Does fault matter for workers’ comp claims?

As a general rule, fault does not matter for workers’ comp claims. It is a no-fault system.

It has specifically been set up this way because it means that employees do not have to sue their employers after an on-the-job injury. Instead, the employer carries workers’ comp insurance. As long as the employee is injured on the job, they already know that their medical bills and a portion of their lost wages will be covered by these benefits, so they give up the right to sue their own employer.

That said, there are exceptions to every rule, and that remains true in this case. There are some situations in which fault can play a role in a workers’ comp case.

Rule violations

For instance, when employees violate company policies or even employment laws, they may not be granted the workers’ comp benefits they would otherwise qualify for. If the employee has done something dangerous that was expressly prohibited and they were injured in the process, the employer may claim that they do not deserve workers’ comp benefits.

A similar issue exists if the employee was under the influence of illegal drugs or intoxicated from alcohol use at the time of the injury. If it is clear that the employee’s injury was due to their own impairment, then their workers’ comp claim may be denied. While they were on the job at the time of the injury, their employer will argue that they could have avoided the accident entirely if they had simply been sober.

Issues like this can sometimes complicate workers’ comp claims, and it is very important to understand exactly how the system works. Injured employees need to know what legal steps to take.