Two Situations Where Workers' Comp Can Be Denied

Posted By Katz, Leidman, Freund & Herman || 23-Jul-2019

Workers’ compensation is a wonderful system. Since employees are injured on-the-job all the time, workers’ compensation is a life saver. Workers’ compensation provides employees with cash benefits and medical care when they get injured in a work-related accident, or when they become ill because of their job.

Most employees are covered by workers’ compensation in New York, and they don’t pay a dime into it. This is because employers are the ones that pay for workers’ compensation insurance. If an employee becomes injured or ill because of their job, the employer’s workers’ compensation insurance pays weekly cash benefits to the employee, and this process is directed by the New York Workers’ Compensation Board, the state agency responsible for processing workers’ compensation claims.

Who is At-Fault in a Workers’ Comp Case?

Before New York State established workers’ compensation laws, an injured employee would have to sue their employer for compensation if they were injured in a work-related accident. Sadly, it was very difficult for injured employees to go up against their employers, who had deep pockets and well-paid attorneys at their disposal.

The workers’ compensation system is quite different than a traditional civil lawsuit. Instead of an employee suing their employer, workers’ compensation is a no-fault system. What this means is the employee can collect compensation regardless of fault.

Once an employee files a workers’ compensation claim, they waive the right to sue their employer in a separate lawsuit. This shields employers from lawsuits, but it also protects employees who are injured because of their own recklessness or negligence.

There are two specific situations where an employee’s workers’ compensation claim can be denied in New York, however, this is the case in most states:

  1. The employee’s injury occurred as a direct result of the employee being under the influence of alcohol or drugs. For example, an employee comes to work drunk, or high on a hallucinogenic, and as a result, they injure themselves.
  1. The employee is injured because they intentionally tried to hurt themselves or someone else. For example, if “Joe” tried to commit suicide and he paralyzed himself in a failed attempt to take his own life, his workers’ compensation claim would likely be denied.

Next: Am I Eligible for Workers’ Comp Benefits?

To learn more about filing a workers’ compensation claim on Long Island or anywhere else in New York, contact Katz, Leidman, Freund & Herman today.

Categories: Workers' Compensation