April 2, 2021 | Workers' Compensation
What happens to your workers’ comp claim if you fail a drug? Fortunately, the answer to this question is nuanced. A positive drug test after a workplace accident does not bar all claims under Oklahoma’s workers’ compensation laws.
For a workers’ compensation insurer to deny a claim due to a positive drug test, it must establish the drug use and accident were related. This allows people who are injured to receive fair compensation if intoxication did not cause their accident.
Here are the important things you should know about workers’ compensation and the ways to receive workers’ compensation benefits after failing a drug test.
Workers’ Compensation Laws in Oklahoma
Workers’ compensation systems protect employees that are injured at work. Oklahoma requires almost all employers to obtain workers’ compensation insurance. They can buy this insurance from a private insurer or through the state’s insurance system. All of these insurers follow Oklahoma’s workers’ compensation laws.
These rules create a “no-fault” system in which the insurer must pay benefits to people that are injured in the course and scope of their employment. The insurer pays out for claims regardless of the cause of the accident and whether the worker was at fault.
This protects employees because they do not need to prove negligence by the employer to receive benefits. Employees receive benefits even if the employer did everything correctly and the employee suffered an accident anyway. Employees even receive benefits if their own negligence caused the accident.
For example, suppose that a machine breaks a worker’s arm. The worker would receive benefits if the accident was caused by the employer’s negligence in maintaining the machine. The worker also receives benefits if the accident was caused by their own mistake in pressing the wrong control while operating the machine. Finally, the worker receives benefits if no one caused the accident.
Exception for Intoxication
Oklahoma has a major exception to its no-fault system. An insurer does not need to compensate an employee for an injury in an accident caused by the employee’s use of drugs or alcohol.
This exception applies when:
The Employee is Intoxicated
Under Oklahoma’s laws, intoxication includes the use of alcohol, illegal drugs, or prescription drugs used in contravention of a doctor’s instructions. This includes any intoxicant that would affect the employee’s physical or mental performance.
The Intoxication Caused the Accident
A worker’s altered state while intoxicated must have a causal relationship to the accident. Although the law does not specifically address the point, this probably means that the worker must use a quantity of alcohol or drugs that would endanger the safety of the worker or another employee.
A beer imbibed the night before work might not create a causal link between the intoxication and the accident. However, a beer during a lunch break could provide this link.
Can an Employer Test for Drugs and Alcohol After an Accident?
Yes. Oklahoma’s Standards for Workplace Drug and Alcohol Testing Act allows employers to conduct a drug and alcohol test after an accident that causes an injury or damages property.
If an employer requests a drug or alcohol test after an accident, the employee must take the test in order to receive workers’ compensation benefits. If the employee refuses to take the test, the employee then becomes ineligible for workers’ compensation benefits.
Timing of Drug and Alcohol Testing
A drug and alcohol test has its greatest value to the employer and workers’ comp insurer if the specimen collection occurs within 24 hours after the accident. If a specimen collected within 24 hours after the accident comes back positive for drugs or alcohol, the law establishes a presumption that the injury was caused by intoxication.
If the employee dies, the state medical examiner will collect a sample. If the sample comes back positive and it was collected within 24 hours of the accident, the insurer can presume that intoxication caused the employee’s death.
Thus, under the normal sequence of events, an on-the-job accident would occur. Next, the employer would notify the workers’ comp insurer of the accident. The insurer would advise the employer to conduct a drug and alcohol test within 24 hours.
Because refusing to take the test will render you ineligible for workers’ compensation benefits, you should take the test. Even if you fail the test, you could still receive workers’ compensation if you can prove that intoxication had no causal link to the accident.
Rebutting the Presumption
You can rebut the presumed link between intoxication and your injuries. According to Oklahoma law, an injured worker rebuts the presumption by presenting clear and convincing evidence that the state of intoxication did not cause the injuries.
What would normally happen is that the workers’ comp insurer would deny benefits if your drug and alcohol tests came back positive. You could then seek a review of the denial from an administrative law judge (ALJ).
You would submit evidence to the ALJ that your accident did not result from a state of intoxication. If the ALJ found this evidence to be clear and convincing, the ALJ could reverse the denial of benefits and order the insurer to pay.
Clear and convincing is an evidentiary standard that can be difficult to pin down. But it is more than “a preponderance of the evidence” and less than “beyond a reasonable doubt.” Some of the facts that might help your case include:
Witnesses who saw you on the day of the accident and did not see any signs of intoxication could support your case.
The amount of drugs or alcohol measured by the test or the fact that you passed a test soon afterward could help you to prove that you were not impaired.
Circumstances of the Accident
If you were injured in a way in which your physical or mental state played no role, you may be able to convince an ALJ that no causal link exists. For example, if you were injured when something fell on you, your state of intoxication would be irrelevant.
Benefits Paid by Workers’ Compensation
Workers’ compensation pays medical benefits and partial income replacement. If an injury causes permanent disability, the insurer pays additional benefits depending on whether your permanent disability is partial or total.
Once you and your workers’ compensation lawyer present evidence that intoxication played no role in your injuries, you become entitled to these benefits.