Do I Need to Be Careful to Qualify for Workers’ Comp?

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Everyone should do their best to stay safe at work and out of workplace accidents. After all, no one wants to suffer a serious workplace injury that could leave them out of commission for a while or even land them in the hospital. But if you get hurt at work and you were admittedly not being as careful as you could have been, does that matter regarding your eligibility for workers’ compensation benefits? Does carelessness disqualify you from receiving workers’ comp?

Thankfully, carefulness is not a factor in most workers’ compensation claims. The premise of workers’ comp is that an injured worker can get medical treatment coverage and possibly partial income replacement no matter what caused their work-related injury or accident. As a no-fault system, workers’ compensation can give you benefits even if you clearly admit that your own mistakes caused your injuries. In other words, you don’t necessarily need to be careful at work to get workers’ compensation – but being careful at work is always a good idea!

When Carelessness Matters in Workers’ Comp

Do not make the mistake of thinking that carelessness is not completely irrelevant to workers’ compensation claims. Although it might be a no-fault insurance system, intentional recklessness that leads to injuries is still an issue. In fact, it could even be argued as a form of insurance fraud.

Workers’ compensation insurance providers have the right to challenge any claim they think might involve an intentionally self-inflicted injury. “Intentional” has a broader definition than you might expect, too. If you were behaving in a way that was obviously putting you in unreasonable danger, then the insurer might be able to deny your workers’ comp claim without violating the terms of the policy.

For example, an employee of a retail store is using a foldable ladder to place products on top of shelves in the backroom. They have been instructed numerous times to descend the ladder whenever it needs to be used, and the ladder has warnings on it saying the same thing. However, the employee decides to “walk” and “hop” the ladder to move it, ultimately causing them to topple over. A security camera records the incident, which the insurance company uses as evidence of egregious negligence to try to deny the claim.

In another example that favors the insurance company even further, two grocery store clerks decide to race around the store as fast as they can for fun. While sprinting through the produce section, they slip on a tomato that a customer dropped on the ground and suffer serious injuries. Workers’ compensation could be challenged because the employees were intentionally engaging in roughhousing that was not permitted by the employer and that should have been recognized as highly dangerous by any reasonable person.

Don’t Let Insurers Push Your Claim Around

It is important to remember that carelessness is not an automatic disqualifier for workers’ compensation claims. Even if you were intentionally horsing around at work and got hurt, you could still have a valid reason to file a workers’ compensation claim. Don’t let your employer or their insurance company decide for you that your claim is invalid. Talk to an attorney about what happened for more information.

Injured workers in Santa Clarita should come to the Law Offices of Wax & Wax with any questions about workers’ compensation claims and eligibility. We offer free consultations to all inquiring clients, so reach out to our attorneys to schedule yours today!