Workers' Compensation Coverage Exceptions for Injuries on the Job

Paperwork With Exception in Red LetteringWorkers' compensation insurance covers medical treatment and wage losses after a wide range of employee injuries in a variety of situations. While these benefits generally cover an employee regardless of fault, there are a few situations where an employee may be denied coverage based on his or her actions.

Exceptions to Illinois Workers’ Compensation Laws

In general, injuries that occur on the clock, on the employer’s premises, or while performing an action that directly benefits the employer will qualify for workers’ compensation. However, each state is allowed to create limitations on when workers’ compensation may be applied.

In Illinois, it may be more difficult to collect workers’ compensation if you:

  • Were intoxicated at the time of injury. The law states that any injuries resulting from an employee’s excessive intoxication by alcohol or illegal drugs are exempt from workers’ compensation. In other words, the employee is exempt for an injury if he is so intoxicated that he cannot carry out his job duties.
  • Were engaged in horseplay. Illinois law exempts workers’ compensation for injuries suffered by employees who were engaged in horseplay at the time of the accident. However, employees who were injured as victims of horseplay (not participants) will still be eligible for workers’ compensation.
  • Violated a law. Employees who were violating state or federal laws at the time of injury are exempt from coverage, and may be unable to claim coverage if they were violating company policies or safety regulations.
  • Started a fight. Injuries from fights in the workplace are typically covered if the employee is a victim of aggression, if the fight had something to do with work, if the work location or environment is dangerous (such as a prison), or if the fight was initiated by a visitor to the workplace. However, an injured employee who initiated the fight (or was one of multiple aggressors) will not be compensated.

If your workers’ compensation benefits were unfairly denied or are being contested, we can advise you on your next steps at no cost to you. Contact the experienced workers' compensation attorneys at Tapella & Eberspacher today at (855) 522-5291 or fill out our online contact form to schedule your free consultation.

 

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