Workers' compensation only covers injuries that result from an accident arising out of and in the course of employment. Employers and their insurance carriers are skilled at applying these limitations to limit or deny claims. Frequently, employees complain that they were tricked into saying or admitting something that later hurt their case.

Only injuries that are caused by an accident are compensable. This means there must be some identifiable cause of the injury outside of the normal work routine. Whether an injury was caused by an accident or not is a frequent issue in contested cases and the NCIC has ruled on this issue in hundreds of different factual situations.
Back injuries are an exception and are usually compensable even if the injury occurs while the employee is engaged in his or her normal work routine.

Compensable injuries must arise from employment. This means the employee must be going about the business of his or her employer at the time of the injury. Whether an employee was on the job is frequently a contested issue.

Occupational diseases such as carpal tunnel syndrome, brown lung, and some cancers may be compensable if: 1) the employee was at an increased risk of contracting the disease compared to the general public, and 2) the hazardous working conditions contributed to the disease.

You can recover under Workers' Compensation even if you are at fault in the accident. Recovery may be denied if the accident is intentionally self-inflicted or is a result of the employee's use of alcohol or drugs. Violation of a safety rule by an employee may cause the recovery to be reduced and violation of such a rule by an employer may cause a recovery to be increased.

If you are injured on the job as a result of the acts of a person who is not your employer or co-employee, you may make claims against both workers' compensation and that party. These third party claims frequently involve auto accidents, slip and falls, and defective products. The employer or workers' compensation carrier has the right to recoup their payments to the extent a third party is responsible for the loss however, the amount of this recovery is negotiable.