What Injuries Aren't Covered by Workers' Compensation? skip to content

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What Injuries Are Not Covered by Workers' Compensation?

Workers’ compensation protects employees by covering medical bills, rehab costs, and any wages lost due to a workplace injury. The insurance policy also offers benefits to an employees’ family if they died due to workplace injury. It is especially important to know what types of injuries are covered by your employers’ workers’ compensation insurance policy, and which are not. At Black & Jones, we won’t let you get bullied by insurance companies because it’s our duty to make the system work for you.

Oftentimes, the injuries that are not eligible for coverage either happen outside of the workplace or are a result of an employee intentionally causing harm or partaking in illegal acts. Please note that each employee injury is unique and will need to be evaluated case-by-case, as there are exceptions to these rules. The following three categories include situations that are generally not covered:


1. Commute and outside of workplace

Injuries that take place during your commute to work or on your way home from work are not covered by workers’ compensation insurance. If an injury happens during a non-paid break, it will be denied by the insurance company but may still be compensable. There is an exception to the coming and going rule. If you are traveling outside of your workplace to complete a job or service, you are eligible for workers’ compensation insurance should you sustain an injury during that time.


2. Policy violations, illegal acts, or intentional acts

An employee who engages in some illegal acts or behaviors that violate the company’s policy is not considered covered if they are injured during the act. This means if the employee is under the influence of a substance, or purposely engages in fighting or horseplay, hurting themselves and/or others, they are also not covered. The exception to the rule involves possible insurance coverage for the person(s) not directly involved, but who was hurt as a result of the situation. And keep in mind, just because you have drugs in your system at the time of injury, doesn’t automatically mean that your injury is not covered. Speak to an attorney to find out if you are an exception to the rule.


3. Termination

If you quit or are fired, you are no longer covered by your employer’s workers’ compensation insurance policy. However, if the injury occurred at the time you were still employed, you may still be able to file a claim. Seek the advice of a trusted lawyer to know your rights!

The benefits of workers’ compensation can help you get back on your feet, but it’s important to know the rules about what types of injuries are eligible for benefits and which ones are not. That’s why our expert team at Black & Jones does the most to fight for you and the compensation you deserve.

If you or someone you know isn’t sure whether their case can receive compensation, contact us today for your free case evaluation here.