The Impact of Substance Abuse Policies on Workers’ Compensation Claims
Workers’ compensation laws in Pennsylvania are designed to provide a safety net for workers injured in the course and scope of their employment, regardless of fault. However, this protection has its limits. One of the more complex exceptions arises when substance abuse is involved in a work injury. Employers may deny a workers’ compensation claim if they can prove that drug or alcohol use caused the injury. In practice, this exception can have far-reaching consequences, especially in workplaces with strict substance abuse policies.
So how do these policies impact workers’ compensation claims in Pennsylvania, and what does the law actually require? Let’s break it down in plain English.
A No-Fault System With a Catch
Pennsylvania’s workers’ compensation system operates on a no-fault basis. This means employees don’t need to prove their employer was negligent to receive benefits. Even if the injury is the result of the employee’s own mistake, compensation is still generally available.
However, the Pennsylvania Workers’ Compensation Act establishes “affirmative defenses” that allow an employer to deny benefits. One such defense involves drug or alcohol use. Specifically, Section 301(a) of the Act bars compensation when the injury results from the employee’s violation of the law (such as illegal drug use) or when the injury “would not have occurred but for the employee’s intoxication.” In these cases, the employer has a complete defense to the claim.
The Burden Is on the Employer
A positive drug or alcohol test does not automatically disqualify a worker from benefits. Under Pennsylvania law, the burden of proof is on the employer to demonstrate both:
- The employee was intoxicated at the time of the incident, and
- The intoxication caused the injury.
This is known as the “intoxication defense,” and courts have emphasized that mere evidence of use is not enough. In Kovalchick Salvage Co. v. WCAB (St. Clair), 519 A.2d 543 (Pa. Cmwlth. 1986), the court held that a positive drug test alone wasn’t sufficient to deny benefits when there was no proof that intoxication caused the incident.
What About Prescription Drugs or Medical Marijuana?
This area of the law is more nuanced. Legally prescribed medications, including opioids, are not a reason to deny a claim by default. However, misuse of medication or performing activities that the medication prohibits, such as operating heavy machinery, could lead to a denial.
Medical marijuana, though legal in Pennsylvania, presents its own challenges. Employers may still discipline workers for being under the influence while on the job. If an employer can prove that marijuana use caused a work injury, they may have grounds to deny the claim.
Drug Testing, OSHA, and Retaliation
Post-incident drug testing cannot be used as a form of retaliation. Under OSHA regulation 29 C.F.R. § 1904.35, employers must have an “objectively reasonable basis” to believe that substance use contributed to the accident before requiring a test.
Acceptable bases for testing include:
- Routine random screening
- Testing unrelated to the injury
- State or federally required testing
- Incident investigations where the test is applied across all involved employees
Targeting only the injured employee may be considered retaliatory and could invalidate the test’s findings.
Refusing a Drug Test
Employees who refuse a post-accident drug test may face more than just denied benefits. They may also be terminated for violating company policy. Employers in Pennsylvania are allowed to enforce drug testing policies using various methods, including urine, blood, hair, or breath tests.
However, if the test lacks reasonable suspicion or appears retaliatory, it may not be legally enforceable. Any denial of benefits based on such a test could be challenged.
Real-World Consequences and Key Takeaways
Substance abuse policies are particularly important in safety-sensitive jobs where post-accident testing is common. Even legal use of prescription drugs can present gray areas if impairment is suspected.
Main takeaways:
- Workers’ compensation is no-fault—except when drugs or alcohol caused the injury.
- Employers must prove both intoxication and causation.
- Drug testing must be supported by a reasonable, non-retaliatory basis.
- Medical marijuana and prescription drugs can still be scrutinized.
- Refusing a drug test can lead to both denial of benefits and job termination.
Why You Need an Attorney
If your claim is denied due to alleged substance use, it’s crucial to consult with a skilled workers’ compensation attorney. You may be able to prove that you were not under the influence at the time of the injury, or that the incident was caused by something else entirely.
At Stern & Cohen, we offer free consultations and are ready to help you navigate the complex Pennsylvania workers’ compensation system. If you’ve been injured on the job and are facing drug testing or a denied claim, contact us today. We’re here to fight for the benefits you deserve.