What Types of Injuries Does Workers' Compensation Cover?

Most employers are required to carry workers’ compensation insurance, which provides benefits to those who have suffered work-related injuries or illnesses. Injured workers can rely on it to cover their medical bills, wage loss, and even vocational rehabilitation.

However, just because you’re injured at work doesn’t automatically mean you’re eligible for workers’ comp benefits. While most injuries are covered, there are some exceptions.

This article covers the types of injuries covered by workers’ compensation insurance. If you’re having a workers’ comp issue or your claim has been denied, consider contacting an attorney near you. An attorney can explain your rights, evaluate whether your injury qualifies for benefits, and guide you through the legal process. 

Work-Related Injuries Eligible for Workers’ Comp

You may be eligible for workers’ compensation benefits if you’re an employee who has suffered an injury or a workplace accident. These benefits cover medical expenses related to the injury, from immediate medical treatment to ongoing care.

A work-related injury occurs 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. But this isn’t the case for all injuries. The following examples may also 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
• Emotional trauma from a workplace robbery
• 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.

What About Fatal Workplace Accidents?

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 Not Covered by Workers’ Comp

While workers’ compensation cases cover most injuries, some situations are excluded. The following injuries may not be eligible for compensation:

• If an injured employee was intoxicated
• If the worker intentionally tried to harm themselves or co-workers,
• The injury occurred while commuting to and from work

However, a commuting injury may be covered if the travel is directly work-related. For example, if a car accident occurred while delivering goods, it is most likely a compensable injury. 

Not All Employees Are Eligible for Workers’ Comp

Not all injured persons can file for workers’ comp benefits. In general, the law applies to full-time and part-time employees. However, only workers correctly classified as “employees” are eligible. The law varies by state, but certain types of workers are not covered by workers’ comp:

• Independent contractors
• Volunteers
• Domestic workers
• Farm laborers
• Casual employees

Some state laws also 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.

If you’re unsure of your worker classification and eligibility, first talk with your employer. You can also ask a lawyer for clarification.

An Attorney Can Help With Your Workplace Injury Claim

Navigating the legal aspects of a workplace injury can be overwhelming. If you’re recovering from an accident at work, you should be able to focus on your health and medical care. Depending on the specifics of your injury, you may benefit from getting legal help with your workers’ compensation claim.

An injury attorney who understands workers’ compensation law can review your case and explain your options. If your injury is covered by workers’ compensation, they can help you pursue a claim or appeal a denial. They can also determine whether you may have a personal injury claim. If so, they can represent you in your personal injury lawsuit.

The right attorney can put their expertise to work for you and help you toward the best outcome possible. 

Because state law is relevant, your legal advisor should also be licensed in the state where you work. FindLaw’s directory of workers’ compensation attorneys can get you started. Select your state or city to review contact and ratings information for local experts.