Getting hurt on the job is stressful enough without the added confusion of figuring out if your injury qualifies for workers’ compensation. In North Carolina, not every workplace incident meets the criteria for a claim.
Knowing what situations might leave you without coverage is crucial. Let’s dive into the specifics so you can better understand the workers’ comp claim process and get the help you need.
Incidents that affect the eligibility of your claim
Workers’ compensation aims to support employees who suffer injuries at work, but not all incidents are eligible. Here are some key scenarios where coverage might not apply:
- Intoxication: If you were under the influence of alcohol or drugs at the time of the accident, insurers may deny your claim. For example, you sustained the injury while under the effects of a medicine you took without a proper prescription. Employers and insurers may argue that intoxication contributed to the accident.
- Intentional harm: Workers’ comp usually does not cover injuries that you cause to yourself on purpose. The system is meant to help with actual accidents, not situations where harm was deliberate.
- Safety violations: In some cases, if an employer fails to comply with safety standards, which leads to an injury, the compensation might be adjusted. This doesn’t necessarily mean you won’t receive any coverage, but the conditions and amounts could vary significantly.
Understanding these exclusions can help you determine the best course of action after an injury. If insurers deny your claim, consulting an experienced attorney can provide clarity and options.
Making informed decisions
Navigating the complexities of workers’ compensation in North Carolina can be daunting, especially if you are unsure of your eligibility. By knowing what incidents might not be covered, you can better prepare and seek the proper legal guidance.