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What Types of Injuries are Not Covered by Workers’ Compensation?

February 19, 2022

In most cases, individuals who sustain an on-the-job injury are able to receive coverage of their medical bills and a portion of their lost wages through workers’ compensation insurance. However, there are situations where injuries may not be covered by workers’ comp. If you are employed in the state of Kentucky, then you need to know which injuries your employer’s insurance may not cover. 

What Injuries Likely Won’t be Covered by Kentucky Workers’ Comp?

In Kentucky, the workers’ compensation system is designed to help just about every employee in the state, and most work injuries and illnesses are covered. However, workers’ compensation insurance carriers will push back against paying certain types of injury or illness claims that occur. This includes, but is not limited to, the following:

  • Injuries sustained as a result of the employee violating company policy
  • Injuries sustained while an employee was committing a crime
  • Injuries sustained when an employee was intoxicated for alcohol or drugs
  • Injuries sustained when the employee was not performing job-related duties 
  • Injuries that occur due to horse-playing in the workplace
  • Injuries that occur as a result of an “act of God”
  • Common one-time injuries such as headaches
  • Most communicable illnesses or diseases that the general public can also catch
  • Heart attacks or stroke that cannot be linked to workplace incidents
  • Injuries caused by fighting in the workplace
  • Injuries suffered due to participation in an off-duty event 
  • Injuries sustained during the commute to and from work

Contact a Skilled Work Injury Lawyer Immediately

If you or somebody you love has sustained a workplace injury and think that you should receive coverage from the workers’ compensation system in Kentucky, then you need to reach out to an attorney immediately. A skilled Kentucky work injury lawyer can examine the facts of your case and help determine the best steps moving forward. This could include going through the appeals process with the workers’ compensation insurance carrier, or this could even mean filing a third-party personal injury lawsuit in certain circumstances.

Even though most work injuries and illnesses will be covered by the Kentucky workers’ compensation insurance system, insurance carriers do tend to push back against rightful claims more often than they should. The reality is that insurance carriers try to look out for their bottom line, which means they use various reasons to delay or deny claims altogether. An attorney will work diligently to push back against aggressive insurance carriers in order to recover the compensation their client is entitled to.

What Coverage is Available for a Covered Injury?

If an on the job injury is covered through workers’ compensation insurance, an individual should be able to receive various types of coverage. This includes:

  • Compensation for all medical care resulting from the injury or illness
  • Physical therapy or rehabilitation expenses
  • A significant portion of lost income
  • Cost for retraining if you have to change jobs
  • Compensation for permanent injuries

The total amount of compensation paid in these situations will vary depending on several factors, including the severity of the injury, how much income needs to be replaced, and whether or not a person sustains a permanent disability.