Pennsylvania employees may still be able to collect workers’ compensation benefits even if they break a safety rule at work. The workers’ compensation system is no-fault, meaning that, in most cases, injured employees may collect benefits no matter who was to blame for the accident. In exchange for providing workers’ compensation insurance regardless of fault, employers are protected from personal injury lawsuits for their employees’ work injuries. However, depending on each state’s laws regarding employee conduct, there may be exceptions to this general rule.
Pennsylvania Employees May Still Be Eligible for Benefits
Generally, workers are eligible for workers’ compensation benefits even if their accident was caused by their own negligence or carelessness. However, workers’ compensation insurance companies will often look for ways to deny benefits and may initially deny a worker’s claim. Insurers may deny benefits because they dispute whether the injury happened at work, they suspect fraud, or they claim another defense, including:
Generally, workers are eligible for workers’ compensation benefits even if their accident was caused by their own negligence or carelessness. However, workers’ compensation insurance companies will often look for ways to deny benefits and may initially deny a worker’s claim. Insurers may deny benefits because they dispute whether the injury happened at work, they suspect fraud, or they claim another defense, including:
Willful misconduct – When an employee intentionally disregards an employer’s rules or interests, the insurance company may use the willful misconduct defense. An injured employee may be denied coverage if he or she purposely violated a known and enforced safety rule.
Horseplay – Workers who are injured as a result of engaging in horseplay at work may be denied benefits. To avoid paying benefits, employers must show that the injury was caused by the employee’s violation of a workplace rule, that the employee knew about the rule, and that the horseplay was disconnected from the employee’s duties.
Intentional self-infliction of injuries – If an employee intentionally injures him or herself, the employer is not required to provide benefits. However, the employer does bear the burden of proving that the employee intentionally engaged in high-risk behavior, which caused his or her injury.
Intoxication/illegal drug use – Workers who are injured while intoxicated or under the influence of illegal drugs may be ineligible for workers’ compensation. However, benefits may be granted if it is determined that the injury would have happened whether the employee was intoxicated/under the influence or not.
Injured Workers Are Not Automatically Excluded from Coverage Due to Safety Rule Violations
Whether an injured worker may collect workers’ compensation benefits even though they violated a workplace safety rule depends on the specific facts of the case. Generally, employees are still entitled to benefits even if they violate a safety rule because the workers’ compensation system in Pennsylvania is no-fault.
Horseplay – Workers who are injured as a result of engaging in horseplay at work may be denied benefits. To avoid paying benefits, employers must show that the injury was caused by the employee’s violation of a workplace rule, that the employee knew about the rule, and that the horseplay was disconnected from the employee’s duties.
Intentional self-infliction of injuries – If an employee intentionally injures him or herself, the employer is not required to provide benefits. However, the employer does bear the burden of proving that the employee intentionally engaged in high-risk behavior, which caused his or her injury.
Intoxication/illegal drug use – Workers who are injured while intoxicated or under the influence of illegal drugs may be ineligible for workers’ compensation. However, benefits may be granted if it is determined that the injury would have happened whether the employee was intoxicated/under the influence or not.
Injured Workers Are Not Automatically Excluded from Coverage Due to Safety Rule Violations
Whether an injured worker may collect workers’ compensation benefits even though they violated a workplace safety rule depends on the specific facts of the case. Generally, employees are still entitled to benefits even if they violate a safety rule because the workers’ compensation system in Pennsylvania is no-fault.
However, insurance companies may deny coverage by claiming several defenses, including willful misconduct, horseplay, intentional self-infliction of injuries, or intoxication/illegal drug use. Employees should therefore seek advice from a qualified attorney in their local area who can evaluate their case and explain all their legal options.
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