Eligible and Excluded Workers Compensation Injuries

If you are hurt at work, you may be eligible for workers compensation benefits.  However, not every injury or illness is eligible for benefits.  On the other hand, many people may suffer conditions for which they could receive benefits, but they do not realize that they are eligible.  If you suffer a work-related injury or illness and your workers compensation claim is denied, contacting an Oklahoma workers compensation lawyer can help you determine whether your claim was unfairly denied; if so, your attorney can help you get the benefits you need. According to the Oklahoma Department of Labor, "An injured worker is entitled to reimbursement for all reasonable and necessary medical treatment resulting from an on-the-job injury. In order for an injured worker to be entitled to temporary benefits, he or she must be unable to work for more than three calendar days."  Compensable injuries must occur both in the course of and arise out of the worker's employment.  There are three types of risk a worker faces:

  • Business risk - Risk of harm specifically connected with employment and job performance. Injuries from business risk are always covered under Oklahoma workers compensation law.
  • Neutral risk - This type of risk has "no particular employment or personal character."  Injuries arising from neutral risk are generally covered if they occur on business premises.  If they occur off-site, they are only covered if the employee faces a greater risk of injury than the general public.
  • Personal risk - Injuries specific to the claimant--such as those related to bodily functions and idiopathic conditions--are generally not covered; however, there are exceptions, particularly when the workplace contributes to the injury.
The "Work Connection" for on-the-job injuries is explained here. Covered injuries or conditions may include fall injuries, burn injuries, repetitive strain injuries, accumulated trauma, hearing loss, vision loss, back injury, heart attack, lung disease, and more. Excluded injuries are those which are determined not to arise out of and in the course of employment.  These include injuries occurring as a result of horseplay, intoxication, failure to use safety devices, and intentional injuries. If you are hurt at work or suffer a disease caused by or exacerbated by employment conditions, be sure to properly document your injuries or illness with your employer, and contact a workers compensation attorney who can help you process your claim or fight for denied benefits.