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Can a worker’s mistake make them ineligible for workers’ comp?

Most people would prefer to go their entire lives without ever utilizing workers’ compensation benefits. Thankfully, the average worker in Connecticut is generally able to avoid an injury on the job that forces them to take time off and necessitates expensive healthcare.

However, for the relatively small fraction of workers who get hurt on the job and require medical care, workers’ compensation coverage is perhaps the most crucial form of protection available to them. They can receive medical coverage that won’t render them responsible for their treatment costs and will even allow them to access disability benefits that can help replace a portion of any wages they may lose as a result of their condition.

Yet, many employees who might be eligible for coverage fail to file a benefits claim because they (understandably) don’t understand how the program works. For example, workers often believe that if they’ve made mistakes that led to their injury, they won’t qualify for benefits.

The program provides no-fault coverage

Certain kinds of insurance do look at fault, and when determining what individual or insurance policy actually applies in a situation, personal liability is often a factor. However, workers’ compensation protects workers from every kind of job injury even if their employer is not directly responsible for the injury.

The program also lacks a rule that would eliminate eligibility for benefits based on an individual’s fault. Simply put, it does not matter who causes the incident in most cases, as the benefits available are a form of no-fault coverage. Fault doesn’t matter for the purpose of securing benefits unless an employer could prove that someone hurt themselves on purpose or violated company policy, which resulted in their injury.

A failed drug or alcohol test, for example, might provide a company with a justification for defending against someone’s benefits claim. With the rare exceptions of those who hurt themselves on purpose or who get hurt due to intoxication on the job, most employees dealing with a work-related health condition won’t have to worry about their personal contributions to the situation making them ineligible for benefits.

Still, workers need to abide by medical recommendations and otherwise seek to establish they have complied with company policy and workers’ compensation rules as much as possible throughout the claims process. Ultimately, learning about the rules that apply to Connecticut workers’ compensation claims may ultimately help injured workers collect the benefits they need while coping with a job-related health issue.

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