Learn About: Injury / Exclusions from Coverage
Injury / Exclusions from
The Ohio workers' compensation system can be confusing. Our learn about pages provide basic information about the Ohio workers' compensation system. You can find out more about the system from our Ohio Workers' Compensation Guide or our explanation of Ohio workers' compensation terms.
Learn about situations where an injury is excluded from coverage:
- R.C. §4123.01(C)(1) denies workers' compensation coverage for most psychiatric conditions. The only psychiatric conditions covered by workers' compensation are psychiatric conditions caused by either an allowed physical injury to the injured worker, or forced sexual activity;
- R.C. §4123.01(C)(2) excludes injuries that occur “primarily” due to natural deterioration from coverage;
- R.C. §4123.01(C)(3) provides that injuries resulting from participation in a voluntary employer-sponsored recreation/fitness activity can be excluded from coverage, but only if the injured worker signed a waiver before engaging in the activity. The waiver only applies to a claim by the injured worker, and does not bar a death claim by a spouse or dependents of the injured worker;
- R.C. §4123.54(A)(1) excludes self-inflicted injuries from workers' compensation coverage. However, the Ohio Supreme Court has held that if a mental condition caused by the employment causes the injured worker to commit suicide, this exclusion does not bar the dependents from receiving workers' compensation benefits;
- R.C. §4123.54(A)(2) provides that an injured worker cannot receive workers' compensation benefits for injuries “caused by” the injured worker's intoxication or use of a controlled substance. This does not mean that an injured worker who tests positive for alcohol or a controlled substance automatically is barred from receiving workers' compensation benefits, because the exclusion only applies when the use of alcohol or a controlled substance “caused” the accident;
- R.C. §4123.01(C)(4) and R.C. §4123.54(G) permit coverage for an injury which “substantially aggravates” a pre-existing condition. However, those provisions exclude the pre-existing condition itself from workers' compensation coverage.
See our injury page for more information about workers' compensation injuries.