Usually, workers are eligible for workers’ comp benefits even if they caused their injury through their own negligence or carelessness. After all, the main motivation behind the workers’ compensation system is to protect the safety of workers and to protect employers from lawsuits. Not assigning fault for the accident is one of the pillars of the system. The main question is whether you were working at the time of the accident and if the injury is related to that work.
However, sometimes employers and their insurance companies look for ways to deny benefits. One way they might do this is by claiming the accident was the employee’s fault.
The employer may claim that the injury was:
- Intentionally self-inflicted
- The result of willful misconduct
- The result of horseplay
- Caused by a violation of the law, including, but not limited to illegal use of drugs
- Caused by intoxication
Intentionally self-inflicted: If an employee hurts themselves on purpose, they will not receive workers’ comp. However, the burden is on the employer to prove that the employee intentionally harmed themself.
Willful misconduct: If an employee purposely violated a known and enforced safety rule, they might be denied workers’ compensation benefits. The burden to prove willful misconduct is on the employer.
Horseplay: If an employee is injured because they were messing around at work, they might not receive benefits. As with willful misconduct, in this case, employers must show that the employee violated a known and enforced workplace rule, AND that the horseplay was not related to their work duties.
Violation of the law: If the worker’s injury was caused by a violation of the law including, but not limited to, the illegal use of drugs, they will not receive compensation. This often comes to light if drugs show up in the employee’s system during their initial treatment.
Intoxication: If the employee’s injury was caused by intoxication, they might not receive compensation. This also often comes to light if alcohol or drugs are found in the employee’s system during their initial treatment.
The “Safety Training” episode of The Office gives an example of someone who could have caused their own injury. Michael turns the safety training into a competition about who has the more dangerous job, the warehouse workers or the office workers, and becomes upset that the warehouse workers think that he has a cushy, safe job compared to theirs.
Darryl: That’s what I’ve been trying to tell you, Mike. It’s serious down there. We do dangerous stuff, man. This is shenanigans, foolishness, Nerf-ball. You live a sweet, little, Nerf-y life. Sittin’ on your biscuit. Never havin’ to risk it.
Michael decides to demonstrate how dangerous office work is, by having Dwight gather all of the workers outside, so he can go up on the roof, pretend to be depressed, and then jump, pretending to kill himself but actually landing on a trampoline.
When the workers come outside, they find Michael on the roof.
Michael: [on the roof] My life! Oh, my life…
Dwight: [on megaphone] Michael, what’s wrong?!
Michael: Everything’s wrong. The stress of my modern office has caused me to go into a depression.
Once the workers figure out what he’s about to do, they convince him to come down without jumping.
But what if he had jumped, and injured himself? Could he have a valid workers’ comp claim?
There is no evidence to suggest that Michael is intoxicated. It’s probably not illegal to go up onto the roof of the office building. Is Michael violating a known and enforced rule? If so, this could be considered horseplay or willful misconduct. It could also be considered intentional self-infliction of harm. Even though Michael doesn’t think he will be injured or killed, a reasonable person would know that jumping off a roof onto a trampoline or bouncy house is very dangerous.
Michael does not seem to think he did anything wrong. At the end of the episode, he says, “An office is as safe as the people in it. And sometimes those people can drive you to crazy things to show the dangers of the office. That’s the danger I found myself in today. I saved a life. My own. Am I a hero? [pause] I really can’t say, but yes.”
If you have suffered a work injury and the insurance company is trying to deny your claim, contact the experienced workers’ compensation lawyers at Aversa and Linn to assist you with understanding your rights under the law.
