Workers’ compensation coverage and the “by accident” requirement, P.1

There are a wide variety of injuries that can occur on the job, regardless of the kind of job under consideration. Some workplace injuries are covered by the workers’ compensation system, while others are not. The primary requirement for coverage, which we’ve mentioned before on this blog, is that the injury was caused by an accident or event arising out of and in the course of employment.

According to the North Carolina Workers’ Comp Employee Handbook, an accident is a separate event preceding and causing the injury for which the worker seeks benefits. Without an accident having occurred, on-the-job injuries are not compensable. This is an important point, because it means that not every injury that occurs on the job is compensable.

There are a couple points that can be made about the “by accident” requirement to highlight the type of workplace injuries that are compensable under North Carolina’s workers’ compensation system. First of all, injuries which occur gradually over time are generally not going to be compensable, since a worker would be unable to show that there was a specific accident that preceded and caused the injury. Now, to be clear, there can be grey area with respect to the gradualness of an injury. In cases where, for instance, an arm becomes progressively painful due to heavy lifting or repetitive motion, it may not be compensable. When there has been some pain in the past, though, and then a clearly identifiable accident that precedes and causes injury to the arm, it may still be possible to receive workers’ comp. Discerning the difference between such scenarios isn’t always easy.

Additionally, workplace injuries which occur in the course of performing routine duties may not be covered either. We’ll say more about this point in our next post.

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