Indiana is a no-fault workers’ compensation state. That means that the investigation into what happened won’t focus heavily on who was at fault for the accident. Instead, it looks to make sure there truly was a workplace accident and that the injuries the victim suffers truly will prohibit them from working their normal job duties.
You can still obtain workers’ compensation benefits even if you were breaking company rules. However, it’s always in your best interest to use all safety materials and follow protocol to prevent workplace accidents in the first place.
What Is Indiana’s Exclusive Remedy Provision?
Workers’ compensation covers medical expenses and wage losses. However, if you want to pursue other areas of financial damages, such as pain and suffering, through a personal injury case, you will have to prove that another party was at-fault for the accident to pursue non-economic damages.
Because of Indiana’s exclusive remedy provision in the Indiana Workers’ Compensation Act, employees cannot pursue other types of cases against their employer even if their employer caused the accident that resulted in the employee’s injuries.
Likewise, injured workers cannot pursue cases against their coworkers if the coworker’s negligence caused the accident. In both cases of the employer and the coworker causing the accident, pursuing a workers’ compensation claim is your only option for recovering financially from the incident.
Like many parts of the law, there can be exceptions to the exclusive remedy provision, which means you should discuss the matter with an Indiana workers’ compensation attorney to be certain you’re proceeding in the best way.
Gross Negligence and Workers’ Compensation Claim Denial
The injuries you sustain for a workers’ compensation claim must have been suffered by accident. That means that you did not mean to do so. The accident must also take place in the course of employment.
That’s not to say that an accident has to take place. There does not need to be a specific moment or instance where you suffer injury. But your injuries have to be suffered by accident. Workers’ compensation is not about a specific event but a bodily injury that took place in the course of the victim’s employment.
Willfully or intentionally putting yourself in harm’s way could be classified as gross negligence. In that case, the insurance company can legally deny your workers’ compensation claim.
Other reasons why your claim might be denied, include:
- Your injuries were self-inflicted
- You were intoxicated or under the influence of drugs
- You were committing an offense, such as trespassing
- Knowingly failing to use safety equipment or appliances
- Knowingly disobeying a written safety rule that is posted clearly in view in a place of work
- You failed to perform a statutory duty
If your claim has been denied, you can appeal the decision within 30 days from the date of denial. In that case, the Indiana Workers’ Compensation Board will review the case.
In these situations, it’s wise to seek an attorney to guide you through the process of appealing the decision and filing the necessary evidence that proves your situation was not a reason for claim denial.
Complicated Workers’ Compensation Claims
Some workers’ compensation claims are clear and simple, such as a person slipping on wet floors inside their place of employment. But not all cases are that clear. Think about if you were driving to pick up catering for an event and suffer a car accident. It might be more challenging to prove you were driving for work purposes.
The more complicated your workers’ compensation claim, the more important it is to have an attorney review your case and offer advice. Injuries in which you are not following company policy are a good example of a more complicated workers’ compensation claim.
Schedule a free consultation with Stewart & Stewart now to protect your rights and benefits.