What Injuries Are Covered by Workers’ Compensation?
By Jade Yeban, J.D. | Legally reviewed by Katrina Wilson, Esq. | Last reviewed August 23, 2023
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Most employers are required to carry workers' compensation insurance. Workers' comp is a type of insurance. It provides benefits to those who have suffered work-related injuries or illnesses. Injured workers can rely on it to cover their medical bills. Workers' comp can also cover wage loss and even vocational rehabilitation.
This article covers the types of injuries covered by workers' compensation insurance.
Work-Related Injuries: What Is Covered by Workers' Comp?
You might be eligible for workers' compensation benefits if you are an employee who has suffered an injury. This injury might be called a "workplace accident." These benefits cover medical expenses related to the injury. They cover expenses ranging from immediate medical treatment to ongoing care. A work-related injury happens while doing something on your employer's behalf. Alternatively, it could happen in the course of employment.
A compensable injury includes physical injuries and impairment that limits your earning capacity. Permanent impairment can result in benefits like permanent partial disability or even total disability. These weekly benefits are meant to compensate for your lost wages. Disability benefits help cover ongoing medical care. These benefits can also cover vocational rehabilitation. This training is meant to help you find employment within your physical limitations.
Most injuries classified as work-related occur at the workplace. However, other factors will be considered. The following examples might be considered work-related accidents:
- An injury that occurred in a company-owned car
- An injury that occurred during a lunch break in the company cafeteria
- An injury resulting from inebriation at a company-sponsored event where alcohol was served
- Mental injuries (like anxiety or depression) sustained on the job or caused by the job
- Pre-existing conditions that worsened during employment
Compensable under workers' compensation insurance can sometimes include those resulting from "horseplay." This includes instances where employees may have been disregarding workplace safety rules. State laws and even some state courts remain divided on this issue.
Workers' compensation covers medical expenses from doctor visits to necessary surgeries. However, you may need to see an approved healthcare provider to ensure your bills are covered. Any out-of-pocket medical costs can be submitted for reimbursement.
Sadly, some workplace accidents can be fatal. In these cases, the workers' compensation system offers death benefits. These benefits are paid to the deceased worker's dependents. This includes compensation for funeral expenses and provides financial support to the dependents.
Injuries Covered by Workers Comp: Are You an Employee?
Not all injured persons can file for workers' comp benefits. The law mainly covers full-time and part-time employees. Employers in most states must carry workers' compensation insurance. However, only workers correctly classified as "employees" are covered, as opposed to independent contractors.
Independent contractors or volunteers may not be covered. Depending on your state, workers' comp may not cover certain types of workers. Checking with a workers' compensation lawyer for clarification is always best.
Some states have nuances. For example, in Wyoming, coverage is not required for undocumented workers. On the other hand, Arizona, California, Texas, and other states specifically include undocumented immigrant workers in employers' comp coverage.
Injuries Not Covered by Workers' Comp
While workers' compensation cases cover a wide range of injuries, some situations may not be covered. If an injured employee was intoxicated, the injury may not be covered. Alternatively, if the worker intentionally tries to harm themselves or co-workers, their injuries may not be eligible for compensation.
Additionally, injuries that occur while commuting to and from work are typically not covered. However, it will be covered if the travel is directly work-related. For example, if a car accident occurred while delivering goods, you most likely will be covered. If you need clarification about whether your injury may be covered, you should talk to an attorney.
Learn More About Injuries Covered by Workers' Comp: Contact a Local Attorney
If you've suffered a workplace injury, are experiencing pain and suffering, and are having difficulties with your workers' compensation claim, you may want to consider speaking to an attorney. An injury attorney understands workers' compensation law and can help review your case. They can review whether you have a personal injury case or a personal injury claim. If so, they can represent you in your personal injury lawsuit.
If you have questions, a workers' compensation attorney can put their expertise to work for you and help you toward the best outcome possible.
Next Steps
Contact a qualified workers' compensation attorney to make sure your rights are protected.