Can I Get Workers’ Comp if the Injury Was My Fault?

 Posted on April 09,2021 in Workers' Compensation

Ideally, workplace accidents would never happen. Unfortunately, even the safest workplaces experience employee injuries. If you were hurt in a workplace accident, you may have questions about your ability to get reimbursement for medical bills and lost income through workers’ compensation. You may wonder, “Can I get compensation if I caused my injury?” Typically, workers’ compensation coverage is “no-fault” meaning that an employee is covered even if he or she was at fault for the accident or injury. However, there are exceptions to this rule.

Criteria for Workers’ Compensation Coverage in California

To know if you can get financial reimbursement through workers’ compensation, you must first determine if you qualify for workers’ compensation coverage. Employers with one or more employees are required to have workers’ compensation insurance per California law. Full-time, part-time, and seasonal employees are covered by workers’ compensation. If you are an independent contractor, you most likely do not qualify for reimbursement through workers’ compensation.

Circumstances of the Injury

Another factor that determines whether you get compensation through workers’ comp is the circumstances of the injury. Normally, fault does not influence an employee’s eligibility for workers’ compensation. If your own mistake caused the accident or injury, you are most likely still covered. However, the injury must have taken place while you were performing work duties.

You may not be covered by workers’ compensation if your injury was caused by:

• Intoxication – If you were under the influence of drugs or alcohol and your intoxication was the cause of the injury, you do not qualify for workers’ compensation.
• “Horseplay” or deliberate misconduct – This is a gray area in California law. Workers are generally not entitled to workers' compensation if they were hurt while joking around or roughhousing. However, case law has established that an employee may be entitled to workers’ compensation for injuries caused by horseplay if this type of conduct was typical at the workplace and known to the employer.
• A fight – If you initiated a physical altercation and you were hurt, you do not qualify for workers’ compensation.
• A self-inflicted injury – If you purposely hurt yourself, you are not covered by workers’ compensation.

If none of these apply and you meet the criteria for workers’ compensation, but you were denied coverage, you can file an appeal. A workers’ compensation attorney can help you fight to get the compensation you deserve.

Contact a Morgan Hill Workers’ Compensation Lawyer

Workers’ compensation in California is available to employees regardless of fault. For help filing a workers’ compensation claim, appealing a denial, and more, contact a Santa Clara County workers’ compensation attorney at Cramer & Martinez, LLP. Call 408-848-1113 for a free consultation.

Source:

https://www.dir.ca.gov/dwc/faqs.html