If Your Workers’ Compensation Claim Is Denied
A Workers’ Comp Attorney Discusses Work-Related Injury or Illness
To be covered under workers’ comp, an injury or illness must be work-related. Although at first impression this may seem a simple determination to make, our experienced workers’ comp attorney has observed many gray areas.
On the Job
Commuting to and from work is not considered a work-related task and injuries stemming from an accident while driving to work are typically not be covered. However, certain injuries sustained while traveling may be covered, such as if commuting in a company vehicle and jobs that require travel away from home, such as for a flight attendant or a traveling salesperson, during the entire time the worker is traveling away from home. There are other exceptions to the “going and coming” rule that may justify a compensable claim.
Although not technically work, events such as a company Christmas party or the office softball league may be covered by workers’ comp. As a Mesa workers’ comp lawyer can explain, these determinations are very fact-specific. There are many cases decided by the Courts that discuss these issues.
It is not unusual for an insurance carrier to deny a claim based on a pre-existing condition, but if work-related activity aggravates an existing condition in such a way that an injury or illness results, the aggravation, may be covered. Further, in certain circumstances, treatment of the underlying condition may also be covered.