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4 reasons an injury may not be covered by workers' compensation

Workers' compensation protections are critical to employers and employees across Florida. These laws allow injured workers to get coverage for their medical bills and lost wages when they are injured, and they protect employers from being sued by employees.

However, while they are critical, these benefits are not available to everyone in all situations without question. There are necessarily restrictions in place. In other words, under certain circumstances, workers' compensation benefits may not be awarded. We examine some of these circumstances below.

  1. The injury is not work-related: Florida workers' compensation laws dictate that to be covered, an injury must arise out of a person's employment. Further, a work-related accident must be the "major contributing cause" of the injuries in order for compensation to be available.
  2. An injury was self-inflicted or the result of recklessness: If an employee was intoxicated at the time of an accident or if he or she intentionally tried to get hurt, any resulting injuries would likely not be covered.
  3. The injured party failed to report the incident properly: An employee must observe statutes of limitations, comply with reporting requirements and receive treatment from an authorized carrier. Failure to do these things can result in denied benefits.
  4. Reported injuries are fabricated or exaggerated: If a worker lies about an accident or overstates the damages suffered, a claim can and should be denied. 

These are all legitimate defenses to workers' compensation claims in Florida. However, for these defenses to be successful, employers must provide their own evidence and arguments. This can involve testimonies from medical professionals, surveillance recordings, witness statements and other resources to establish why an injury is not compensable.

Considering how complicated this can be, it is often in an employer's best interests to have legal guidance and support when defending against workers' compensation claims. With the help of an attorney, employers across Florida can ensure they are in compliance with workplace safety requirements and do not wind up being held liable for an accident or injury unnecessarily.

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