Georgia Workers' Compensation: Specific Situations That May Not Be Covered


October 08, 2010

The workers' compensation system provides employees with a fast efficient system for obtaining compensation for on the job injuries while shielding employers from liability for civil litigation for such injuries. Because an employer is shielded from potential civil liability for injuries employees suffer in the workplace, employees may be compensated even if their own careless conduct was the cause of their work related injury.

While the fault of an employee is generally not a barrier to a successful workers' compensation claim, there are certain types of conduct and situations under Georgia workers' compensation law that will prevent an injured employee from being compensated. At Montlick and Associates, Attorneys at Law, we have been helping employees who suffer work related injuries for over 25 years. If you or someone you love suffers an on the job injury, call Montlick and Associates, Attorneys at Law, for a free initial consultation. A brief list of situations or examples of conduct that may prevent a successful workers' compensation claim include the following:

Rough Housing: An employer does not have to compensate an employee who is injured when engaged in rough housing or horse play. If the employee who is injured was an innocent party to the rough housing, the employee may still receive workers' compensation.

Aggravation of Pre-Existing Conditions: An employee may recover if a pre-existing condition is aggravated by an accident or duties on the job. However, lost wage and medical benefits are limited to the point at which the employee is restored to the pre-aggravation condition. Additionally, benefits for permanent loss of bodily function are limited to permanent loss of function due to the aggravation only.

Assaults: An assault by a third party may be covered, but it depends on the reason for the assault. If the reasons for the assault are personal, such as, a third party attacking an employee because he believes the employee kissed his girlfriend, the assault would generally not be covered. Conversely, a bank employee who suffers a broken hip when being shoved during a bank robbery would be entitled to workers' compensation.

Physical Altercation: A physical altercation at work can be compensated but only if the injured employee seeking compensation was not the aggressor, and the subject matter of the dispute leading to the altercation was related to the job (such as a fight initiated by a critique of the quality of a co-worker’s work performance).

Emotional Conditions Unaccompanied by Physical Injury: While emotional illnesses, such as depression may be covered, they typically must accompany a physical injury. In other words, if depression results from suffering a physical injury or manifests itself in a physical way, such as migraines, this could be covered.

Injuries During Recreational/Social Activities: If you are injured during a company softball game or while dancing at a company Christmas party after work, these injuries likely would be covered because they do benefit the employer even though they are not "work" per se and are after hours.

Injuries During Lunch or Scheduled Breaks: These injuries would generally not be covered unless you are engaged in a task for you employer like running an errand or performing some other task for your employer during your scheduled break or lunch. Generally an injury that occurs during a “regularly scheduled” lunch break is outside the scope of employment. However if the lunch break is not regularly scheduled and is in any way contingent on the demands of work, or if the employer restricts the movements of the employee during the lunch break, such as requiring the person to be on the premises or to be available to respond to business emergencies, then those restrictions imposed for business reasons for the benefit of the employer are likely to cause the lunch break to be considered in the course and scope of employment. Also, accidents that occur on the premises of the employer, shortly before arrival at work or shortly after leaving work may be compensable claims based on the doctrine of “reasonable time for ingress and egress.”

Are there other exceptions where I may not be covered by workers’ compensation insurance?

If an employee is off the clock, such as on the way home from work, the employee’s injuries would not be covered unless the employee is engaged in some sort of business errand during the commute. If an employee is injured as the result of being intoxicated or under the influence of drugs on the job, such injuries would also not be compensated by workers’ compensation.

Auto Accident During Commute: Workers' compensation generally would not cover an employee injured during his standard commute to and from work, but might if the employee was taking care of company business or running an errand on the way to or from work.

While the workers' compensation system is a fast, efficient way for an employee to seek compensation for medical expenses and lost wages resulting from a work related injury, it can sometimes be difficult to determine if a particular situation or injury will be covered. The Georgia Workers' Compensation Attorneys of Montlick and Associates, Attorneys at Law, have been representing employees injured on the job for over 25 years. If you have questions about whether your job related injury is covered, you should contact us today for your free initial consultation. We are available to assist clients throughout all of Georgia including, but not limited to, Albany, Athens, Atlanta, Augusta, Columbus,Dalton, Gainesville, Macon, Marietta, Rome, Roswell, Savannah, Smyrna, Valdosta, Warner Robins and all smaller cities and rural areas in the state. Call us today for your free consultation at 1-800-LAW-NEED (1-800-529-6333), or visit us on the web at www.montlick.com. No matter where you are, you are just a phone call away, and we will even come to you.


Please Note:
Many of our blog articles discuss the law. All information provided about the law is very general in nature and should not be relied upon as legal advice. Every situation is different, and should be analyzed by a lawyer who can provide individualized advice based on the facts involved in your unique situation, and a consideration of all of the nuances of the statutes and case law that apply at the time.