What issues ARE covered by workers comp?
The answer to this burning question is relatively straightforward. Any injury that you suffer at work that is covered under California Workers’ Compensation law. That includes both physical injury to your arms, to your wrist, to your legs, any type of physical injury. It also may include psychological injury as a result of the type of work that you have.
Here’s what’s covered by workers comp:
Impact injuries that occur at work such as slipping and falling, getting struck by a falling object, getting caught in a piece of heavy machinery, or getting into any other sort of accident at work.
Car accident injuries:
These injuries are sustained while performing a workplace task, such as transporting a company product, driving a crane, truck, or another piece of company equipment, or traveling from one worksite to another.
Overuse and repetitive motion injuries:
If you perform similar repetitive movements or tasks repeatedly throughout your day, such as entering numbers on a computer or fastening a component on an assembly line, you are at risk of developing a repetitive motion or repetitive stress injury (RSI).
Ex: Carpal tunnel syndrome, back, knee, or shoulder injuries caused by lifting, turning, or carrying, or nerve damage.
Viruses, disease, and other conditions caused by exposure to toxins:
These conditions exposed to the workplace can be things like smoke inhalation, asbestos, and radiation. Employees who contract the novel coronavirus at work should be covered as well.
Psychological and emotional conditions:
This can include post-traumatic stress disorder, anxiety, and other stress disorders caused by workplace conditions.
Aggravation of pre-existing conditions:
As a rule, workers cannot collect workers’ compensation benefits for injuries or diseases that weren’t first incurred on the job. However, if employment-related tasks make an employee’s injuries worse, then that employee may still be eligible for benefits for the additional pain and suffering caused by their employment-related tasks.
This is a type benefit that is paid to a deceased worker’s dependents. They include burial expenses and cash benefits.
Death benefits are not paid all at once in a lump sum. Rather, they are paid in weekly installments, similar to the way temporary total disability benefits are dispersed. Once the death benefits run out, any dependent children under the age of 18 will continue receiving survivors’ benefits at the temporary disability rate until they become legal adults. Adult children who are mentally or physically incapacitated will receive benefits for life. The temporary disability benefit rate is equal to two-thirds of the employee’s average weekly earnings before he or she passed away.
If an injury occurs during lunch break, it may be considered work-related if it happens at the company cafeteria, on other employer-owned grounds, or otherwise connected to the course of employment (for example, lunch with a client at a restaurant). Additionally, an injury resulting from inebriation may be considered work-related if alcohol is provided at a company-sponsored event. Mental injuries (such as anxiety or depression) may be covered if they were sustained on the job or caused by the job. Finally, a preexisting condition that has worsened during the course of employment may be covered under workers’ compensation as well.
What issues Are NOT covered by workers comp?
While California workers’ compensation laws provide broad coverage for workers who suffer injuries or illnesses on the job, there are some types of issues that may not be covered.
Here are some examples:
Illnesses and injuries that pre-date current employment:
Even if they manifest during current employment. Injuries that were preexisting but which are made worse by job-related duties, however, such as an old back injury that is exacerbated by lifting boxes, may be covered.
Injuries that occur during a worker’s private, non-work time:
This may include injuries sustained during a lunch break, at company events, or even while traveling to and from their place at work. Injuries that occur on business trips, on the other hand, are likely covered.
Injuries sustained when a worker deliberately violates a workplace safety rule:
Such as by electing to consume alcohol or drugs while on the job.
If an employee intentionally causes harm to themselves or others, or intentionally causes damage to company property, it may not be covered under workers’ compensation.
Mental health issues:
Mental health issues, such as stress or anxiety, may be covered if they are directly related to work-related events, but may not be covered if they are not related to work.
Other deliberate or illegal conduct:
Such as if a worker starts a physical fight.
Furthermore, workers’ compensation does not usually cover contractors or subcontractors, meaning if you are not an employee, an attorney might advise you to pursue compensation from the responsible party directly.
In some cases, third parties—such as a building owner, property owner, or equipment manufacturer—may also have liability. A workers’ compensation lawyer can help you identify the responsible party and determine the best route to pursue.
It’s important to note that each case is unique, and whether an injury or illness is covered by workers’ compensation in California can depend on the specific circumstances of the case.
SOMETIMES INJURED EMPLOYEES WILL HAVE TO FIGHT TO GET WORKERS COMP BENEFITS!
Even when employees make valid claims for injuries that should be covered, many employers will contest employee workers’ compensation claims. This can delay injured workers’ abilities to get the benefits they need. If you’ve been hurt on the job in Southern California, call us today at Solov & Teitell!