Could I be denied workers' compensation if I was intoxicated when the accident occurred?
UPDATED: May 9, 2012
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In most cases, injuries that happen because an employee is drunk or using illegal drugs are not covered by workers' compensation insurance. If an employee's injury is "self-inflicted," then there is no claim.
What is a Self-Inflicted Injury?
This is different from the concept of 'fault.' An accident can be an employee's fault without being self-inflicted. But someone who, for instance, shoots himself in the foot with a gun he brought from home can be said to have a 'self-inflicted' injury. Someone who works at a gun range and drops a gun while doing a work-required "quick draw" demonstration, however, can probably still successfully pursue a workers' comp claim, since the maneuver was within the scope of his employment. Further, no-fault laws allow for stupidity. But if the quick draw was against company policy, then a claim may be defeated.
What Happened to "No Fault"?
In "no fault" states, courts rarely look to the specific cause of an accident. An oft-seen exception is drug use, because there is a strong public policy incentive to discourage illegal drug use, especially at work. The system generally makes exceptions when it wants to discourage certain workplace activities. Illegal drug use, crimes, and employee actions outside the scope of their employment (in general) are just a few examples of such activities.
What if I Don't Admit, or Allow a Test for, Drug Use?
Some company policies require drug testing after an accident, and this in turn is the gateway to a valid workers' comp claim. No test, no comp. But states have widely varying interpretations about privacy rights and required drug testing. Some industries, for instance, are entitled to condition employment on unannounced drug testing. Trucking and transportation are common examples.
Do Prescription Drugs Matter?
Yes, it can make a difference - if it was your prescription. This advice is meant to cover only illegal uses, or use in violation of company policy. Some drug use is protected under medical privacy or disability laws. In one recent case, the door was opened for a valid workers' comp claim when prescription marijuana was determined to be a contributing cause to an accident at work.
What if the Accident Would Have Happened Anyway?
In at least one state (Illinois), workers' comp claims may be allowed even if drugs or employee drunkenness were involved. In another state (Kentucky), blame can be contributory (like in a tort case involving contributory negligence). This law, along with a policy of subrogation, can sometimes protect an employer from any duty s/he would otherwise have to pay a claim, especially in a third party lawsuit. But if the drug use was not proven, then the claim may still be allowed. If you think this question is an important factor in your case, then you should definitely consult with an experienced workers' compensation attorney. These issues are complex matters of law.
Can the Employer Choose to Ignore Possible Drug Intoxication?
The employer typically has a duty to explain in detail what appears to have happened in an accident: the employer will probably report the accident and its likely causes in its Report of (Industrial) Injury form, or through a report to the employer's insurance carrier.