Injuries Not Covered by Workers’ Compensation in Connecticut

Workers’ compensation provides important protections for Connecticut employees who are injured on the job. Medical treatment, wage replacement, and disability benefits are often available regardless of fault. However, workers’ compensation does have limits. Some injuries fall outside the system, and knowing these exclusions can help you understand your rights and next steps if a claim is denied.

Injuries That Happen Outside of Work Duties

Workers’ compensation only applies to injuries that occur in the course of employment. Injuries that happen while commuting to or from work are generally not covered. The same is true for injuries sustained during unpaid breaks when you leave the workplace for personal reasons.

There are important exceptions. If your job requires travel between locations, driving for work, or performing tasks off site, those injuries may still qualify. The key question is whether the activity benefited your employer at the time of the injury.

Self-Inflicted Injuries and Intoxication

Connecticut law excludes injuries that are intentionally self-inflicted. Workers’ compensation is designed to protect employees from accidents, not deliberate acts.

Injuries caused by intoxication may also be excluded, but the burden is on the insurance carrier to prove that alcohol or drug use was a substantial factor in causing the injury. A positive test alone is not always enough. These cases are often contested and depend heavily on the surrounding facts.

Injuries Caused by Fighting or Horseplay

Workplace injuries that result from fights or horseplay are typically not covered. If you initiate a physical altercation or voluntarily participate in rough behavior, your claim may be denied.

There are exceptions. If you were the victim of an unprovoked assault or acting in self-defense, coverage may still apply. The circumstances of the incident matter, and each case is evaluated individually.

Injuries While Violating Company Policy

Injuries that occur while violating company rules may be excluded, but not every rule violation results in a denial. For a claim to be denied, the violation must be serious and directly related to the injury.

Examples may include operating machinery without training, ignoring required safety equipment, or entering restricted areas without authorization. Even then, coverage may still apply if the rule was rarely enforced or if supervisors were aware of and tolerated the behavior.

Recreational Activities and Social Events

Injuries during voluntary recreational activities are generally not covered. This includes optional company outings, holiday parties, or sports events.

If attendance is required or if the event primarily benefits the employer, an injury may qualify. Mandatory retreats, required team-building events, or activities closely tied to work duties are evaluated differently under Connecticut law.

When You May Have Other Legal Options

If workers’ compensation does not apply, you may still have other legal remedies. One common example is third-party liability. If someone other than your employer caused your injury, such as a negligent driver, contractor, property owner, or equipment manufacturer, you may be able to file a personal injury claim.

In rare cases, intentional acts by an employer may fall outside the workers’ compensation system. These claims require strong evidence and are handled separately from standard workers’ compensation cases.

Understanding Your Rights After a Denial

A workers’ compensation denial does not always mean the end of your case. Many denials are based on misunderstandings, incomplete evidence, or incorrect application of the law. Reviewing the reason for denial is critical before assuming no benefits are available.

At Sousa Law, we help injured Connecticut workers understand why claims are denied and explore all available options. Whether that means appealing a denial, gathering additional evidence, or pursuing a separate personal injury claim, our team is here to guide you.

If your workers’ compensation claim has been denied or you are unsure whether your injury is covered, call (203) 929-8283 today for a free consultation.