly, fighting in the workplace may end up not being covered.  That said, while a personal altercation between two employees may fall outside of coverage if one employee is attacked by another after a poor job performance review, the injuries to the employee who did not instigate the fight may be covered.

If you have questions about what types of injuries are covered by workers’ compensation, call us today.  We can talk with you about workers’ compensation and your business.

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