Aug 12

Intoxication and FECA claims

If you are an employee and you become intoxicated, whether through drinking or drugs you could potentially lose your workers compensation benefits if you get hurt on the job. Every state has its own rules on intoxication. Many states would have you lose your workers compensation benefits if the intoxication is the sole cause of your work injury. Some states have you lose your benefits if your injury is the ‘proximate cause’ of your injury. I believe only one state has the injured employee lose their benefits if they are intoxicated regardless of whether you are intoxicated or not. Many states in the country choose have variations of these three methods.

FECA is supposed to have the middle ground standard of ‘proximate cause’ as the test of whether you lose your benefits or not. Basically, had you not been intoxicated, you would not have been injured. Having said this, I had a case recently where OWCP and then ECAB denied a deceased employee benefits in part due to his intoxication. The employee was on ‘travel status’ and this was also part of the reason the claim was denied. In my opinion, there was a bias against the claimant in this case because of the intoxication (specifically because we were talking about a drug, albeit one that was not illegal at the time of death).

The law is supposed to be blind and not discriminate against individuals because of habits or behaviors we do not like. I find this to be a fantastic ideal, but in real life, it often gets thrown out the window with very negative results. In any situation where human beings are involved, bias comes into play. Consequently, intoxication claims can be more difficult to win than they should be.

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