What Is Not Covered by Workers’ Compensation?

workers compensation claim
Workers’ compensation policies are no doubt a lifesaver to employees who get injured at the workplace. Workers’ compensation works on a no-fault system where it doesn’t matter who caused the injury.
You can make a claim as long as the injury was a consequence of your work.
These policies cover most work injuries, but for a few exceptions.

Workers’ Compensation Definition of a Covered Injury

Workers’ compensation covers injuries or illnesses that occur while you are doing something benefitting your employer. It means you can claim compensation if:

  • You were injured while performing work duties.
  • The injury is a consequence of repetitive work activities.

Workplace Injury After Clocking Out

clocking out

Most states cover injuries that occur on the work premises, even after clocking out. Examples are injuries in the company parking lot or while you enter or leave the building.
However, any injuries that occur once you are done with work and leave the premises are not covered.

Workplace Injury During a Break

Many states consider it beneficial to employers if their workers stay onsite for meals or rest breaks. It saves the employees valuable time, and they remain accessible to the employer all the time.
So workers’ compensation might cover your injuries if they occurred while taking a break in your company premises.
You are typically not eligible for benefits if you got injured during break time but outside the workplace.
However, there are exceptions, like the injury occurring while you were out of the premises running a work errand. For example, while picking up the meeting lunch or attending a business meeting.

Off-Site Workplace Injury

workplace injury

Any injury that occurs off-site is covered only if you were doing something benefiting your employer. It includes injuries that occur while:

  • Working from home or answering a work call in a car
  • Any professional or job-related training
  • Traveling between two work premises
  • Traveling on business but off-duty

As each state has its workers’ compensation qualifications, it’s better to consult your Glendale workers’ compensation lawyer to determine your eligibility.

Recreational Activities

Many offices organize team building and recreational activities for their staff like happy hour or a company picnic. While workers’ comp may not cover most injuries, a few factors increase the chances of the injury coverage like:

  • Compulsory attendance at the event
  • Your attendance benefitted your employer
  • Conducting the activity at your workplace and during working hours

The event isn’t covered by workers comp if it was voluntary and for the employees’ benefit.

Intoxication or Substance Abuse

intoxication or substance abuse

Most state workers comp laws exclude any injury caused by the employees’ intoxication. However, you may be eligible for benefits if you can prove that the accident was unavoidable or not your fault. For example, a few factors are increasing you’re getting hit from behind while working.
Most states consider injuries non-occupational if the drug testing indicates high alcohol or drug levels. However, it’s sometimes difficult for employers to prove your intoxication.
So don’t assume that you are ineligible for workers comp just because you fail a drug test. An experienced workers’ compensation attorney in Glendale can prove your injuries were within the scope and course of employment.

Horseplay or Fights

Workers’ compensation doesn’t cover any injury due to jokes or horseplay as it falls outside the scope of employment. But there are exceptions here, too, like your employer tolerating ongoing horseplay.
And you may not be compensated if you get in a row over your favorite sports team. However, you are eligible for benefits if your co-worker hits you for complaining about their performance.

What Isn’t Covered by Workers’ Compensation?

workers compensation

Workplace injuries while commuting to and from work are outside the course and scope of employment. So workers’ comp might not cover damages that take place during your regular morning commute to the office.
However, exceptions are if:

  • You were driving a company car
  • Don’t have a fixed workplace like traveling salespeople
  • You were running a work errand like picking up the CEO from the airport

In short, each state has its own workers’ comp rules and exceptions. Contact your lawyer if your employer or their insurance company argues that your injury isn’t covered. Your lawyer will evaluate your case and decide if you should claim or not.

Scroll to top