How Fault Plays Into Workers’ Compensation Claims

How Fault Plays Into Workers’ Compensation Claims

One of the great aspects of workers’ compensation is it often doesn’t take into account whose fault the injury was. Whether a machine malfunctioned, you tripped over a desk chair someone left out or you spilled a boiling substance on yourself, nobody is “blamed” for the incident. Workers’ compensation covers individuals who are employees of the company, who have an illness or injury, and whose illness or injury was proven to be obtained during the course of employment.

Exceptions When Fault Is Considered

Though most cases don’t look at fault, there are a few exceptions when fault will be considered. They include the following.

  • If you were intoxicated or using illegal drugs on the job. In such a case, you would be at fault and your coverage could be denied.
  • If you started a fight with another employee, your boss or someone visiting the workplace. Again, because you acted negligently in starting the fight, you may be denied coverage.
  • If you were in the act of committing a crime. Even if the injury was clearly related to your job, if you were in the act of committing a crime when it happened, you would probably be put at fault and denied.
  • If you violated company policies, especially if you were warned not to. If your employer knows you’ve been violating company policy and does nothing about it, you could possibly still have a case. If the employer has been warning you to stop violating the policies, it could look worse for you and you could be denied coverage.

Other Options for Obtaining Coverage

If fault is given because of one of the aforementioned exceptions, you may have some other options for obtaining financial coverage. First, you could contact your personal health insurance provider to see what sort of coverage you have. You may have to pay a deductible and co-pays for medical coverage, but it would be better than nothing.

Second, you could file a civil lawsuit against your employer, a coworker or a third party you feel is actually responsible for your injury. Your lawyer can help you determine who to sue and how to move ahead with the action.

Contacting Your Attorney

If you are injured on the job, one of the first things you should do is contact a workers’ compensation lawyer in Manitowoc, WI. Though fault isn’t typically considered, there could be some exceptions you weren’t thinking about. Your attorney can help you navigate the reporting and filing processes, as well as work on a lawsuit should it come to that. Contact your attorney today.

Thanks to Hickey & Turim, SC for their insight into workers’ compensation claims and fault.

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