(1) 
Injured/Diseased Employees and Beneficiaries. Each employee injured or killed due to an accident or who has suffered an occupational disease in the course of his or her employment, or such employee’s dependents or beneficiaries, shall receive compensation in accordance with this chapter, except as otherwise provided herein. Such payment shall be in lieu of any and all causes of action whatsoever against the Tribes.
(2) 
Special Rules for Noncustodial Situations. If an injured employee, or the surviving spouse of a deceased employee, does not have the legal custody of a dependent child on whose account payments are required to be made under this chapter, such payment shall be made to the person having legal custody of such child, but only for the periods of time after the Workers’ Compensation Committee has been notified of the fact of such legal custody. It shall be the duty of any such person receiving payments because of legal custody of any child to immediately notify the Workers’ Compensation Committee of any change in such legal custody.
(Ord. 108 § 108.2.1, 10-6-2006 (Res. 2006-312))
(1) 
Intentional Injuries. If injury or death results to an employee from the deliberate intention of the employee to bring about such injury or death, neither the employee nor the widow, widower, child, or dependent of the employee shall receive any compensation whatsoever under this chapter.
(2) 
Institutionalized Child. A physically or mentally incapacitated child, while being supported and cared for in a Tribal, State, or Federal institution, shall not be a dependent or beneficiary or be counted as a beneficiary in fixing the amount of any compensation to be received under this chapter.
(3) 
Double Death Benefits for Children Precluded. A child may receive payments as either the natural child of a deceased employee, or the stepchild of another deceased employee, but shall not receive double payments as both.
(4) 
Children Who Become 18 Years of Age. Any payments to or on account of a minor dependent or beneficiary of a deceased or temporarily or totally permanently disabled worker shall terminate when any such child reaches the age of 18 years, unless such child is a dependent physically or mentally incapacitated child or is under 23 years of age and enrolled as a full-time student in an accredited school. Payments to students who have attained age 18 shall be made directly to the student. Payments to or on account of any dependent physically or mentally incapacitated child over the age of 18 years shall continue in the amount previously paid on the account of such child until they shall cease to be dependent. When enrolled as a full-time student in an accredited school, payments to children who thereafter reach age 18 shall continue in the amount previously paid on the account of such student until they reach age 23 or cease to be enrolled full-time, whichever comes first. Where the employee sustains an injury or dies when any of his or her offspring are over the age of 18 years and either a dependent physically or mentally incapacitated child or enrolled full-time in an accredited school and are under age 23, the payment to or on account of such beneficiary shall be made as herein provided.
(5) 
Minor Children Not Dependent. Minor children of the employee who are not dependents of the employee as defined in this chapter are not covered by these provisions.
(Ord. 108 § 108.2.2, 10-6-2006 (Res. 2006-312))
If it is determined that an employee had, at the time of sustaining an injury and/or occupational disease, a preexisting medical condition, it shall be considered as follows:
(1) 
Compensability. If it is determined that an injured employee had, at the time of their injury, a preexisting medical condition and that such medical condition delays or prevents complete recovery from the injury, it shall be ascertained, as nearly as possible, the period over which the injury would have caused disability were it not for the preexisting medical condition.
(2) 
Permanent Partial Disability. In making a claim closing determination, it shall be ascertained, as nearly as possible, the extent of impairment which the injury/disease would have caused were it not for the preexisting condition. Disability benefits shall be awarded only for the portion of disability related to the work injury or disease.
(Ord. 108 § 108.2.3, 10-6-2006 (Res. 2006-312))
(1) 
Employees determined to be acting outside of the course or scope of their employment shall be afforded no coverage, compensation, or benefits under this chapter.
(2) 
An employee injury occurring while the employee is commuting to or from work is not within the due course or scope of employment unless such travel is in direct connection with the employee’s work and was specifically requested by the employer.
(3) 
Liability for compensation shall not exist against the Tribes for any injury sustained by an employee if the injury is caused by any of the following:
(a) 
Where the injury is caused by the intoxication, by any intoxicating substance or the unlawful use of a controlled substance, of the injured employee;
(b) 
Where the injury arises out of an altercation in which the injured employee is the initial physical aggressor;
(c) 
Where the injury is caused by the commission of a criminal act by the injured employee and the employee is found to have committed such act beyond a reasonable doubt by a court of competent jurisdiction;
(d) 
Where the injury arises out of voluntary participation in any off-duty recreational, social, or athletic activity not constituting a part of the employee’s work-related duties, including, but not limited to, activities sponsored by the employer, except where these activities are a reasonable expectancy of, or are expressly or impliedly required by, the employment; or
(e) 
Where the employee has willfully and deliberately caused his or her own death.
(4) 
Where the employee’s use of an intoxicating substance or unlawful use of a controlled substance at the time of injury has been established, there is a rebuttable presumption that the injury was caused by the intoxication.
(Ord. 108 § 108.2.4, 10-6-2006 (Res. 2006-312))
Any employee receiving benefits under this plan who is subsequently confined in, or who subsequently becomes eligible therefor while confined in, any penal institution under conviction and sentence shall have all payments of such compensation canceled during the period of confinement. After discharge from the institution, payment of benefits henceforth due shall be paid; however, no back pay for the time spent incarcerated shall be awarded to the employee. If the incarcerated employee has any beneficiaries during such confinement period, they shall be paid directly the monthly benefits which would have been paid to them had the employee not been so confined. No payment shall be made to or on behalf of the incarcerated employee during confinement. Any lump sum benefits to which the employee would otherwise be entitled but for the provisions of this section shall be paid on a monthly basis to the beneficiaries.
(Ord. 108 § 108.2.5, 10-6-2006 (Res. 2006-312))