The details surrounding each workers' compensation claim are unique. Therefore, it is not always easy to predict whether an injured worker will receive benefits or have them denied, especially if there is reason to suspect that the injured employee's actions or negligence could have been a factor in the accident.

In many previous cases, the New York Workers' Compensation board has ruled that in order for an injury claim to be compensable, it must "arise out of and in the course of employment." Boards and courts across the nation often make similar rulings. In a recent case from another state, a woman was granted compensation for a tripping accident at work despite the fact that she had illegal drugs in her system at the time of her fall.

In 2008, the woman was working as a restaurant server in Louisiana when she tripped over a container of potatoes in the kitchen. The incident left her with a broken wrist. She was taken to the emergency room and was subjected to drug testing.

Test results revealed both Xanax and marijuana in her system. The Xanax was legally prescribed, and it was later revealed that she had smoked marijuana four days before her fall. Because of the drugs found in her system, her employer and its insurance company denied the woman benefits except for the cost of the emergency room bill.

The case first went before a workers' compensation judge and was eventually appealed. In short, two of the main issues debated were whether or not the woman was intoxicated and whether or not intoxication caused the accident.

In the end, the appellate court ruled that there was not enough evidence to prove that she had been intoxicated on the day of the accident. Furthermore, the court said, "the accident was not of the nature that any intoxication was a contributing cause."

Therefore, the woman was awarded medical care costs and temporary total disability benefits.

Employees who have been injured on the job may have legitimate claims but are sometimes hesitant to report them for fear that they will be denied because of illegal or negligent behavior on their part. In situations like this, it may be helpful to seek the advice of a qualified workers' compensation attorney, as fear of denial may be unfounded.

Source: Business Insurance, "Injured worker entitled to comp benefits despite positive drug test: Court," Roberto Ceniceros, Feb. 3, 2012