Compensability in a Workers’ Compensation Claim
Knowing When a Work-Related Injury is Compensable
Not every injury that occurs at work is work-related, and some injuries are not caused by an accident. The workers’ compensation attorneys at Peterson White in Knoxville can help you determine whether an employee’s injury is actually a compensable injury covered by workers’ compensation insurance.
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Who is Eligible for Compensability?
First, for an injured person to qualify for benefits, he or she must be an employee. Although this may sound simple and straightforward enough, but companies are often surprised to find out that people they consider independent contractors or even owners are deemed employees by state law.
Furthermore, other parties may be deemed employers based on up-the-ladder liability in subcontractor situations.
Defining the Compensability of an Injury
Generally, an injury or condition is a compensable workplace injury only if it both occurs during the course of employment while the worker is carrying out his or her job duties. The “course of” employment generally refers to the...
“Arising out of” employment generally refers to the cause or source of the accident. A person might be injured at work while on the clock, but while performing an activity that is not part of their job, such as doing something that is for their own benefit, rather than their employer’s benefit.
However, these definitions are not consistent from state to state, and there are some exceptions. For example, under the personal comfort doctrine, which allows for reasonable activities that attend to one’s own personal comfort, such as going to the bathroom or taking a lunch break on the work premises, are considered incidental to the employment.
How an Employer Can Defend Themselves
Next, several defenses are available to employers, depending on the state and the specific facts of the claim. Possible defenses include:
- Drug or alcohol intoxication
- Intentional self-inflicted injury
- Safety violations
- Misrepresentation on the employment application
- Failure to follow medical advice
- Lack of notice to the employer that an injury has occurred
- The statute of limitations
Discuss the Details of Your Case With a Free Consultation
If you are in the middle of a workers’ compensation case, the team at Peterson White in Knoxville will help guide you with which work-related injuries and which are not. These cases can be complicated, so it is crucial to hire skilled legal assistance to skillfully navigate the obstacles you may encounter.