Workers’ compensation is a “no-fault system,” which means an injured or ill worker can file a claim and receive medical care and workers’ compensation benefits regardless of “who” was at-fault for the accident. So, even if the worker was to blame for the accident, they could still file a claim and no one would judge them for making a mistake on the job. However, when an injured worker files a workers’ compensation claim, they are barred from filing a lawsuit against their employer.
In the majority of cases, injured workers can file claims and receive benefits, but that is not absolute. There are exceptions to the rule. Generally, a worker cannot file a workers’ compensation claim and receive benefits if: 1) the worker was under the influence of drugs or alcohol at the time of the accident, 2) the worker was intentionally trying to injure themselves, or 3) the worker was intentionally trying to harm someone else. Additionally, the injury has to be work-related.
Was Your Injury Work Related?
In order for an injured worker to have their workers’ compensation claim approved, their workplace injury or disease has to be directly related to their work. Meaning, it must have occurred on-the-job or during the course of their work – this applies to work-related injuries and occupational diseases.
Sometimes, a worker will get injured at home or on the weekend, away from work, and they’ll try to say it was work-related. If the injury was not work-related, the workers’ compensation claim will be denied.
Other times, the injury did in fact occur at work or the worker is suffering from an occupational disease, but the employer or the employer’s insurance company denies the claim because they say the injury or disease is not work-related when it is. In such cases, the worker should file an appeal with the South Carolina Workers’ Compensation Commission.
If your employer or their insurance company is arguing that your injury is not work-related, contact Masella Law Firm, P.A. for help.