You get injured while working. Should you report it or go to your own doctor instead? In California, every employer must carry workers comp insurance. And any injury sustained on the job is covered by that insurance.
What makes you eligible for workers’ compensation?
There are three general requirements for determining whether you are eligible for workers’ compensation.
- Your employer must be required by law to carry workers’ compensation insurance.
- You must be an employee of that employer.
- You must have an injury or illness that is work-related.
Let’s take them one at a time.
Employer required to provide coverage
In the state of California, any company or business that has one employee or more must carry workers’ compensation insurance, or provide proof they are self-insured. There are very few exceptions to this law, so virtually everyone is covered.
Employee of company
To be eligible for workers’ comp, you must be an employee of the company.
Independent contractors are usually not eligible in case of an injury. Volunteers are also usually not covered, though California does allow non-profit organizations to opt in to provide coverage for volunteers.
There are gray areas in the law, however. Some employers try to categorize people as independent contractors, when, by legal definition, they are actually employees. In those cases, the injured employee may be eligible for coverage under their employer’s policy (if it exists).
Work-related injury or illness
The injury or illness must be work-related. In most cases, this is easy to determine. You injured your shoulder while carrying a heavy box at work. You tripped and fell down the stairs at work. You developed carpal tunnel syndrome due to heavy use of the computer keyboard. Those are all easy to see as work-related injuries.
Some injuries or illnesses may not be so easy to figure out if they are work-related or not. Here are a few examples:
- If you are out of the building, grabbing a sandwich for yourself at a nearby deli and sustain an injury, then you are likely not covered. However, if you are there picking up a lunch order for your employer, you may be covered.
- You are attending an employee baseball game off hours. You get hit by a ball and sustain an injury. The injury is likely covered by workers’ comp. After the game ends, if you trip getting into your car and sustain an injury, you may or may not be covered.
- If you are on a business trip and sustain an injury, it is likely covered. If you routinely drive a company car back and forth to work, and sustain an injury during your commute, you are likely covered. If you are driving your own car and sustain an injury during your commute, it is likely not covered.
If you have a work-related injury, you may need to seek legal counsel to make sure you get the proper medical care, disability benefits, and compensation you are eligible for.