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What does no-fault mean in workers’ compensation claims?

On Behalf of | Aug 1, 2024 | Workers' Compensation |

Workers’ compensation in Virginia provides injured workers with certain protections and benefits. Injured employees who are eligible for workers’ comp can receive medical coverage and lost wages. Not everyone is eligible for workers’ comp. For example, employees injured outside of work are typically not eligible for benefits.

Injured employees may worry that they would not qualify for workers’ comp benefits because of the nature of their accident. However, workers’ comp is a no-fault system. What this means is that workers can typically qualify for benefits no matter how their accident happened. Whether the accident was caused by their own actions, by an equipment issue or by the negligence of a co-worker or employer, an injured employee could still receive workers’ comp coverage. 

However, there are a few scenarios when the fault of an accident is called into question. As a result, an injured employee may not be eligible for benefits. Here is what you should know:

When does fault matter?

After a workplace accident happens, an investigation is usually made. This investigation is to determine how the accident occurred in the first place and what can be done to prevent it in the future. However, an investigation may reveal that an employee is not eligible for workers’ comp benefits. It may reveal the following:

  • Self-inflicted wounds: A worker may be ineligible for workers’ comp benefits if their injuries were self-inflicted. They may have intentionally injured themselves to receive benefits.
  • Drug or alcohol use: Substance use can impair workers. If substance use directly caused a workplace accident, a worker may be denied claims. 

Workers may need to seek legal guidance as they pursue workers’ comp claims. They can also appeal a denial and receive medical and wage benefits.

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