As you pursue a workers’ compensation claim, you will come up against a series of obstacles. These obstacles may include health limitations because of your injuries. Or these obstacles may arise because your employer finds a loophole around your claim.
We’ve mentioned in previous posts that when you file a workers’ compensation claim, you have to prove that the injury happened on the job, and you have to prove medical causation, which means that no outside factors other than your work task caused the injury.
Within these proofs, employers can find many ways to get around your claim. Do not let them take your compensation away from you. Familiarize yourself with their tactics so you and your lawyer can build a solid, undeniable defense.
1. Self-Inflicted Injuries
In rare circumstances, employers may claim that their injured employees intended to become injured so they could pad their pockets with the compensation money. You may see this kind of defense with claims where the employee has a somewhat low income-but it can occur with any kind of workers’ compensation claim. The employer wants to pin fault on you to void the case.
2. Negligence or Failure to Follow Rules
More commonly, an employer will say that an employee’s injuries occurred because of failure to pay attention. The employee did not adhere to safety rules, or simply operated heavy equipment while distracted. As a result, the employer did not cause the problem and should not have liability for it. You will have to prove that you did not behave in a negligent way before sustaining injuries.
“Horseplay” refers to another way your employer may try to dodge your claim. Essentially, if you acted rowdy or clowned around before the injury occurred, your company may point the finger at you instead of giving you the compensation you require. Therefore, you will either have to attest that you kept your actions professional, or you will have to verify that you should have been safe no matter how you acted.
4. Intentional Misconduct
Intentional misconduct goes beyond horseplay and indicates that you purposefully violated safety rules in the name of fun or rebellion. You didn’t intend to sustain injuries, but you did intend to do something unsafe. You will need your lawyer’s help to refute this claim as well so no obstacles stand between you and your compensation.
When a person becomes intoxicated or uses illegal drugs, his or her inhibitions suffer, so he or she may try to do unsafe things. Alcohol and drugs also undermine one’s motor skills and depth perception. Employers sometimes try to say that you became injured because you worked under the influence. Luckily, your lawyer can arrange blood tests and other proofs that help you get around this defense.
6. Medical Causation
As mentioned above, you have to prove medical causation when you file a workers’ compensation claim. If you have a preexisting condition, or if your physiology has any characteristics that could have caused the injury instead, the company you work for could attempt to use that condition to void your claim.
Depending on your circumstances, you and your lawyer may have the ability to prove that you should not have sustained the injury despite any preexisting conditions.
7. Failure to Notify Employer
When you become injured on the job, you have the responsibility to tell your employer about the incident no more than 120 days afterward. If you wait longer than that, the court may deny your claim. However, if a coma or other severe debilitation kept you from reporting the accident, you can prove that you lacked the ability to tell your employer on time.
8. Failure to Follow the Statute of Limitations
Depending on the state you live in, you may have to deal with a statute of limitations on your workplace injury. The statute of limitations may give you up to three years to file your claim. It may give you more, or it may give you fewer. In any case, make sure you file your claim as soon as possible so your employer cannot use this defense against you.
9. No Connection to Employment
Perhaps you became injured at a company party. Or perhaps you sustained injuries as you carried your heavy briefcase across the ice in the morning. With either of these situations, you will have to prove that your injury occurred because of something your employer did. Otherwise, he or she may posit that your injury happened due to outside factors, not something work related.
Workers’ compensation claims may seem complicated and intimidating, especially if you try to navigate them on your own. Study our posts on the subject to become more informed, and do not forget to hire a lawyer. Your lawyer can see which of the above defenses your company may gravitate to, and he or she can help you prepare for and then overturn that defense.