When it comes to workers’ compensation laws for on-the-job injuries, each state has its own statutes. However, they generally cover the same types of injuries. This includes acute injuries suffered in work-related accidents, repetitive motion injuries from chronic use and over-exertion, and occupational illnesses.
If you have questions about your on-the-job injury or the insurance company denies your claim, discussing your options with a workers’ compensation lawyer near you is a good next step. Most provide free consultations for injured workers.
Understanding the Injuries Covered by California Workers’ Compensation Laws
According to the California Division of Workers’ Compensation (DWC), there are two types of injuries covered by workers’ compensation in the state:
Acute injuries occur because of a sudden accident, incident, misstep, or one-time event. Usually, the employee, a coworker, the company, or a third party acts carelessly or recklessly to cause the event and injuries.
However, workers’ compensation insurance is a no-fault system. Here, you can receive benefits as long as you were not intoxicated or engaging in horseplay when the incident happened. Your injuries must have also happened while you performed work-related duties.
Examples the DWC uses to illustrate acute injuries include:
- Hurting your back from a fall
- Getting in a crash while delivering goods
- Receiving burns from an open flame
Repetitive Motion Injuries
Workers’ compensation also pays for job-related repetitive motion injuries. These injuries generally come from doing the same task over and over or having repeated exposures at work. Back, arm, and hand injuries are common. Knees and hips are also commonly affected.
The DWC examples of repetitive motion injuries include:
- Wrist injuries, such as carpal tunnel syndrome
- Hearing loss caused by loud noises in the workplace
Looking Further into the Types of Covered Injuries
Almost any work-related injury or illness could fall under the workers’ compensation laws in most states. There are exceptions to these rules, but they are narrow, and the courts often side with covering the employee when these cases make it in front of a judge.
On-the-job incidents and injuries can happen in any type of workplace and any industry. They may seem more likely on construction sites or in industrial plants, but accidents happen in corporate offices, daycare centers, stores, shops, and more. This is why all employers in California with at least one employee must provide coverage, with the exception of government offices.
When it comes to how accidents happen, one workers’ compensation insurance company gives the example of:
- Breaking an arm in a slip and fall in the office
- Developing carpal tunnel syndrome from typing at your computer
- Mesothelioma from exposure to asbestos
The process required for reporting the injuries also differs by the type of injury. This is one reason why employees need to understand what workers’ compensation covers. A fall might call for a visit to the nearest emergency department or urgent care clinic. In some cases, you might even need to call an ambulance. Your supervisor will likely know about the incident immediately, but you should still officially notify them in writing as soon as possible.
With chronic use injuries, you might not know what is wrong until you see your doctor and receive a diagnosis. Some states require you to see an approved medical provider in the workers’ compensation insurer’s network before they will approve these claims.
When it comes to a repetitive motion injury or occupational illness, you should notify your supervisor or human resources department as soon as possible after you receive a diagnosis. You sometimes only have up to 30 days to submit an official notice in writing or file the appropriate form. Meeting this deadline protects your right to the coverage you deserve.
Workers’ Compensation Laws Exclude Some Injuries
There are some injuries excluded from workers’ compensation benefits in most states. These rules can vary slightly based on the applicable laws, but excluded injuries generally include:
- Intentional self-inflicted injuries
- Accidents caused by the employee’s drinking or drug use
- Injuries that occur while commuting to or from work (under most circumstances)
- Injuries sustained while violating company policy
- Incidents caused by fighting or horseplay
- Injuries suffered while committing a serious crime
Many states also treat stress-related or psychiatric disorders differently than physical injuries. It may not be possible to receive workers’ compensation benefits for a mental health disorder, even if it occurred because of issues within the workplace. A workers’ compensation attorney Los Angeles can assess your claim and offer further advice if you face this type of medical concern.
What If the Workers’ Compensation Insurer Denies My Claim?
Unfortunately, some workers’ compensation insurance companies look for reasons to deny or reduce the value of a claim. They may allege that:
- An alleged on-the-job injury happened somewhere else
- The injury was unrelated to the worker’s job
- Another exception makes the worker ineligible for benefits
If this occurs in your case, you have options. You should consider contacting a Los Angeles personal injury attorney who handles workers’ compensation cases. They can help you understand how to fight the denial. They can handle any appeals and review your case to determine if you have additional options for compensation, such as a third-party negligence claim.
You Could Partner With a Lawyer at No Upfront Cost
Workers’ compensation lawyers cannot charge you upfront fees for handling your case. They can only collect attorney’s fees from the benefits or settlement they recover for you. This makes it possible to hire an attorney regardless of your current financial situation.
Discuss Your On-the-Job Injury With Our Workers’ Compensation Team
KJT Law Group provides free case reviews for injured workers in California. You can discuss your injuries and legal options for compensation with a team member today. We can review your case and help you seek approval for your workers’ compensation claim. Most workers in California qualify for coverage after a workplace injury. Contact us now by calling (818) 507-8525.