Compensable Injury — Insurance Claims Definition
Workers Comp
An injury or illness that arises out of and in the course of employment and qualifies for workers compensation benefits.
Compensability requires employment connection — not commuting (going and coming rule exceptions exist), not horseplay in some cases, and not purely idiopathic events unless work contributed. Occupational diseases have additional tests.
Examples
A nurse contracts a bloodborne pathogen from a needlestick at work — likely compensable; same disease from community exposure is not.
Common Mistakes
Assuming all pain at work is compensable without medical causation. Missing reporting deadlines that bar claims.
