Generally speaking, a workers’ compensation claim should not be denied just because the injury was the fault of the worker. This is because workers’ comp itself has been established as a no-fault system. The employee does not have to sue the employer to receive compensation, and the employer has to provide those benefits, even if the employee did something that caused their own injury.
An example could be a roofer who is working with an automatic nail gun. Maybe they are in a rush, and they suffer serious injuries when they accidentally hit their own hand with the nail gun. They are rushed to the hospital and they will recover, but they need workers’ comp benefits for their medical bills and a portion of their lost wages.
It may be true that the worker’s own mistake is what caused this serious injury. However, they can still typically seek compensation.
Are there any exceptions?
There can be exceptions to this rule in some cases. However, it is generally when the worker has shown a higher degree of negligence and not just made a simple mistake. For instance, if the employer can demonstrate that the worker was under the influence of alcohol or drugs when the accident occurred, then workers’ comp claims may be denied.
Similarly, perhaps the employee clearly failed to follow workplace procedures, took unneeded risks or was engaging in horseplay or other unnecessary activity. They did something that deliberately put themselves in harm’s way, which could complicate their workers’ comp claim.
Navigating these types of claims can certainly be complex, and it is very important for employees to know exactly what legal options they have, what steps to take and how they can receive the benefits they deserve after a workplace injury.
