What workers compensation covers and doesn’t cover

When workers in Charlotte, North Carolina, get injured, they often cannot perform their job at full capacity as they once did. Even with good health insurance, the medical bills from a workplace injury can get costly. Workers’ compensation pays employees a portion of their income until they recover, but not all injuries are covered by workers’ compensation.

Injuries Covered By Workers Comp

To make a valid workers’ compensation claim, the injury must relate to work within the scope of employment. It is easy to get workers’ compensation coverage for occupational diseases that have a strong link to the job and rarely occur in the general population. For example, black lung disease has a strong medical link to the coal mining industry.

Employees are commonly covered when they perform work tasks off-site, such as picking up company mail. Some states cover certain mental health conditions, and others cover repetitive stress injury, but with restrictions. Even as the medical world becomes more aware of stress-related illnesses, some common illnesses, such a blood pressure or stroke would need substantial evidence.

Injuries Not Covered By Workers Comp

If an employ leaves the job site for a non-work related task, they likely don’t have a workers’ compensation claim. For example, an employee who falls at the fast food place picking up their lunch won’t get covered.

Under the coming and going rule, injuries during commute are generally not compensable. However, there are exceptions, such as on assignment for an employer or no fixed work site.

Injuries from horseplay commonly count as outside the course of employment. For example, if two employees race down stairs and one falls and sprains a knee, they likely won’t get covered. If one of them knocks another employee down causing them injury, that person would get covered.

Cooperate events may or may not get covered based on the circumstances. If an employee must attend to avoid losing their job and gets injured, they will likely get covered.

Pre-existing conditions and even intoxication shouldn’t prevent an employee from getting workers’ compensation in some cases. If an employee feels they have been unfairly denied coverage, they should seek legal assistance.