Workers Comp – The Gray Areas

Getting injured at work and receiving worker’s compensation as a result seems like a pretty straight forward idea. That is, until how you sustained your injuries comes into question. Some situations fall into a gray area and worker’s compensation may or may not be covered depending on your particular situation. If your workplace injury or illness falls into one of these gray areas then call our office to have a lawyer that will be on your side.

Disease/Illness

If your workplace conditions have exposed you to or caused your disease or illness, you can be covered under worker’s compensation. A common illness covered by worker’s compensation is Black Lung Disease, which is suffered by coal miners who have spent an extended period of time inhaling coal dust. Proving your illness or disease is the direct result of your workplace conditions and not something you would have gotten regardless of your workplace conditions can be very difficult to do if the disease has not already documented to be environmentally caused, like Black Lung Disease.

Lunch Break

Depending where you are on your lunch break, paid or otherwise, can affect whether or not you are covered under worker’s compensation. Leaving your workplace to grab a bit e to eat typically is not covered but coverage could be a possibility if you were also grabbing lunch for your boss. If your company has an on-site cafeteria where you can order lunch or sit down and eat your own lunch from home, then injuries sustained on-site could be covered.

Misconduct

Worker’s compensation can still cover your injuries while at work even if you were acting negligently, careless, or intentionally doing something wrong. Allowing this type of behavior is a trade-off for insurance companies, they cover injuries as the result of misconduct or negligence and in exchange, the employee is not allowed to sue their employer for their injuries. An exemption from this would be any intentional, self-inflicted injuries.

Traveling

In most cases, commuting to and from work in a private vehicle is excluded from worker’s compensation but getting injured while on a business trip can still be covered. Individuals who drive a company car could still be covered under worker’s compensation even if they were not officially “clocked in” when the injury happened. A good example of this is a police officer driving his department issued vehicle to his designated station to clock in and receive his job tasks for the day.

Corporate Events

Any corporate or company sponsored event such as an after-hours holiday party, company retreat, or company picnic can still fall under the protection of worker’s compensation coverage. This also includes corporate events where alcohol is served.

Hearing Loss

If you work in a noisy environment, like a machinery, and suffer from hearing loss as result, then worker’s compensation should cover the costs of your hearing loss. Typically, in the case of hearing loss, you only have to show that the hearing loss was caused by your working environment and not another source.

Mental Conditions

In order to claim mental conditions under worker’s compensation, it must have been caused by your working environment. Stressful working conditions that cause anxiety or depression or Post Traumatic Stress Disorder (PTSD) experienced by first responders are examples of some of the mental conditions that could be included under worker’s compensation coverage.

Pre-existing Conditions

Some pre-existing conditions could receive coverage under worker’s compensation benefits if your job task required a specific movement that aggravated an old injury and you need new medical attention for it.

 

Regardless of how you are injured at work, be sure to notify your employer as soon as possible of your injuries. You will be required to file a report and should be given information on where to have your injuries treated. If your employer or insurance company denies you worker’s compensation benefits and you believe that you should be covered, contact our office for a case analysis.