Most employers in New York are required to carry workers’ compensation insurance. The state expects companies to insure their employees in case they get hurt on the job or are diagnosed with an occupational illness. Workers’ comp coverage protects the company from financial liability by providing direct support to workers with a medical issue related to their work.
Most workers who need benefits have straightforward claims, although some will find that their employer or the insurance company wants to limit what benefits are paid. To legitimately push back against a claim, the insurance company must show there is a reason to limit benefits.
One of the factors that could impact what benefits you obtain is the fault for your injury. Typically, workers’ comp insurance provides no-fault coverage. Even if you trip over your untied shoelace in the course of your employment and get hurt as a result, you can claim benefits. You don’t have to show that your employer was to blame.
However, there are two scenarios when your fault for a workplace injury could prevent you from getting benefits.
When you caused the injury intentionally
If your employer or the insurance company determines you intentionally injured yourself to qualify for workers’ compensation or secure a leave of absence, you can be denied benefits.
When impairment led to your injury
While you may enjoy a drink after work, that same drink could affect your rights if you consume it during your lunch break. Drug and alcohol testing is frequently part of the process for a workers’ compensation claim. If it can be shown that you were under the influence and also that your impairment was the cause of your injury, it could mean you do not qualify for workers’ compensation benefits.
With the exception of those two circumstances, most workers hurt on the job will be able to rely on workers’ compensation for disability benefits and medical coverage. Speaking with an experienced workers’ comp lawyer can help you get the benefits you deserve.