Workers' Compensation Insurance Eligibility – Assessing Risk

To determine eligibility for workers' compensation benefits, an employee must prove that his on-the-job injury 1) occurred while working or 2) stemmed from the nature or responsibilities of the job. He must also demonstrate that the risk of injury was augmented by being at work and by performing job duties. Such risk generally falls into one of the following categories:

Risk Directly Linked to Employment

A factory worker injured after his hand was lodged in a machine would not have sustained the injury had he not been at work - his job was the only reason his hands were near the machine. This, presumably, qualifies him for workers' compensation insurance benefits.

Personal Risk

An employee who developed adult-onset diabetes after years of smoking, neglecting to exercise, and choosing a poor diet would not be eligible for benefits, because the risks and injury were personal rather than work-related - unless the employee can prove otherwise.

Neutral Risk

These cases are the most difficult, because the contributing factors are either mixed or unclear. Examples include a lifeguard who developed heatstroke while on the job, a teacher assaulted by a parent after school, and a person injured at work during an earthquake or other natural disaster.

Once increased risk has been proven, the employee must demonstrate that the job injury took place during the course of employment - meaning not only that she was employed by the company at the time of injury, but also that the injury was connected to employment. The injury does not necessarily have to occur during normal work hours to merit workers' compensation.

Speak to a Workers' Compensation Lawyer

If you have been injured on the job, it is important to consult a workers' compensation attorney for a case review as soon as possible. An attorney can determine if you are eligible for insurance benefits and help you build a strong case.