Workers' Compensation: Understanding Coverage, Common Injuries, And Limitations

​When employees sustain injuries while performing their duties, employers have a responsibility to provide compensation for their injuries. Workplace accidents can have a profound impact on employees, potentially leading to partial or permanent disabilities and causing them to take time off work, resulting in income loss. Workers' compensation insurance plays a critical role in helping injured employees by covering their medical expenses. However, it's essential to understand that not all injuries qualify for workers' compensation coverage. This article aims to clarify what worker's compensation can cover, outline common injuries, and explain its limitations.

Injuries Covered by Workers' Compensation:
Worker's compensation insurance typically covers a range of common workplace injuries, including but not limited to:

1. Bone fractures: Injuries that involve broken bones.
2. Cuts, lacerations, and punctures: Wounds caused by sharp objects or tools.
3. Muscle sprains, strains, and tears: Injuries resulting from overexertion or strenuous physical activity.
4. Slips, trips, and falls: Accidents that occur due to slippery or uneven surfaces.
5. Repetitive strain or stress: Conditions like carpal tunnel syndrome, tendonitis, and back pain caused by repeated movements or poor ergonomics.

"Fatal Four" Workplace Accidents:
The Occupational Safety and Health Administration (OSHA) has identified the "fatal four" accidents that commonly occur in the workplace. Workers' compensation can cover injuries resulting from these accidents:

1. Falls: Injuries sustained from falling from heights or on the same level.
2. Electrocution: Injuries caused by electrical shocks.
3. Being struck by an object or equipment: Injuries resulting from objects or equipment hitting an employee.
4. Getting crushed or struck between objects: Injuries occurring when an employee is crushed or caught between objects.

Situations Not Covered by Workers' Compensation:
While workers' compensation provides crucial support to injured employees, there are situations where it may not apply. Some instances that are typically not covered include:

1. Self-inflicted injuries: Injuries resulting from fights or altercations initiated by the employee.
2. Injuries due to intoxication or drug use: If the employee was under the influence at the time of the injury.
3. Injuries occurring outside company hours: When the injury happens outside of work-related activities or working hours.
4. Involvement in unlawful activities: If the employee was engaged in illegal activities at the time of the injury.
5. Intentional harm by one party to another: Cases where one person intentionally inflicted harm on another.
6. Disregard of safety rules or company policy: Injuries resulting from the employee's failure to adhere to safety guidelines.

Exclusions for Contractors and Subcontractors:
It's important to note that workers' compensation insurance typically does not cover contractors or subcontractors. In such cases, legal advice may be necessary to pursue compensation directly from the liable party.

Third-Party Responsibility:
In some instances, third parties like property owners, equipment manufacturers, or building owners may share responsibility for workplace injuries. Consulting a workers' compensation lawyer can help determine the liable party and the best course of action.

In conclusion, employers are responsible for maintaining a safe workplace and providing employees with the necessary support through workers' compensation insurance when injuries occur. Understanding what workers' compensation can cover and its limitations is essential for both employers and employees to navigate workplace injury claims effectively.

At Schneiderman Insurance Agency, we do our best to make sure that our clients are well-protected with affordable and comprehensive policies. To learn more about how we can help you, please contact our agency at (818) 322-4744 or Click Here to request a free quote.

Disclaimer: The information presented in this blog is intended for informational purposes only and should not be considered as professional advice. It is crucial to consult with a qualified insurance agent or professional for personalized advice tailored to your specific circumstances. They can provide expert guidance and help you make informed decisions regarding your insurance needs.​