5 Types of Injuries not Covered by Workers’ Compensation – the Surprising List

May 24, 2023

5 Types of Injuries not Covered by Workers’ Compensation – the Surprising List

workers' compensation does not cover every injury, such as company violations

According to the California Employment Development Department, workers’ compensation is a state-mandated legal remedy that benefits workers who suffer a work-related injury.

Workers’ compensation protects employees who may be able to receive payment while they are off from work due to an on the job injury. There is also protection for employers, who can avoid dealing with potentially high-priced lawsuits every time a worker is injured on the job.

Just because you are injured on the job does not mean you can automatically qualify for workers’ compensation.  You would have to prove that your injury was due to a work-related incident. 

Even then, just getting injured at work does not always lead to a successful claim.

Here are five injury situations where you would not qualify for workers compensation:

Violating company policy – If your company has a set of rules in place, you must abide by those rules to file a workers’ comp case. This may include any of the aforementioned situations, or other infractions, if they are not policies at your place of employment.

For example, if your job requires you to wear a helmet, you choose to go helmetless, and then suffer a head injury, your case will most likely be dismissed since you did not comply with company regulations.

Intentional acts – You cannot intentionally injure yourself with the idea of abusing the workers compensation system.  In fact, you may face a lawsuit over insurance fraud.

For example, purposely stepping on a sharp nail to injure yourself would disqualify you from receiving workers’ compensation since you deliberately staged the injury.

Illegal activities – Getting injured while breaking the law would disqualify you from receiving benefits.  For example, a rideshare driver who uses illegal drugs while on the job, then gets in a car accident, could be found negligent in a way similar to intoxication.

Horseplay – Engaging in playful acts outside of your job description with coworkers that results in injury may lead to an ineligible case. For example, an arm wrestling tournament with the coworkers at your dental office that led to a broken hand may not qualify, as arm wrestling is most likely not within the scope of your job description.

Intoxication – If you were drinking alcohol on the job and suffered an injury, your case may be dismissed. For example, if drinking liquor caused you to fall from a high spot at work, alcohol impairment will most likely be used against you.

workers' compensation does not cover injuries from workers who are drunk

While this is a list of examples that may disqualify you from a case, there are many situations where you will be eligible. 

If you’re injured while performing an activity within the scope of your job, you may be eligible for workers’ compensation.  

Common causes of workplace injuries are:

Your employer is required to carry workers’ compensation insurance.  There are only certain situations where a company would not provide workers’ compensation insurance for their employers.

For example, a company that hires independent contractors is not required to provide workers’ comp for those specific employees.

If you think you may have a workers compensation claim, it’s best to contact a Southern California injury lawyer. At C&B Law Group, we have years of experience helping injured employees like you get the compensation you deserve.  

Benefits you may be able to recover for a workers’ comp claim include:

  • Medical benefits 
  • Disability benefits (temporary or permanent)
  • Vocational rehabilitation
  • Dependent death benefits

The statute of limitations for a workers’ compensation claim in California is one year. Don’t wait, contact our workers compensation attorneys at C&B Law Group about your injury today for a free consultation.  

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