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What Conditions and Injuries Aren’t Covered by Workers’ Compensation?

October 12, 2020

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Provided they have at least one employee, all employers in Ohio are required to carry workers’ compensation insurance. That insurance kicks in if one of those employees gets hurt on the job and can’t work and earn a paycheck. But while workers’ comp covers a wide variety of accidents, injuries, and illnesses, it doesn’t cover everything.

What IS Covered by Workers’ Comp?

First, it’s important to establish what workers’ compensation covers. The list is long and comprehensive, and includes conditions like:
  • Most on-the-job injuries (such as slip-and-fall injuries, strained muscles, and lacerations)
  • Lost or reduced mobility due to repetitive motions (such as carpal tunnel)
  • Chronic pain
  • Illnesses caused by one-time or chronic exposure to contaminants or toxins at work
  • Non-lethal electric shocks
  • Occupational-related diseases

What ISN’T Covered by Workers’ Comp?

Ohio is considered a no-fault workers’ compensation state. That means that workers who may have contributed to or caused their own accidents, injuries, and illnesses while on the job may still be eligible for benefits if their condition means they’re unable to work. However, not everything is covered by workers’ comp, including:
  • Psychiatric conditions—Workplaces can be stressful, and certain occupations put workers at higher risk than others of developing depression, anxiety, and even post-traumatic stress disorder. Unfortunately, these conditions aren’t covered by workers’ compensation unless they originated due to a workplace-related injury or sexual assault.
  • Age-related conditions—It’s natural for a worker performing manual labor in his 60s or 70s to be more susceptible to aches, pains, reduced mobility, and injuries than a worker in his 20s or 30s. When it’s determined that impairment or disability is caused primarily due to the natural aging process, workers may be ineligible to pursue benefits.
  • Injuries suffered after signing a waiver—Company outings can range from after-work happy hours to softball games to bungee jumping. Because the risk of injury in certain activities can be high, employers may ask that workers sign waivers before participating. If a worker signs a waiver and then gets hurt, they may be unable to file a workers’ compensation claim.
  • Pre-existing injuries—A worker with a history of back injuries, pain, and immobility may begin working a job that puts stress on his back. If he re-injures it, he may be unable to get workers’ compensation unless there’s significant proof that his job-related duties resulted in a significant or substantial aggravation of the existing injury.
  • Minor injuries—Workers’ compensation is typically only offered when injured workers will miss a fairly significant amount of time on the job—at least one week or more. Injuries that either don’t result in lost time and pay, or that result in only a few days of being at home or in the hospital recovering may not qualify for benefits.
  • Injuries caused while intoxicated or impaired—Workers who get injured while drunk, intoxicated, or impaired after consuming alcohol, prescription medications, or street drugs may have their workers’ compensation claims denied. This happens if their employers are able to prove that their injuries were the result of their impairment and not their job duties or workplace.

After a Workplace Injury, Don’t Risk Your Claim Getting Denied

The Ohio Bureau of Workers’ Compensation (OBWC) also may deny claims for a wide variety of reasons, despite being a “no-fault” state when it comes to workers’ comp claims. Because of that, it’s essential to have an experienced law firm on your side from day one. Without one, you may be subject to false allegations from your employer or simply an uncooperative supervisor or manager who fails to corroborate your story of what happened. At Nurenberg, Paris, Heller & McCarthy, our Ohio workers’ compensation lawyers know what is and isn’t covered by the OBWC, and we also know their criteria for reviewing and approving claims. The sooner you contact us after your on-the-job injury or illness, the sooner we’ll create an application for you that will maximize your chances of getting approved for the benefits you need. Contact us today for a free consultation.

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