What Are the Situations that Might Disqualify You from Receiving Workers’ Compensation Benefits?
When you have been involved in an accident at work or have become ill because of exposure to a workplace hazard, your first course of action will typically be to file for workers’ compensation benefits, provided your employer subscribes to the state program. Unlike other states, Texas does not require that an employer purchase workers’ compensation insurance. As a practical matter, though, the majority of companies do provide work comp benefits for their workers.
Qualifying for Workers’ Compensation Benefits
The Texas workers’ compensation laws were enacted to provide benefits to both workers and employers. Because workers’ compensation benefits are fixed, based on the injured worker’s prior income, an employer does not have to worry about an exorbitant award from an overly sympathetic jury. For workers, the benefits include both fairly rapid access to benefits (provided the claim is approved) and the fact that the worker does not need to prove negligence by the employer. In fact, the only requirements to be eligible for workers’ compensation are evidence that you suffered an injury and that the injury occurred in the ordinary course of your employment.
Situations Where You May or May Not Qualify for Work Comp Benefits
In most instances, your injury will occur while you’re engaged in regular tasks. There are, however, some situations that may not be so clear:
- Injuries suffered while on a break—Suppose you slip and fall in the lunchroom while on an approved break. You weren’t performing any duties related to your job. Can you still claim work comp benefits? As a general rule, yes. If you take a break—even a lunch break—on the premises of your employer, you can still recover work comp for any injuries suffered on the break, provided you weren’t engaged in other actions that might disqualify you (horseplay or some other prohibited action). If, however, you leave the employer’s premises for a break, you will be on personal time and won’t qualify for work comp. For example, if you leave the office and go to a restaurant for lunch, you won’t be able to claim work comp if you are involved in a motor vehicle accident. However, if you were also running an errand for your employer, you may still qualify.
- Injuries suffered at a company social event—As a general rule, you can qualify for workers’ compensation benefits if you are hurt at a company golf outing, social mixer or other event, even if attendance was not mandatory. You may be disqualified if your actions were unreasonable—for example, if your injuries were caused by your excessive consumption of alcohol. You may, nonetheless, be eligible for work comp if your employer provided the alcohol.
- Injuries while traveling—Injuries suffered on your commute typically don’t qualify for workers’ compensation, unless you deviated from your normal route to perform a task for your employer—stopped to pick up bagels or went to the post office, for example. You may also be eligible if you went directly from home to a work-related appointment. As a general rule, injuries suffered at a work-related convention, conference, training or similar event are covered by workers’ compensation, though you may not be eligible if you were engaged in a wholly personal activity at the time (such as out jogging or working out at the gym).
Contact the Workplace Injury Lawyers at Bailey & Galyen
At the law offices of Bailey & Galyen, we have protected the rights of injured people throughout Texas for more than four decades, including men and women who have been hurt on the job. Our Texas work injury lawyers have a comprehensive knowledge of the workers’ compensation laws in Texas and know how to help you get the benefits you deserve when you have suffered a workplace injury. To learn more about how we can protect your rights throughout the workers’ compensation process, contact us by e-mail or call our offices at one of the convenient locations listed below. Our phones are answered 24 hours a day, seven days a week.
