Most employers and employees know that workers’ compensation coverage can help after an injury or accident. However, there is often some confusion about what types of claims are covered.
A lack of clarity can have serious implications for businesses, since filing excessive claims raises your risk profile and rates. It can also affect employees who mistakenly believe their medicare care is covered and then are left with a hefty bill after a claim is denied. The answers to a few questions can often help you determine eligibility.
Where Did the Accident Happen?
Generally speaking, workers’ comp only covers illnesses and injuries that happen at work. So, if you are hurt at home and then aggravate your injury on the job, you are probably not going to receive benefits.
Do You Have a Preexisting Condition?
Most preexisting conditions are not covered by workers comp. However, each policy is different, and there are certain conditions and situations where this rule does not apply. If you have worsened or aggravated an old injury, you will want to be extra careful to follow all filing steps and save paperwork.
What Caused the Injury?
Another common situation where your injury is not covered by workers comp insurance is when you caused the accident through negligence, criminal activity, or violating workplace policies. Be sure to document the situation that led to your injury to avoid claims of misconduct.
There are several situations where workers’ comp coverage does not apply. Understanding your coverage is often the best defense to preventing confusion.