If you’ve experienced a workplace injury, you may wonder whether your employer’s workers’ compensation insurance will cover your medical bills and time off work. Generally, the answer is yes — as long as the injury happened within the scope of your job duties, it should qualify for a compensation claim. Still, looking at similar injuries that have previously qualified can increase your confidence in your claim.
Review the common injuries covered by workers’ compensation insurance and examples of injuries this benefit will not likely cover.
What Do Workers’ Compensation Benefits Cover?
Under California law, all employers must offer workers’ compensation benefits, even if they only have one employee. This benefit should be available to part-time and full-time employees who experience injuries while performing their duties.
Workers’ compensation generally covers the following types of injuries:
- Physical injuries: Broken bones, bruises, internal damage, and other physically measurable injuries
- Mental injuries: Mental illnesses resulting from trauma, abnormal stress, or violence at work
- Occupational illnesses: Illnesses resulting from hazards within the workplace
- Cumulative trauma injuries: Injuries that worsen over time due to repetitive movement or long-term strain
In all of these cases, you must be able to show a direct link between your job duties and the injury or illness.
Common Workplace Injuries Covered by Workers’ Comp
Any injuries that meet the above requirements could qualify for workers’ compensation coverage, but some injuries are more prevalent than others. Common injuries covered by workers’ compensation insurance in California are as follows:
Lifting Injuries
Labor-intensive jobs often require workers to lift heavy objects. Many job descriptions even include the minimum weight employees should be able to lift to qualify for the position.
But just because an employee can lift a heavy object doesn’t mean it is safe to do so. A stressful, busy workplace environment may encourage employees to lift objects unsafely or neglect adequate safety measures in the name of time.
Common injuries from incorrect lifting include back, neck, and shoulder injuries.
Slips, Trips, and Falls
Slip and fall injuries can happen in any type of industry. Often, these injuries result from wet, slippery floors, icy sidewalks, torn carpeting, and uneven flooring. They may be more common in workplaces that require employees to meet tight deadlines, as workers may lose their footing when rushing from task to task.
Slips, trips, and falls could result in broken bones, bruises, internal bleeding, head trauma, and spinal injuries.
Repetitive Motion Injuries
Employees often do not realize repetitive motion injuries are forming until it’s too late. These injuries can develop in any workplace — for example, long-term office workers sometimes develop carpal tunnel due to the position of their wrists on keyboards. However, repetitive motion injuries are especially common in factories in which workers complete the same motions day in and day out.
Repetitive, long-term motions can cause nerve damage, torn tendons and ligaments, and muscle injuries.
Lacerations
Cuts, scrapes, and puncture wounds can also happen in any job. These types of injuries often occur when workers trip and fall or misuse equipment. They may also occur due to fluke, one-off incidents, such as dropping a pair of scissors at an office job.
Many lacerations only require a few stitches to heal, but some need more intensive treatment, such as tendon repair surgery.
Falling Object Injuries
Warehouse owners are responsible for ensuring employees stow merchandise safely to prevent falling object injuries. When heavy, large objects fall on workers, they can lead to significant injuries such as concussions, broken bones, traumatic brain injuries, and even paralysis.
Injuries From Contact With Equipment
Machinery malfunctions and misuse can lead to serious injuries and death. Workers must understand how to operate all equipment under their supervision. Meanwhile, employers are responsible for adequately training and overseeing equipment use.
Does Workers’ Compensation Cover Injuries That Are the Worker’s Fault?
You may hesitate to file a worker’s compensation claim if you know you were at fault for the injury. Thankfully, fault doesn’t matter in a workers’ compensation claim as long as you did not purposefully injure yourself and the injury happened while completing your job duties.
Intentionally injuring yourself for a workers’ compensation claim is a form of insurance fraud, which is a felony in California. You could face up to five years in prison and up to $50,000 in fines for insurance fraud; it simply isn’t worth the risk.
You can’t blame your employer if your injury happened outside of work. But if it happened while traveling to and from a job site, you may still be eligible for compensation depending on whether travel is part of your job duties.
Injuries Workers’ Compensation Does Not Cover
The list of injuries covered by workers’ compensation insurance is extensive, as almost any injury that happens within the scope of one’s job duties could qualify. But workers’ comp does not cover a few specific types of injuries and illnesses:
Pre-existing Conditions
If the insurance company suspects that your injury was pre-existing, it may deny your workers’ comp benefits. You’ll need to show that an accident or incident at work caused your injury.
Meanwhile, if you can prove that your job duties worsened an existing injury, you may qualify for coverage.
Common Illnesses
Workers’ comp only covers occupational diseases, not everyday illnesses like the flu, strep throat, and the common cold. You can easily pick up these illnesses from coworkers or anyone else you come into contact with daily, and your employer isn’t necessarily responsible when you contract them.
Injuries Resulting From Breaking Company Policies
In some cases, if you broke a company’s rules and experienced an injury, you may not be eligible for compensation. The lines for this exception are a little blurry; workers’ compensation lawyers can help you seek compensation even if you technically went against company policies.
Seek Legal Assistance With Workers’ Comp Claims
Now that you know the common injuries covered by workers’ compensation insurance, you’re ready to begin filing your claim. Contact Khalil Law Group at 714-617-7870 for dedicated assistance from a workers’ compensation attorney.