Benefit payments for workers’ compensation claims total $61.9 billion per year. If you’ve been injured at work, you may have a workers’ compensation claim and are entitled to your own payment.
But not all injuries that happen at work are eligible for compensation claims. Use this guide to determine if your injury qualifies for you a legitimate claim.
Must Be Work-Related
Your injury or illness needs to be directly related to your work. This means that either the environment or an event exposed you to the injury. Work-related is a loose term and can cover injuries that happen on work premises while on break or after clocking out.
Repetitive Stress Injury
Your injury doesn’t have to be from one single event. It’s increasingly more common that employees see a workers compensation doctor for painful conditions that result from performing the same motion repeatedly throughout the day.
The most obvious form of this type of injury is carpal tunnel from typing. But it can also occur in factory workers or anyone that performs a physical task repeatedly.
Compensation Claims That Don’t Qualify
Each state has specific laws about what doesn’t qualify, but there are some common themes that run throughout. These are scenarios that fall outside of the course or scope of employment.
Commuting to and From Work
If you’re driving your own car to your fixed worksite location, then any injuries sustained during this time are probably not covered. There are some exceptions, such as driving a company vehicle or not having a fixed worksite.
Recreational Activities
Injuries during social events are typically not covered, such as at a company picnic, happy hours, or parties. Some factors can affect this and make it more likely that your claim will get covered.
Substance Abuse or Intoxication
If it’s discovered that you were under the influence of drugs or alcohol when the injury occurred, then your injuries aren’t covered. There are rare cases where you can still make a successful claim, but you’ll need to prove that the injury is in no way your fault. For example, you’re under the influence of alcohol while standing on the factory line when another employee strikes you from behind with a forklift.
Employee Fighting or Horseplay
Injuries that happen because of employee fighting or horseplay are not covered under workers’ comp. There are some exceptions, such as employer tolerated or encouraged horseplay.
Do You Have a Qualifying Injury?
If you have a mental or physical condition or injury that is a direct result of your employment, then you may have a valid workers’ compensation claim. If you’re unsure, it’s best to review the workers’ compensation claims laws of your state.
Your first step should be to visit a doctor to assess your injuries and an attorney to discuss your legal options.
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