An employee who is injured in an accident while on the job may have a number of questions about what to do and what is allowed, and one of these questions can involve fault. If the employee is partially or totally at fault for the accident, does it affect the employee’s ability to pursue a workers’ compensation claim? Does fault play a role at all in the process? We have asked attorney Alaina Sullivan, about what you should do. Here is what she had to say: What Is Workers’ Compensation Workers’ compensation is an insurance program offered through employment that consists of payments required by state law to be made to an employee who is injured or disabled in an accident while at work. Every state has its own set of rules and guidelines. The expenses that are traditionally covered include medical expenses, lost wages, cost of re-training, and even survivor benefits, if the injury resulted in a death. However, if the employee chooses to file for workers’ compensation, he or she is waiving the right to file a lawsuit for personal injury against the employer. Is Fault Needed in Workers’ Compensation Cases? If an employee is hurt while working, he or she is entitled to workers’ compensation benefits. This right to pursue workers’ compensation includes situations where the employee is to blame for the accident. In fact, workers’ compensation has nothing to do with fault. The employee does not need to prove that the employer caused the accident or that other employees also caused the accident. Even if the employee’s behavior was negligent and caused the incident that led to his or her injuries, he or she would still be entitled to file a claim for benefits. What types of incidents are and are not covered by workers' compensation insurance? Workers' compensation insurance is designed to cover injuries that result from employees' or employers' carelessness. The range of injuries and situations covered is broad, but there are limits. States can impose drug and alcohol testing on the injured employee, and can deny the employee workers' compensation benefits if such tests show the employee was under the influence at the time of the injury. Compensation may also be denied if the injuries were self-inflicted; where the employee was violating a law or company policy; and where the employee was not on the job at the time of the injury. What Accidents Are Not Covered by Workers’ Compensation Insurance? The purpose of workers’ compensation is to cover injuries that resulted from accidents, normally caused from the employer’s or employee’s negligence. The range of what can happen can include pretty much anything from a filing cabinet falling onto an employee to a forklift accident. However, certain situations can arise where the employee causes the incident and the employer does not have to cover the injury. These situations normally include the employee being under the influence of drugs or alcohol and the accident happening because of his or her altered state. Some states require that the injured employee submit to drug and alcohol testing before benefits can be given, and if the tests show that he or she was under the influence, the employee may be denied workers’ compensation benefits. In addition, if the employee’s injuries were self-inflicted or caused with the purpose of getting the company to pay for benefits due to fraud, he or she may be denied the claim. Also, if the employee was willfully violating a company policy or law, this violation may also be a further reason for the claim being denied. Personal Injury Lawsuits Fault does come into play if the employee chooses to not file for workers’ compensation but rather proceeds to file a personal injury lawsuit against the employer instead. In these situations, fault is a consideration. Considering the fact that the types of relief that can be sought in a court matter are higher in value than in a workers’ compensation claim, employers are more likely to fight back if a suit is filed against them. The employer may seek to point out the ways the employee was at fault and caused the accident to happen to help defend the company from paying for damages in court. Contact an Attorney Today If you have been hurt in an accident while on the job and have questions about whether you can file for workers’ compensation benefits, it is recommended that you contact an attorney to answer your questions. A licensed attorney trained in workers’ compensation law will be able to review your case and determine your best course of action. To receive the compensation you deserve, contact an attorney in your area today. Additional Resources Worker's Compensation and Fault Why Should I Get a Workers’ Compensation Attorney?
