What Kind of Injuries Are Not Covered by Workers’ Compensation?

April 24, 2022

Suffering an injury at work can be a life-changing event depending on the severity of your injury. One of the reassuring aspects of such a situation is that you have Workers’ Compensation on which you can rely to ensure that you have the resources necessary to pay for your medical treatment.

There can be concerns that your injuries will not be covered under your Workers’ Compensation plan. There are no injuries specifically that Workers’ Compensation would not cover. However, the circumstances that led to those injuries are the primary factor in determine whether you will receive the much-needed benefit.

It can be frightening when you are hurt, and you could fear that you might not be eligible for Workers’ Compensation. Additionally, your employer may be reluctant to offer it to you or make efforts to dissuade you from filing a claim. An experienced Workers’ Compensation lawyer can help protect your rights and ensure you receive the benefits to which you are entitled.

What Constitutes a Workplace Injury?

To be considered a workplace injury, Maryland has several specific parameters that constitute a workplace injury that are covered under Workers’ Compensation. A person must be injured while they are fulfilling the tasks necessary to complete their job when they are actively on the clock.

In addition, to qualify for Maryland’s Workers’ Compensation insurance, the worker must have been injured while in Maryland or working for a company that primarily resides in Maryland. If a person is injured in this state while passing through as part of their job for an out-of-state company, they will not be covered, although they will be covered under the Workers’ Compensation of the state where the business is primarily located.

What Conditions Are Not Covered by Workers’ Compensation?

Just because you are injured at work does not mean that you are automatically eligible to collect Workers’ Compensation. The law protects companies from those who are attempting to exploit the system or defraud it in a certain way. Nor will the insurance reward bad behavior. 

If you sustained an injury from legitimate reasons while you are working no matter if that injury is minor or severe, Workers’ Compensation will cover it. However, there are certain circumstances in which regardless of the severity of your accident, you will not be eligible for Workers’ Compensation. Those circumstances include the following:

• Previous condition: You may not be eligible to collect Workers’ Compensation if you sustain an injury caused by a preexisting medical condition. An example would be if arthritis led to joint injuries.
• Personal risk: If you are hurt while engaging in an activity in which you assume personal risk that is outside the scope of your job, you could be denied in your claim. 
• Work deviation: This includes any activity in which you engage that does not follow along the lines of your normal workday. It could also include you engaging in an activity that although furthers your work goals, does so in a manner not in keeping with your traditional work responsibilities. In other words, if you attempt to use a tool you have never used for a task for which it was not originally intended and you are injured, you will probably not be covered under Workers’ Compensation.
• Intentional conduct: If a worker deliberately injures themselves, they will not collect on any benefits, including if they were to hit themselves with a heavy tool or roll something sizable over their leg. This would also include if an employee asked a co-worker to deliberately injure them.
• Recreational activity: If a person is hurt during an office party or a work social gathering even if it is being held on work grounds and sponsored by the company, they may not be covered under Workers’ Compensation. If the only purpose of the event is to foster employee health and morale, it will not be covered. To be eligible, a worker must obtain some other benefit and the event must be a part of the demands of the job, so it must have mandatory participation.
• Horseplay: If two workers are messing around or wrestling and one becomes injured, they will not be eligible to collect on Workers’ Compensation. This also includes individuals who are engaged in an actual fight. If there are any bystanders standing around watching and they become injured, they might be eligible to collect. 

Companies are always looking for opportunities to avoid having to pay out on their Workers’ Compensation benefits, and one way to do that is attempting to misclassify the circumstances that led to an accident. A Workers’ Compensation lawyer can help prove that an injury was sustained under the proper conditions to warrant a Workers’ Compensation claim.

Are Occupational Diseases Covered under Maryland Workers’ Compensation?

Most people associate workplace injuries with a sudden incident that occurs that causes one or more workers to sustain an injury. It could be a burn, a broken leg, or something more severe. The reality is there are a few other injuries that occur from actions taking place at work that develop over time and manifest with little warning. 

One of those is occupational diseases, which is when a chronic ailment occurs because of work or occupational activity. The law covers these situations, as they do arise from and during your regular work schedule. Given the nature of these conditions, however, to help you receive benefits under Workers’ Compensation, you will need a letter from a qualified physician attesting to your injury and the conditions that might have led to it.

There are several occupational diseases associated with workplace injuries in which the connection may not be as clear as others. That does not mean that a claim should not be pursued. Your Workers’ Compensation lawyer can help you prove that the injury you sustained was the result of the actions you took at your job.

Can I Receive Benefits for Repetitive Stress Injuries?

Another long-term injury that can result from working in a job in which a person is engaged in the same movements daily is repetitive stress injury (RSI). It is also known as a repetitive strain injury, and it is a tendon or nerve disorder that occurs when a person repeats the same motion repeatedly across a long period.

In general, this problem falls under the eligibility requirements for Workers’ Compensation, although these situations can get more complicated. One of the most common forms of this condition is carpal tunnel syndrome, which manifests itself as a numbness and tingling in the hand, arm, and fingers. The cause of this condition is usually a pinched nerve in the wrist. 

Another common RSI is tendinitis, which is when the tendons become inflamed resulting in significant pain for the victim. These can impact any tendon in the body that connects muscles to bones. The complication arises in determining the cause of these injuries. If they are the result of a preexisting condition, the person may not be eligible for Workers’ Compensation; if they are due to the repetitive nature of the work that they are doing, the condition would be covered.

It is essential to have a seasoned Workers’ Compensation lawyer on your side who will be able to find the best doctor who can provide testimony as to the origins of your condition.

Are There Companies Exempt from Offering Workers’ Compensation in Maryland?

All businesses that employ people in the state of Maryland must offer Workers’ Compensation. By default, a sole proprietor or partner is excluded, although they can opt back in but at a rate of $58,000 a year.

Corporate officers are also included but can elect to be exempt. Finally, those LLC members who provide a service for monetary compensation are statutorily covered.

Government agencies are exempt from state mandates, although they offer their own version of Workers’ Compensation. If you believe that your company is not offering this benefit when they should be doing so, speak with a lawyer who can determine your company’s legal obligations.

Baltimore Workers’ Compensation Lawyers at LeViness, Tolzman & Hamilton Help Workers Ensure Their Injury Is Covered Under Workers’ Compensation

If you have been hurt at work and are concerned that your employer will not cover your injury, the Baltimore Workers’ Compensation lawyers at LeViness, Tolzman & Hamilton will fight for you. We will use our experience to help prove that the conditions of your injury justify your claim. Call us today at 800-547-4LAW (4529) or contact us online to schedule a free consultation.

Our offices are conveniently located in Baltimore, Glen Burnie, and Prince George’s County, where we represent clients throughout Maryland, including those in Anne Arundel County, Carroll County, Harford County, Howard County, Montgomery County, Prince George’s County, Queen Anne’s County, Maryland’s Western Counties, Southern Maryland and the Eastern Shore, as well as the communities of Catonsville, Essex, Halethorpe, Middle River, Rosedale, Gwynn Oak, Brooklandville, Dundalk, Pikesville, Parkville, Nottingham, Windsor Mill, Lutherville, Timonium, Sparrows Point, Ridgewood, and Elkridge.