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California Workers' Comp -What's Not Covered?
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California Workers' Comp
Workers’ compensation is a system in the United States designed to protect employees who suffer job-related injuries or illnesses. Understanding how this system works is necessary for workers to ensure fair treatment and proper compensation in times of need.
Are you relying on workers’ compensation to cover your potential workplace injuries?
While workers’ compensation can provide valuable coverage for many work-related injuries, it’s important to understand what is not covered. Contact Goldberg & Loren today to schedule a consultation and get the information you need to protect yourself and your financial well-being. Don’t wait until it’s too late!
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What's Not Covered Under California Workers' Compensation?
In California, certain situations and conditions are not covered under workers’ compensation. These include:
- Injuries that occur while an employee is off duty or not engaged in work-related activities
- Self-inflicted injuries or injuries that result from the employee’s willful misconduct
- Injuries that occur due to intoxication or drug use by the employee
- Injuries that result from a physical altercation that the employee started
- Emotional or mental injuries that do not have a direct physical cause
- Injuries that occur during the employee’s commute to and from work (with some exceptions)
- Injuries that are the result of horseplay or activities unrelated to work duties
- Injuries that occur while the employee is engaging in activities that are not related to their employment
What is and is not covered under California workers’ compensation can vary based on individual circumstances and the nature of the injury. [1] Consult with our workers’ compensation lawyers in California for more personalized advice.Â
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What Workers' Compensation Will Cover
The program is intended to support employees in handling their medical expenses and lost wages in the event of a work-related injury. Workers’ compensation insurance is a no-fault statute, which means that it provides coverage for medical bills and lost wages in the event of an injury, but it also prevents individuals from suing their employers or holding them responsible for the injury. [2]
If someone is injured at work, workers’ compensation will provide coverage for the following:
- Certain job replacement benefits
- Income replacement
- Lost wages
- Medical bills including any surgery, clinic visits
- Medical equipment such as ambulatory devices, braces, wheelchair
- Prescription medications
- Rehabilitation costs to regain muscle function, strength, etc.
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Contact Goldberg & Loren today for a free consultation regarding your workers’ compensation case. Don’t pay unless you win!
FAQs
Self-inflicted injuries or those resulting from an employee's willful misconduct are typically not covered, nor are injuries resulting from intoxication or drug use by the employee. Injuries that stem from physical altercations initiated by the employee are typically excluded from coverage. Mental injuries that lack a direct physical are generally not covered.Â
Injuries that occur during an employee's commute to and from work are generally not covered under California workers' compensation. Such injuries are typically deemed outside the scope of employment. There are certain exceptions to this rule, such as instances where the employee is on a special assignment or traveling between job sites as part of their work responsibilities. Injuries that occur in employer-provided transportation or while running errands specifically for the employer may be eligible for coverage.
Injuries during breaks or lunch periods are usually not covered unless the employee was performing a task directly related to their job duties when the injury occurred. These situations can be complex, and the determination of coverage may depend on the specific circumstances and the policies of the employer.Â
Sources:
[1] What Does Workers’ Comp Not Cover? | AmTrust Financial. (n.d.). AmtrustFinancial. https://amtrustfinancial.com/blog/small-business/what-is-not-covered-by-workers-comp-insurance
[2] Workers’ compensation insurance in California. (n.d.). ADP. Retrieved November 29, 2023, from https://www.adp.com/resources/articles-and-insights/articles/w/workers-compensation-insurance-california.aspx
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If you need professional legal guidance regarding what is and is not covered by workers' compensation in California, our team of experienced lawyers is ready to assist you. Feel free to contact us today for the answers you need.
George Goldberg
Senior Partner
Over 30 Years of Workers' Compensation Representation All Over California, Including the Following Cities and Communities:
- Los Angeles, CA
- San Diego, CA
- San Jose, CA
- San Francisco, CA
- Fresno, CA
- Sacramento, CA
- Long Beach, CA
- Oakland, CA
- Bakersfield, CA
- Anaheim, CA
- Stockton, CA
- Riverside, CA
- Irvine, CA
- Santa Ana, CA
- Chula Vista, CA
- Fremont, CA
- Santa Clarita, CA
- San Bernardino, CA
- Modesto, CA
- Fontana, CA
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