Common Employer Defenses Against Workers’ Comp Claims

Common Employer Defenses Against Workers’ Comp ClaimsWhile the state of New Jersey’s laws for workers’ compensation are typically decided on a no-fault basis, there are some regulations in place that allow for an employer to deny claims. While an effectively implemented workplace safety program can deter against regular injuries and illnesses, accidents are still bound to happen. However, before using your New Jersey Workers Compensation coverage, determine if any of these defenses apply to the incident.

Horseplay- If an employee is purposefully misbehaving and disregarding safety regulations, you may be able to defend against the worker’s compensation claims.

Self-Inflicted Injury- If the injury was intentionally self-inflicted, the employer can deny benefits altogether.

Under the Influence- If the worker was under the influence of alcohol or illegal drugs at the time of injury, this is a valid defense against payments of claims, as well.

Idiopathic Condition- According to KK&O Law, an employer may argue that a condition is idiopathic, meaning that the condition arises spontaneously or from a cause that cannot be identified. As such, if the injury is unrelated to the job or was developed prior to working for your company, you may be eligible to deny benefits.

Failure to Follow Procedures- The employer may also be relieved of financial obligations if the worker fails to file the workers’ compensation form incorrectly or fails to follow proper guidelines. These include, but are not limited to, reporting the incident immediately, following up with doctors, attending appointments, taking appropriate medication, and communicating diagnosis to the employer.

At Tri-State Insurance Agency, we offer comprehensive insurance packages to safeguard businesses like yours. As the construction, manufacturing, and transportation industries are susceptible to many risk exposures, we underwrite tailored policies with you in mind. To learn more about our products, contact us today at (888) 990-0526.