What Does Worker’s Compensation Not Cover?
The purpose of worker’s compensation is to cover the expenses of employees who are hurt in the course and scope of employment in exchange for a worker giving up their right to sue their employer for the harm caused while on the job. However, there are many situations that are surprisingly not covered by worker’s compensation in Wisconsin that cause many accidents and injuries to workers around the Milwaukee area every year.
At Gillick, Wicht, Gillick & Graf, our dedicated and skilled Wisconsin worker’s compensation lawyers are here to help you and your loved ones after a workplace accident. To learn more about your legal options after an injury, call or contact our office to schedule an evaluation of your case today.
Accidents Not Covered by Worker’s Compensation
Generally speaking, worker’s compensation in Wisconsin covers the cost of injuries that arise out of or occur within the course and scope of employment. In other words, an accident is covered if an employee is hurt while engaging in an activity or performing a task for the benefit of the employer. This rule is often used to determine whether an accident should be covered under worker’s compensation benefits, and some of the most common situations when an injury is excluded from coverage include the following:
Coming and Going Rule
Travel to and from work is typically not covered by worker’s compensation, as an employee is not considered in the course of their employment when going to or returning home from work. The coming and going rule also applies if an employee leaves their worksite for lunch and an accident occurs.
Exceptions to this rule include when an employee leaves to pick up lunch ordered by the employer for their workers and accidents that occur between the employee parking lot and the building. Accidents are also covered if an employee does not have a fixed worksite, is driving a company vehicle, is traveling for business, or is performing another task for the benefit of the employer.
Intoxication
Accidents on the job are also not covered if the employee injured was intoxicated at the time of the injury, and the intoxication contributed to the accident. Intoxication includes being under the influence of alcohol or controlled substances while at work, but a worker may still be eligible for worker’s compensation benefits if they were impaired at the time of the accident, but the impairment did not contribute to the injuries.
Intentional Acts & Horseplay
Any injuries caused by horseplay at work are typically not covered by worker’s compensation in Wisconsin. The reasoning is that horseplay on the job does not further the course of business for the employer and therefore, should not be covered if an injury occurs. The same reasoning applies if an employee is injured by engaging in an intentional act, such as fighting, while at work.
However, a worker may still be covered by worker’s compensation if they are hurt by the horseplay or intentional act but were not directly involved in the action. For example, if two employees are engaging in horseplay and accidentally injure a third person, that third person may qualify for worker’s compensation, while any injuries that happen to the two workers horseplaying will not.
Pre-existing Conditions & Acts of God
Worker’s compensation only covers injuries that occur while on the job, and it does not cover pre-existing conditions that are not aggravated by a work injury. This is often an issue when the injury is one that arises out of repetitive movement or occurs soon after a worker begins new employment. Similarly, injuries that occur because of “Acts of God” are also not generally covered by worker’s compensation benefits.
Illegal Activities & Policy Violations
Employees are also not entitled to worker’s compensation benefits if they are injured on the job while engaging in illegal activity. The reasoning behind this is that illegal activities are not in the course and scope of employment, nor do they benefit the employer. Relatedly, a worker cannot collect worker’s compensation if the accident occurred while the employee was violating a company policy, procedure, or protocol.
Independent Contractors
Lastly, it is important to note that worker’s compensation is only available to workers who are classified as employees. Independent contractors are not entitled to collect worker’s compensation benefits, even if they are hurt while in the course and scope of the job. An experienced attorney can help determine whether a worker has been misclassified as an independent contractor when they should be considered an employee and therefore eligible for worker’s compensation benefits.
What Are Your Legal Options?
If you or a loved one has been injured on the job but is being denied worker’s compensation benefits, it is important to know that you have legal options. The first option is to secure an experienced attorney to review the facts of the case to determine whether you should actually be entitled to worker’s compensation benefits for your injuries. An attorney can advocate for your right to compensation while you recover after an accident.
The second option is to file a personal injury claim against those responsible for the accident. Compensation for a personal injury claim differs from the benefits offered through worker’s compensation. Personal injury damages cover all economic and non-economic harm, which includes the following:
- Medical bills
- Lost wages
- Property loss
- Loss of future income and earning capacity
- Pain and suffering
- Emotional distress
- Disability
- Disfigurement
- Loss of enjoyment of life
Many people have questions about worker’s compensation in Wisconsin. To learn more about your rights, talk to an attorney at Gillick, Wicht, Gillick & Graf today.
Contact Our Milwaukee Worker’s Compensation Attorneys
Have you or someone you know been injured on the job, or have questions about whether injuries that you suffered are covered by worker’s compensation in the Milwaukee area? If so, the experienced and knowledgeable Wisconsin worker’s compensation attorneys at Gillick, Wicht, Gillick & Graf are here to help. Call the office at 414-257-2667 to speak with one of our proficient attorneys today and schedule a free, no-obligation initial consultation for your case.
