Am I Entitled to Workers’ Compensation If My Injury Is My Fault?

Entitled to Workers’ Compensation
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You are injured at work, but it was the result of something you did. Thus, it is your fault. You are concerned that you may be disqualified for workers’ compensation as you recover, but that is to the contrary. Fortunately, you are still eligible for workers’ compensation even if you are to blame, in part or entirely, for your injury.

In some states, workers’ compensation is considered “no-fault”, which equates to an injured party being eligible for benefits whether it was their fault or the employer’s fault in an injury that occured during work. This applies for a state such as New Jersey, which is why if you are hurt, find the best work injury lawyers in Toms River NJ to handle your case. While you may not always need a lawyer to look over a workers’ comp claim, it is good to have a legal professional readily available in the case that an issue takes place and you need information or guidance on how to move things along. It doesn’t matter if the injury was on a construction site or in a high-rise office building.

Instead of proving the negligence of your employer, an injured worker must show that the injury occurred within the “course and scope” of your job duties.

As usual, there are exceptions that you should be aware of.

Being Intoxicated

You will not be eligible for workers’ compensation payments if the injury you sustained was caused by being under the influence of alcohol or drugs, either illicit or prescribed. For your claim to be rejected, it would have to be demonstrated that the injury was caused primarily by the use of drugs or alcohol.

Rough-Housing

Your workers’ comp claim may be dismissed if your injury was caused by your rough-housing. Also called “horseplay” or “skylarking”, this refers to any instance of an employee goofing around or playing while on the job. In these types of cases where an injury takes place from horseplay, the court will rule that the injury did not “arise out of your work,” which effectively implies you were not performing your job when you were hurt.

Fighting

Workers’ compensation does not cover injuries caused by you initiating a fight with a co-worker or client. You may be eligible to receive benefits if you were injured while defending yourself from another person who initiated the fight. How is this determined? The important question is who threw the initial punch. If you are found to have thrown a punch first, you will not be eligible for benefits.

Hurting Yourself On Purpose

If you cause your own injuries on purpose, you may not only be denied workers’ compensation, but you may also be prosecuted for insurance fraud. It is unlawful to stage accidents or hurt oneself in order to get benefits.

The aforementioned are the most prevalent exceptions to the “no-fault” rule that you should know. In most cases, if you were injured while performing the duties of your job, there should be no issues with you qualifying for workers’ comp.

Lastly, you should know that proving any workers’ comp exceptions falls on the responsibility of the employer or their insurance provider. 

If you have any concerns about your workers’ comp claim, a visit to a lawyer should be scheduled as soon as possible. Do not try to handle a claim by yourself if you are not fully aware of the laws governing the benefits in your state. Retaining a lawyer will give you the greatest chance of receiving the benefits you are entitled to, especially if your employer is trying to deny you of this.