By design, Ohio workers’ compensation covers most work-related injuries, accidental deaths on the job, and occupational illnesses. In practice, workers’ comp benefits can be denied on several grounds.

Some of the reasons following injuries are not covered by workers’ compensation in Ohio:

  • The injury did not keep the employee out of work for three or more days, which is considered the minimum period for a temporary disability.
  • The employee did not seek medical treatment for a purported injury or illness, which will leave the employee without required proof of medical need for time off work.
  • The employee intentionally caused his or her own injury.
  • The injury resulted from horseplay such as playing a prank, play-fighting or even just general goofing off. On the other hand, an employee who is assaulted by a co-worker or customer can qualify for workers’ comp benefits.
  • The injury occurred while the employee was engaged in illegal activity such as trespassing or stealing materials from a worksite.
  • The injury happened while the employee was drunk or under the influence of drugs. Employers routinely test employees after workplace accidents and having a prescription for medical marijuana will not be accepted as an excuse for failing a drug screen.
  • The supervisor told the employee not to perform the task that led to the injury, death, or injury.
  • The injury occurred while the employee was performing a task that is well outside of his or her job description, such as an accountant rewiring the light above his cubicle.
  • The employee ignored safety rules. Examples of this range from not wearing protective clothing to lifting heavy objects with improper form.
  • The employee was performing tasks for which he or she lacked the proper training or credentials, such as driving a company truck despite not holding a commercial driver’s license.
  • The injury occurred while the employee was commuting to or from work and not on the clock. Traveling for work, however, is usually covered by workers’ comp.

Applicants for workers’ comp benefits should expect to hear each of the listed challenges that could conceivably apply to their situation. Employers do not relish opportunities to sign off on workers’ comp claims, and investigators with the Ohio Bureau of Workers’ Compensation actually have the job of finding excuses to deny benefits.

Partnering with an experienced and caring Columbus workers’ comp attorney will help an injured or ill employee track down, organize and submit all the evidence needed to overcome challenges to their claims. A lawyer who knows the ins and outs of the workers’ compensation claims process will also be able to advise and represent the family of an employee who lost his or life to a workplace accident.

To learn more about what workers’ compensation will cover in Ohio, schedule a free, no-pressure consultation with an Agee Clymer Mitchell & Portman attorney. We take appointments online and over the phone at (614) 221-3318 or (800) 678-3318. If your health or other consideration make visiting our Columbus offices, we can come out to meet you.