Los Angeles | West Covina | Santa Ana | Long Beach
Experience you need.
Trust you expect.
Results you want.

Call Us (Available 24/7)

(562) 561-2669
(213) 732-3436
(805) 800-8799

Se Habla Espanol !​


Mon - Fri
8:00 AM - 5:00 PM

Are you injured on the job? Workers’ Comp might not cover some of your Injuries.

Workers’ Comp might not cover some of your Injuries | Gaylord & Nantais

Workers’ comp is a system with inside the United States that offers benefits to workers who were injured or ended up unwell because of their job. State governments commonly administer this system as a part of social welfare programs. The United States established the Workers’ Compensation in 1908 to enact the Workers Compensation Act in New York. The program has gotten amended and expanded over the years, with most states now providing benefits for temporary and permanent disabilities, death, and medical expenses. Employers pay W.C. insurance premiums, and state-run insurance funds pay benefits.

Each year, hundreds of people get injured at the job. Based on the Bureau of Labor Statistics, in 2016, there were almost 3 million nonfatal places of work accidents and illnesses. That’s more than 7,500 injuries each day.

The most common type of injury is a musculoskeletal disorder, such as a sprain, strain, or tear. These accidents account for more than one-third of all workplace injuries. Other common types of damages include: – slips, trips, falls, contact with toxic objects and equipment, fires, etc. Workers’ compensation is accessible to almost all the employees in the United States, except the federal government.

The program is obligatory in maximum states, which means employers should offer their employees insurance. The system gets administered on the state level, with each state placing its very own guidelines and regulations. However, it is crucial to recognize that workers’ compensation isn’t necessarily an insurance program.

Workers’ reimbursement is a no-fault system. Because of this, a business enterprise need not show negligence for the worker to obtain benefits. Benefits get provided no matter who was at fault for the injury. It is a way to compensate the injured employees for their inconveniences and pains. However, several injuries don’t cover under workers’ compensation. It includes injuries that occur while the worker is off the job or on vacation. It also has self-inflicted wounds, such as those caused by drug or alcohol abuse.

Injuries not included in Workers’ Comp

Several injuries and illnesses do not cover under workers’ compensation. These can include injuries or diseases resulting from a worker’s negligence, injuries or illnesses while traveling for work, and psychological injuries. These can consist of:

Injuries that occur while the employee is off the clock

Injuries that occur while the employee is off the clock are not typically workers’ compensation claims. The injury did not happen while the employee was performing their job duties. For example, an employee injured while on a break or traveling to work occurred while off the clock.

Injuries that happen through horseplay or other reckless behavior

Injuries caused by horseplay or other reckless behavior is generally not covered by workers’ compensation, but some exceptions are there. Generally, damages caused by horseplay or other reckless behavior is not covered by workers’ compensation because they are considered the result of personal choices rather than job-related risks.

Self-inflicted Injuries

Self-inflicted injuries are the injuries caused by the employee and not by their work. They happen when employees are not following the safety guidelines that have been put in place by their employer. Many injuries are self-inflicted and do not get covered under workers’ compensation.

Common self-inflicted injuries are drug or alcohol abuse, horseplay, or fighting.

Injuries that happen while the employee is committing a crime

When an employee is injured while committing a crime, they can typically not collect compensation benefits. It is because their injury gets considered to be “outside the scope of their employment.” For example, if an employee is injured while robbing a bank, they would not collect workers’ compensation benefits as the injury took place off the course of their employment. Even though these injuries can reduce your chances of receiving compensation, remember that exceptions always exist.

If you get injured at the workplace under the circumstances mentioned earlier, it is best to consult an experienced Workers’ Comp attorney or even attorneys. Discuss the details with your attorney and understand where your claim stands before making any decisions.

As established above, there are a variety of injuries that don’t get covered under workers’ compensation. If you have been injured and are not sure if you are covered, please contact at (562) 561-2669/(213) 732-3436 our office for a free consultation or visit our website at Gaylord and Nantais Attorneys at Law. We will review your case and know if you are eligible for workers’ compensation benefits.


Picture of Thomas M. Nantais

Thomas M. Nantais

Thomas M. Nantais is the Partner of Gaylord & Nantais, a legal firm specializing in workers’ compensation, in the state of California. This firm deals in getting hearing loss compensation and work related injuries compensation for those who have worked in the state of California. With his sincere efforts, Thomas is committed to meet the highest standards of the legal industry, and aims to provide the clients with an honest and aggressive representation.

Leave a Reply

Need Help?

Get a Free Case Evaluation

Get your case evaluated from the most trusted attorney in Long Beach and Los Angeles