What Types of Work Injuries Aren’t Compensable?

When it comes to workers’ comp, state law determines which injuries are covered. However, in most cases, injuries occurring on the job that are considered “out of the course of employment” will fall under workers’ comp coverage. If individuals are injured while performing their job duties or if they suffer any illnesses resulting from unsafe work conditions, injured workers may be able to file and recover damages through a workers’ compensation claim.

When First-Aid Kits Are Sufficient for Treating Injuries

If an employee is injured on the job and an on-site first-aid kit is adequate for treating the injury, the injury typically won’t be considered severe enough for a workers’ comp claim. In many instances, smaller injuries such as cuts, bruises, and scrapes won’t be covered by workers’ comp.

One exception would be if an individual is regularly exposed to a chemical that causes persistent headaches, as this would be considered an occupational disease.

Injuries Beyond the Workplace

Individuals who sustain work-related injuries outside of the building where they work may be able to file a workers’ comp claim, as long as the injury occurs when the employee was performing duties under the scope of employment.

For example, an employee might be driving his or her own vehicle or a company vehicle to visit a customer when an accident occurs. If the injuries sustained in the accident are severe enough to warrant professional treatment, the employee may have a workers’ compensation claim.

On the other hand, injuries resulting outside of the scope of employment, including those that occur during the commute to or from the workplace, will not warrant a workers’ comp claim. Injuries that take place while the worker is out on a lunch break will also normally be considered outside of the scope of employment and ineligible for workers’ comp. Fighting and horseplay among employees are also incidents that aren’t considered work-related, nor are injuries resulting from drug or alcohol use.

Injuries Occurring Over Time

In addition to one-time accidents and injuries, certain cumulative injuries and conditions that develop over time could result in a workers’ comp claim, but it’s important to make sure that they’re the direct result of work-related activities. As previously discussed, repeat chemical exposure causing chronic conditions is often involved in workers’ compensation claims, as are other conditions including respiratory conditions or carpal tunnel syndrome.

State laws often refer to these types of conditions as “occupational diseases” when they develop over time due to repeated events and stress in the workplace. Other labels for these injuries may include “repetitive stress injuries,” “cumulative trauma injuries,” or “slowly developing injuries.”

If an employee is uncertain about whether or not an injury or condition that developed over time is the result of work-related events or stress, he or she can speak with a medical professional to determine the cause. A doctor may even be able to help the employee file a workers’ comp claim if it’s determined that work could be the cause of the disease or condition.

Mental Illness

Mental health conditions could also qualify as injuries or occupational diseases warranting workers’ compensation. A majority of states cover conditions that arise over time such as anxiety and depression, along with psychiatric injuries such as post-traumatic stress disorder resulting from physical trauma or other events taking place on the job.

The best way to determine if an injury or condition qualifies for a worker’s comp case is to learn about the laws in the state where the injury took place and the circumstances required to file a claim. Keep in mind that stress often isn’t enough to file a claim, as work-related stress is commonplace for many workers.

If an employee has sustained an injury that he or she believes is work-related, the best steps to take would be to consult with a doctor for treatment and an attorney for advice before filing a claim.