Are Workers’ Compensation Benefits Available for All On-the-Job Injuries?

Workers’ compensation benefits are available for any job-related injuries. While that covers a variety of injuries and illnesses, there are exceptions, like if you were injured while engaging in risky behavior. Even if your injuries don’t qualify for workers’ compensation benefits, you may still have options. The workers’ compensation attorneys at KJT Law Group offer guidance if you have problems securing benefits.

Injuries That Are Covered (and Not Covered) by Workers’ Compensation

Determining if your on-the-job injury qualifies you for benefits depends on how you sustained the injury. The circumstances are sometimes the deciding factor.

In theory, any injury you sustain in the course of your duties should qualify. In practice, employers and insurers often work to avoid paying out claims, sometimes by blaming you or another party for your injuries. Knowing what scenarios are scrutinized can help you protect your rights following a workplace injury.

Covered by Workers’ Compensation

Workplace injuries and illnesses can arise from:

• Repetitive motions
• Overwork
• Exposure to toxic substances
• Slips and falls
• Getting struck by objects
• Malfunctioning equipment
• Motor vehicle accidents
• Extreme temperatures

If you were hurt by any of these while conducting your business, your employer’s workers’ compensation should cover the injury or illness.

Not Covered by Workers’ Compensation

You likely will not receive benefits if your injuries are from:

• Fights
• Goofing around
• Intoxication
• Social events
• Self-infliction
• Illegal actions

Generally, if you were hurt while doing something explicitly for work, the injury is probably covered. An injury that happened at a required work conference? Probably covered. An injury at a voluntary networking cocktail hour with coworkers after you clocked out? Probably not.   Nonetheless, you could still receive compensation for some of these situations through other avenues. Even if your employer’s workers’ compensation coverage doesn’t apply, if someone else caused your injuries, you can potentially recover your losses through a lawsuit.

Your Employment Status Matters When Seeking Workers’ Compensation

Every employee, whether they’re full-time, part-time, or seasonal, qualifies for workers’ compensation benefits, per the California Department of Consumer Affairs. However, independent contractors, freelancers, and volunteers are not eligible for workers’ compensation benefits because they are not considered employees. Even if you were hurt on company grounds doing a job specifically for a business, your employer may avoid responsibility based on your job status.

However, employees receive workers’ compensation benefits in exchange for agreeing not to sue an employer for negligence. If you don’t qualify for workers’ compensation, you may qualify for a lawsuit if someone’s negligence caused your injuries. A personal injury attorney from our firm can provide a personalized analysis of your case to see if you are eligible for this option.

Benefits Available for Covered On-the-Job Injuries

If you qualify for workers’ compensation benefits, you can receive help with:

• Medical bills
• Rehabilitation
• Disability
• Lost income

You can receive medical treatment until you reach maximum medical improvement—essentially, your new normal. Rehabilitation benefits can provide for both physical rehabilitation and vocational rehabilitation. If your injuries prevent you from working in the same capacity, you may qualify for assistance in finding and training for a new job.

Disability benefits depend on whether you have a temporary or permanent disability, and whether it is total or partial. Temporary total, for instance, is when you are completely unable to work but will recover and return to work eventually. By contrast, permanent total disability means you will not recover from your injury, which will affect your future work.

If You Have Trouble Accessing Your Benefits

Getting workers’ compensation benefits for an on-the-job injury isn’t always a smooth process. You might encounter difficulty due to:

• Disputes over whether your injury occurred at work
• Disagreements about your treatment or care
• Pressure to return to work before you’re ready
• Early termination of your benefits
• An unfair denial of your claim

If you encounter any of these situations, you can contact our workers’ compensation attorneys. We are familiar with the reasons claims are denied or disputed and have experience with fighting back.

Other Options for Compensation if You’re Hurt on the Job

On-the-job injuries can provide grounds for a personal injury lawsuit. The main requirement is negligence, meaning if someone’s action or inaction caused you harm, you can sue them to recover medical compensation, lost income, and pain and suffering.

When You Can Sue Your Employer

You can pursue a lawsuit against an employer if:

• Your employer inflicted intentional harm.
• Your injuries happened due to illegal actions.
• Your employer was uninsured.
• Your employer denied you access to workers’ compensation.
• You were not an employee.

Any injury scenarios outside of workers’ compensation coverage could provide grounds for a lawsuit if negligence was involved—that’s the trade employers make when they decide to avoid paying for workers’ compensation benefits.

Since these types of cases can involve other legal issues, including crimes like assault or fraud, you can hire our employment law attorneys to learn more about how to proceed with a third-party case.

When You Seek Damages From Another Party

Some scenarios that disqualify you from workers’ compensation benefits could provide you with grounds for a claim or lawsuit against a third party. You may also find you can pursue a lawsuit while still accepting benefits. Some possibly liable parties in a third-party claim include:

• Coworkers. If they attacked you or acted in a way that was unnecessarily reckless, causing you injury, you can hold them liable.
• Vendors. If someone else came to your workplace, such as to service machines or sell products, causing your injury, you can sue them for negligence.
• Property owners. If your injury occurred while on someone else’s property, such as a restaurant or hotel during a work event, you can hold the property owner responsible.
• Product manufacturers. If a defective product or piece of equipment caused your injury, you can sue the product manufacturer for design, production, or installation errors.

We can go over whether you can pursue a workers’ compensation claim, a lawsuit, or both based on the facts of your case.

KJT Law Group Can Assist You With Workers’ Compensation Benefits

When you partner with our California legal team, your goals become our goals. During your free consultation, we can review your story and craft a plan to help you access the care and compensation you need. Call today at (818) 507-8525.