Generally, workers’ compensation is considered “no-fault” insurance. An employee who is injured due to their own mistake or negligence can in most cases still qualify for benefits.
There are some exceptions, such as if they intentionally injured themselves, if there was a “willful failure” to use personal protective equipment, if they were engaged in “recreational or social activities” or “when intoxication or the unlawful use of controlled dangerous substances…is the natural and proximate cause of injury or death….”
How a New Jersey Supreme Court case led to legislation
It’s been generally accepted that unless a worker’s intoxication is determined to be the “sole cause” of their workplace accident, they may still be entitled to workers’ comp. That rule was upheld by the New Jersey Supreme Court in a case where the court noted that for that to change, the law would need to be changed. That’s what some New Jersey state lawmakers are working to do.
There’s currently a bill working its way through the state legislature that would remove the “sole cause” rule. The new proposed language states that workers’ comp can be denied if “the injury or death occurs as a result of intoxication” and “the intoxication is a material contributing factor to the injury or death.”
The proposed changes would also require employees injured while they were intoxicated to prove that their intoxication didn’t cause their injuries. Additional new language states, “If the employee was intoxicated when the injury or death occurred, it shall be presumed that the injury or death was caused by the intoxication and the employee shall be barred from receiving workers’ compensation. that the injury or death was caused by the intoxication and the employee shall be barred from receiving workers’ compensation.”
Why knowing the law is important
An employer and their workers’ comp insurer would still need to prove that an employee was intoxicated when they were injured if they didn’t admit to it. Nonetheless, these proposed changes to the law would make it more challenging in many cases for an employee to get workers’ comp benefits if they were drinking prior to an accident – for example, if they had a drink or two at lunch before returning to work.
While the bill may or may not pass both houses of the legislature and be signed by the governor, it’s still important to know that these changes may be coming. Any workers’ comp claim can become challenging. Employers and their insurers will generally look for opportunities to deny a workers’ comp claim. That’s why those facing a denial shouldn’t just accept this as the final outcome without getting legal guidance.