What is considered a workers’ compensation injury?

Worker’s compensation insurance covers injuries and deaths on the job and occupational-related illnesses. How to determine if workers’ compensation insurance covers something is easier to understand by considering these examples broken into three categories of a covered claim, that may be a covered claim and a claim that might face denial.

Examples of usually covered workers’ compensation claims:

  • Falls: If a construction worker falls off a ladder while working on the job, that type of claim is covered.
  • Accidents using tools: Common accidents, which may occur when using tools, include cuts, burns, and eye injuries.
  • Fractures: Sprains, strains, and broken bones are other frequent injuries that happen at work.
  • Vehicle Accident: If you are injured in a vehicle accident while driving or riding in a company-owned vehicle, workers’ compensation insurance and commercial vehicle insurance should cover the claim. Even if you are using a personal vehicle for a job-related purpose, your claim may get approval.

A claim covered by worker’s compensation is not limited to what happens at the job site. If the injury or death occurs while an employee performs job-related tasks, the claim may get approval, even if the injury or accident happens at some remote site. This rule also applies while going from one place to another on a job-related task.

Examples of workers’ compensation claims that may get approval:

  • Occupational Injury or Illness: Experiencing an injury or illness caused by exposure to toxic materials at work may be covered, such as mesothelioma from asbestos exposure.
  • Hearing Loss: Hearing loss may develop over time. The problem may not show up while the person is still employed. If it is probable that the hearing loss came from work-related causes, the claim may get approval.

Examples of covered workers’ compensation claims that might face denial:

  • Not Employed: If you get fired from your job and subsequently have an accident on the way home from work, this would not be a covered worker’s compensation claim.
  • Personal Negligence: If you caused the accident by acting in a negligent way, such as operating a piece of equipment while intoxicated, the claim might face denial.

What to do if your workers’ compensation claim is denied?

If you have a denied workers’ compensation claim, call (877) 776-9558 to get a free consultation with an attorney. Many workers’ compensation claims can still be processed even if they got a denial at first. There might be technical problems with the documents or a filing date that the company staff unintentionally missed.

It is best to have your attorney review your case and find out what is repairable, if anything, to fix any problems that created a denial.

To preserve your rights, it is important that you speak to an attorney right away. If you think your case may face denial, you do not have to wait to receive a formal denial. Before this happens, you can take action to get help from an attorney specializing in workers’ compensation cases.

Every workers’ compensation case is different. Call (281) 475-4535 or fill out the form on the website to make an appointment for a free consultation with a qualified attorney to talk about your case.