What Does Workers Comp Actually Cover?

Workers comp is a type of liability insurance that protects two parties: both the employer and the employee. Both parties typically pay into a pool of money with each paycheck. When an employee is injured on the job, the employer can dot the “I”s and cross the “T”s to make sure that the employee can use that aforementioned pool of money for healthcare resulting from the injury, regardless of whether or not the employee has health insurance. It also helps protect employers by reducing the chance that an employee will file a personal injury lawsuit.

Workers comp covers accidental workplace injuries. An employee may be allowed to dip into the pool of money to cover healthcare costs, costs associated with lost wages or earning potential, costs of physical therapy, or funeral expenses if the worst should happen. Believe it or not, workers comp might even pay more if an employee is scarred because of the injury! Employees probably won’t need a slip and fall attorney for a simple accident, and that’s thanks to workers comp.

But there are exceptions to every rule, and workers comp is no different. What isn’t covered? It depends on where you live and what happened. For your state rules and regulations, check with your employer (or a lawyer if you don’t trust your employer). 

Here’s what we can say for sure. If the accident was caused by an employee — and keep in mind there’s a very stark legal difference between cause and effect — then the employee might not be covered. One obvious example involves fighting. If an employee tries to punch another employee or customer in the face, misses, and is whacked in retaliation, then workers comp absolutely will not cover his broken nose. He started the fight, after all. On the other hand, if the employee is hurt in a fight they didn’t start, then workers comp would absolutely cover medical expenses. 

The first thing an employer will likely do after an employee is injured in an accident is ask the employee to submit to a drug test. Don’t want to take the drug test? That’s legally fine, but you’re sure to lose your job. Take the drug test and it comes back positive? Bye Felicia. You’re sure to lose your job. Keep in mind that some drug tests will come back positive even if you consumed alcohol a full 24 hours prior. So even though the tests aren’t always fool-proof, an employee could still be screwed over — and need to pay for their own medical expenses after an accident. 

If you are an employee and were hurt while working, then you should have already contacted your direct supervisor. Failure to do so might make it more difficult for you to make a workers comp claim later, especially if there’s no video footage of the accident or no one around to corroborate your story. When reporting the injury, provide a full accounting — including your written story, if possible — and make it as detailed as you can.