Workers’ compensation coverage varies by state, but in general, it is meant to cover only injuries that occur while on the job. This can pose a problem when an employee gets hurt away from work but still needs help addressing an injury. For example, an employee may slip and fall on ice outside of work and sustain a concussion that prevents them from doing their job as efficiently as before.
For future reference, it is good to know what injuries are not covered by workers’ compensation.
7 common injuries not covered by workers’ compensation:
- Intentional acts — Injuries or illnesses caused intentionally by workers are not covered by workers’ comp insurance policies.
- Policy violations — Workers’ compensation benefits do not apply to employees who are injured for violating policy, procedure or protocol.
- Illegal activities — Workers’ compensation policies do not cover injuries caused by illegal activities on the job site.
- Driving to/from work — An employee who suffers an injury during their commute to or from work is not covered by workers’ comp. An exception may be made if your employer counts your commuting time as part of your workday.
- Intoxication — Employees who were injured because they were under the influence of an illegal substance and intoxicated will normally not be covered by insurance.
- Terminated employees — Those who have lost their jobs or been terminated will no longer be covered by workers’ comp insurance unless they were injured prior to the termination.
- Horseplay — In general, horseplay does not serve the purpose of doing business. So any injury resulting from it would not be covered. If an employee suffers injury during the incident but was not directly involved in the horseplay, then this rule does not apply.
Physical therapy for nonqualifying injuries
For injuries not covered by workers’ compensation but that still need treatment to recover, physical therapy should still be considered. Some employees may be able to pay out of pocket for physical therapy services. In other cases, an employee’’s health insurance plan may also pick up some of the costs if the insurer has a contractual agreement with the physical therapist’s practice.
For injuries that are not covered by workers’ compensation, physical therapists can help in these ways:
- Determining work duties appropriate for recovery — Physical therapists can help with these nonqualifying injuries by working with the employee’s supervisor or manager to determine which parts of the job are too difficult for them to perform safely and effectively.
- Conducting an evaluation — A physical therapist can determine how best to treat an injury after evaluating it. This helps them provide the right treatment for the injury. Treatment options they may opt to use include therapeutic exercises and modalities like manual therapy to reduce pain.
- Recommending any needed medical equipment — A physical therapist can recommend equipment that can make life easier such as braces, slings or crutches.
What about qualifying injuries?
A physical therapist can play an integral role in an employee’s recovery from a qualifying workplace injury. Working with a physical therapist may look like this:
- Assessing your condition — The first step is an evaluation to determine how you move in relation to your injury or condition. The therapist will also ask questions about your health history, symptoms and goals for therapy.
- Developing a customized treatment plan — Next, the physical therapist creates a plan that’s personalized for you based on their findings. Such plans may include manual therapy, exercises, stretches and other modalities.
- Tracking your progress — The goal is to get you back to a state where you are able to perform all your previous functions. Your physical therapist will help measure your progress toward this and other recovery goals.
Injuries not covered by workers’ compensation may seem like a complicated topic. However, whether your injuries are covered or not, you can still see a physical therapist.
Do you need swifter recovery from a work-related injury? Armor PT can help
Are you suffering from a work-related injury? Whether workers’ compensation will cover your treatment or not, don’t delay any longer. Contact us at Armor Physical Therapy to schedule a one-on-one consultation and comprehensive evaluation. Our physical therapists have helped many other patients who suffer from on-the-job injuries and can help you, too. The path to your recovery is just a phone call away.