If you have recently been injured and are seeking workers compensation benefits, you will have to show that your injury or illness is work related.  Typically, if you were doing something for the benefit of your employer and you became ill or was injured as a result, then your injury or illness can be classified as work related.  You must meet the following eligibility requirements  to receive benefits: 

  • Be an employee 
  • Your employer must carry workers’ comp insurance 
  • You must have a work related injury or illness 
  • You must meet your state’s deadlines for reporting the injury and filing a workers’ comp claim 

Here are some common situations: 

Lunch Breaks

Usually, injuries that happen on an employee’s lunch break are not considered work related.  If you were hurt while eating lunch on the company’s premises (lunchroom or cafeteria) the injury will generally be considered work related unless you were doing something during the lunch break that wasn’t allowed or fell within exceptions to workers’ comp coverage.  

Company Events 

If your company sponsors special events like parties, picnics or sporting games, injuries that occur at these events are usually considered work related.  There can be an exception if the employer doesn’t require their employees to participate in the off-duty events.  

Travel 

Under the “going and coming rule,” workers comp generally doesn’t cover injuries sustained during your commute to and from work.  There are exceptions to this rule including: 

  • Driving a company vehicle 
  • Required to bring your own car for business use during the work day 
  • Doing special errands for your employer 
  • Traveling on a business trip 
  • An employee who regularly travels for work or doesn’t have a regular fixed work site 

Misconduct

If you were injured while breaking a workplace safety rule or doing something that your employer has prohibited, your injury might still be covered by workers’ comp.  This is part of the workers’ compensation bargain. Employees do not have the right to sue their employer for work-related injuries but those injuries are usually covered by workers’ comp regardless of fault.  There are some exceptions to the rule.  For example, workers’ comp usually doesn’t cover injuries that happen because an employee was under the influence of alcohol or using illegal drugs.  Several states rule our workers’ comp coverage when the injured employees were: 

  • Trying to hurt themselves or someone else 
  • Committing a serious crime 
  • Horseplay
  • Breaking a workplace rule on purpose 

Illness, Cumulative Injuries and Stress-Related Conditions

Workers’ comp may also cover cumulative injuries developed over time (repetitive stress injuries RSIs) occupational diseases and other illnesses resulting from on the job exposure and physical or psychological illness resulting from workplace stress.  In these cases, it may be difficult to prove that the illness or injury is work related especial in the case of infectious diseases like COVID 19.  If a pre-existing condition was irritated at work, it could possibly be considered a workplace injury.  

If you have questions regarding your injury or illness call Losi & Gangi today at 716-854-1446.  Our attorneys will help answer all of your questions and find out whether you might be eligible for benefits under worker’s comp.  

Article adapted from: https://www.nolo.com/legal-encyclopedia/workers-compensation-injury-or-illness-32964.html