Liability Defenses in Workers’ Comp Cases

A no-fault insurance program that compensates injured workers for their economic losses was a key part of the Grand Bargain between workers and management, in which injured workers agreed to give up their rights to sue in court. However, employers quietly reserved a few liability defenses. More on that below.

To overcome these defenses, a Tampa workers’ compensation lawyer must thoroughly review cases and diligently collect evidence. Case reviews identify possible defenses, so an attorney is prepared to refuse them. Evidence is usually the key to a successful outcome in a workers’ compensation matter. Usually, there’s a direct relationship between the amount of evidence presented and the amount of compensation an Administrative Law Judge awards.

Alcohol/Drug Use

This defense, and all others, varies slightly among different insurance policies. Usually, however, the insurance company won’t pay benefits if the victim was under the influence of drugs or alcohol at the time.

Usually, the effects of alcohol build over time. However, the impairing effects of alcohol begin after the first drink. Usually, however, the insurance policy defines “impairment” as similar to “intoxication,” or the complete loss of mental or physical faculties. Unless the victim took a Breathalyzer or other alcohol test at or near the time of the injury, alcohol impairment is almost impossible to prove.

Similarly, a drug test must be administered at the time of the accident. Even then, questions abound. Generally, marijuana and other drugs powerfully affect people for a few minutes, then the effects wear off significantly. So, victims might have trace amounts of drugs in their systems, but a Tampa workers’ compensation lawyer can successfully argue that the victim wasn’t under the influence of drugs at the time.

Horseplay

This defense is similar to the not work-related defense, which is discussed below. Usually, insurance policies exclude claims based on horseplay.

The horseplay must be unrelated to job duties, at least in most cases. Assume Moe and Larry race each other to clean their work areas first, and Larry falls and breaks his leg. The race isn’t horseplay, at least in most cases, because it was related to his job duties.

Not Work-Related

This defense is the most common trauma injury or occupational disease liability defense in a Florida workers’ compensation matter.

Frequently, a pre-existing condition increases the risk or severity of a trauma injury, like a fall, or an occupational disease, like toxic exposure lung disease. Full benefits are available in these cases, as long as the work-related illness or injury substantially caused the victim’s damages, and the pre-existing condition was a contributing cause.

A non-work condition may have the same effect. Hearing loss is a good example. Most people hear loud noises all the time, not just at work. Once again, full benefits are available in these cases, as long as the work-related illness or injury substantially caused the victim’s damages, and the coexisting condition was a contributing cause.

 Reach Out to a Detail-Oriented Hillsborough County Lawyer 

Injury victims are entitled to important financial benefits. For a confidential consultation with an experienced workers’ compensation lawyer in Tampa, contact Kobal Law. We routinely handle matters throughout the Sunshine State.

Source:

siepr.stanford.edu/publications/working-paper/rejecting-grand-bargain-what-happens-when-large-companies-opt-out