After a work-related injury, workers’ compensation may be your lifesaver. These benefits will help pay for your medical bills and cover your lost wages during your recovery. However, you may be wondering if your injuries qualify for workers’ compensation. Let’s see what injuries aren’t covered by workers’ comp.
All work injuries are different. Therefore, your benefit eligibility will depend on the specific details of your case.
If your injury was your fault, occurred outside of your regular workplace, or took place while you were doing something not directly related to your job, keep reading to determine if you qualify for workers’ compensation.
What is a covered injury?
Workers’ compensation covers all injuries and illnesses sustained within the scope of your employment. Courts often interpret this in favor of the employee, so there is a good chance you can receive benefits.
Additionally, keep in mind that workers’ compensation is a no-fault system. Hence, even if you were responsible for the accident, that won’t affect your eligibility for compensation.
Cases where your injury may be covered
However, not all cases are so straightforward. You may suffer an injury during an activity that may or may not be related to your job. In these cases, the circumstances surrounding your injury will be vital in determining whether you qualify for the compensation you need.
Lunch break injuries
Believe it or not, if you are injured while taking a break in an on-site cafeteria, your injuries may be covered. That’s because, in most states, the courts consider it a benefit to the employer for employees to spend their breaks at the workplace. Therefore, they can be compensated for injuries that occur during this time.
However, suppose you leave your workplace for lunch and suffer an injury on the way. In that case, you probably won’t be able to receive workers’ compensation benefits for your injuries.
Injuries after clocking out
If you “clocked out” right before getting injured on the job, you may still qualify for compensation. For example, if you are injured in your employer’s parking lot after your shift ends, you may be able to receive workers’ compensation benefits. However, after you leave your employer’s property, what happens next won’t be covered.
Workers’ compensation will also cover injuries that occur while working away from your job site. For example, if you are injured while receiving a work call in the car, interviewing a potential client, or during a business trip, you may be able to apply for benefits.
It all depends on whether your injuries occurred “within the scope of your employment.” Each state has different interpretations of that statement, which is why you should consult with a Los Angeles workers’ compensation attorney, like C&B Law Group, to find out if you qualify for compensation.
Cumulative stress injuries
Injuries resulting from the cumulative stress of your work activities also qualify for compensation. For example, if you work in an office typing all day, you could suffer from carpal tunnel syndrome. As long as you can prove that your condition is work-related, you should be able to receive benefits.
Typical workers’ compensation exclusions
There are certain situations in which your injuries usually don’t qualify for workers’ compensation. If any of these apply to you, you may want to consult with a local workers’ compensation attorney to determine how to proceed.
Commuting to and from work
If you are injured going to or coming from work, you will probably not be eligible for workers’ compensation benefits in most cases. This is because commuting to and from work falls outside the scope of your employment.
However, if you were commuting to or from work while driving a company vehicle, things change. In these cases, you may be able to receive compensation. Consult a workers’ compensation attorney near you for more details.
Many companies organize recreational activities for their workers, such as picnics, parties, conferences, happy hour, etc. If you are injured during one of these events, you may not qualify for compensation.
However, if your employer benefited somehow from your presence at the event, your injuries may be covered.
If your injuries are minor and can be completely cured with a first aid kit, they may not be enough to qualify for compensation. Workers’ compensation benefits usually cover more severe injuries, affecting your short- and long-term earning capacity. A small bump or cut won’t suffice to obtain benefits.
Workers’ compensation doesn’t cover any injuries that occur due to the employee being under the influence of drugs or alcohol. Even if your injury occurs at the workplace, if you fall down the stairs because you have been drinking, rest assured that you will not receive any benefits.
Horseplay and fights
Horseplay is typical in some workplaces. However, keep in mind that horseplay and pranks are entirely outside the scope of your employment. Therefore, if you are injured due to these activities, you won’t be eligible for compensation.
Similarly, if you are injured from fighting with a co-worker, you may not qualify for compensation. However, if a co-worker hits you because you complained about their work performance, you may be able to receive benefits.