What Can Disqualify You From Workers’ Comp?

Workers Compensation

Generally speaking, Illinois employees have a right to receive workers’ compensation through their employer if they are injured on the job. However, there are some scenarios in which someone could be disqualified from receiving benefits.

Injury Isn’t Actually Related to Work

One of the primary reasons why workers’ compensation could be denied is if the injury isn’t actually related to work. To qualify for compensation, the injury must be sustained in the course of fulfilling work-related duties, which excludes such things as commuting to and from work or participating in employer-sponsored recreational activities.

In these cases, a personal injury lawsuit may still be possible, depending on the circumstances. In addition, your employer may try to pass your injury off as being unrelated to work when the opposite is actually true.

Missed Deadlines

Another case where you might be disqualified form receiving benefits is if you miss deadlines for reporting your injury or filing your claim. In Illinois, the deadline for reporting an injury is 45 days, while filing a claim must be done within three years (or within two years of when you last received benefits for the injury, whichever is later).

Failing to meet these deadlines will make it impossible to receive workers’ compensation benefits, even if everything else in your claim checks out.

Contractor Vs. Employee

Often, employers will hire independent contractors rather than employees. A contractor is not entitled to workers’ compensation benefits. That said, sometimes employers misclassify employees as independent contractors, in which case the worker does have a chance of claiming workers’ comp. Doing so would likely involve significant legal action, however.

You’ve Left the Job

In some cases, leaving your job could disqualify you from certain benefits. For instance, you might be disqualified from receiving certain disability benefits if you quit. However, that disqualification may not apply if you are fired. Ultimately, it depends on your situation.

Intoxication, Horseplay, and Fighting

Other areas can be a little tricky when it comes to receiving benefits. For instance, if you are intoxicated on the job and are injured as a result, you might not have a case. However, your employer has to prove that your intoxication was the sole proximate cause of your injury. If there were other factors, you could still receive compensation.

Engaging in horseplay or starting a fight can also disqualify you from receiving benefits. Again, however, your employer has to be able to prove that you voluntarily engaged in horseplay or started the fight. In addition, engaging in a fight that isn’t related to work will also usually bar you from receiving benefits.

Workers’ Comp Claims Aren’t Always Denied Fairly

While there are many scenarios in which your workers’ compensation claim could be denied, employers can often be unfair about it. Sometimes, they may try to make an injury look like it doesn’t qualify when in fact it does, such as by trying to make it seem like it wasn’t related to work. If your employer tries this, you’ll need legal representation from an experienced workers’ compensation attorney.

In the event that your claim is denied, contact us at Hart David Carson LLP for a consultation.

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