Workers' Compensation E-Newsletter

Workers' compensation claim may be barred if employee misconduct is involved

An employee injured at work is usually eligible for workers' compensation benefits, including cost of medical care and compensation for lost wages. It generally does not matter what the cause of the injury was, nor whether the employee was responsible for the accident or if the employer caused the injury. The workers' compensation system is designed to assist injured employees regardless of fault. In limited cases, however, the fault of the employee may affect the ability to receive benefits. Since this type of exception is contrary to the purpose of workers' compensation laws it is only available in extreme cases.

Most states' laws prohibit an employee from receiving workers' compensation benefits if the employee is culpable for acts or omissions that constitute willful misconduct, serious and willful misconduct, or intentional and willful misconduct. There are subtle distinctions between these phrases but they share a common focus on willful misconduct by an employee.

Willful misconduct is something more than mere negligence or carelessness. It is an intentional or deliberate act. In order to constitute willful misconduct an employee must generally make an extreme departure from ordinary care in a situation where a high degree of danger is apparent. They must act either with the knowledge that their action is likely to result in serious injury or with wanton and reckless disregard of the possible consequences. An employee's act or omission must be serious to rise to the level of willful misconduct. Bad judgment or mistakes due to excitement, inexperience, or inattentiveness are not usually enough to prevent an employee from successfully bringing a workers' compensation claim.

Since negligence is not relevant for worker's compensation purposes, misconduct must be something more than mere negligence. In some states gross negligence could be willful misconduct, but in other states even gross negligence does not qualify. Gross negligence is usually defined as a wanton or reckless disregard for human life or acting with knowledge of the fact that it could result in serious injury to another. Although the definition of the phrase gross negligence seems to parallel that of willful misconduct, they are not necessarily the same standard.

A determination that an employee's behavior amounts to willful misconduct does not mean the claim for benefits will automatically be denied. It is also necessary to show that there is a casual connection between the misconduct and the injury; that the misconduct caused or contributed to the accident. If there are several factors that contributed to the injury then the claim will only be barred if the misconduct was a substantial factor.

Courts have been reluctant to find an employee has forfeited a right to workers' compensation benefits due to misconduct. Statutes that call for this result are sometimes construed in favor of the employee. If the evidence fails to show that the employee was guilty of acts within the statutory prohibition the employee will often be able to receive benefits. Even an employee who is guilty of willful misconduct may receive benefits if is it shown that the employer acquiesced in the behavior. Forfeiture of worker's compensation benefits is a harsh remedy and is not resorted to lightly.

What is willful misconduct?

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What is willful misconduct?

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