When Can You File a Workers’ Compensation Claim?

A Santa Rosa workers’ compensation lawyer can help employees make claims for work-related injuries

If you are an employee, you can file a workers’ compensation claim if you sustain an injury or illness that is work-related. A Santa Rosa workers’ compensation attorney can help employees make a claim when their injuries meet those standards.

Compensable Injuries

For workers’ compensation purposes, an injury can be a physical or mental harm, or a disease or illness. The injury may be caused by a specific event or, as in the case of a carpal tunnel injury, it may develop over a period of time.

Employees are entitled to make workers’ compensation claims for injuries that arose from their employment and occur during the course of their employment. An injury is considered “compensable” under these circumstances.

An injury that is treated with first-aid care rather than medical treatment is not usually a compensable injury. Minor cuts, bruises, and superficial burns are examples of injuries that are usually treated with first-aid and thus do not qualify for workers’ compensation benefits. An injury that must be treated by a physician, however, will usually be considered a compensable injury.

An injury is disabling if it significantly interferes with work. Specifically, an injury that causes an employee to miss at least three days of work will be regarded as disabling.

Certain work related injuries may not be compensable even if they are disabling or require medical treatment. Those kinds of injuries sometimes include:

Injuries caused by the employee’s intoxication
Intentionally self-inflicted injuries
Injuries caused by fighting if the employee started the fight
Injuries caused during the commission of a felony by the employee
Specific injuries that are not claimed until after the employee is terminated (unless the employer was notified of the injury before the employee was terminated or other conditions are met)

Employees who suffer a compensable injury and are denied workers’ compensation benefits should seek advice from a workers’ compensation attorney in Santa Rosa.

Work-Related Injuries

Employees can file a claim for workers’ compensation benefits when their compensable injuries are work-related. Whether an injury is work-related depends on whether the injury “arose out of employment” and whether it occurred in the “course of employment.”

An injury arises out of employment if working caused the injury. Establishing that an injury arose out of employment will require a Santa Rosa workers’ compensation attorney to determine exactly how the injury occurred. The attorney may then need to review the facts with a physician to prove that the injury was caused by work activity.

An injury occurs in the course of employment if the activity that caused the injury was part of, or incidental to, the employee’s job description. For instance, a traffic accident that injures an employee may occur in the course of employment if the employee was driving to carry out a job duty. Even if the employee made a short detour to grab lunch from a drive-through window, the driving may be considered incidental to employment. A traffic accident in the drive-through lane might therefore cause an injury that is covered by worker’s compensation. If the worker drives to a more distant destination to pursue a personal errand, however, the employee might not be acting in the course of employment even if the employee is being paid for his or her time.

Deciding whether an injury is work-related will depend upon the circumstances, as well as California precedent that has applied workers’ compensation law in other cases. A Santa Rosa workers’ compensation lawyer is in the best position to advise injured employees whether their injuries will be deemed to be work related.

Preexisting Injuries

Suppose an employee lifts a heavy piece of furniture at home and experiences a back injury. The injury is clearly not work-related. However, suppose that the employee, having recovered from that injury, lifts a box at work and reinjures his or her back. Was the injury work-related?

The employer’s insurance company might say that the back injury occurred at home and not at work. But California workers’ compensation law provides that the aggravation of a previous injury (or preexisting condition) is treated as a new injury. If a preexisting injury that was not work-related is aggravated by something the employee does while working, California workers’ compensation law will regard the injury as a new injury.

Of course, the insurance company might argue that the sole cause of the injury was lifting furniture at home and that nothing the employee did at work aggravated the injury. That’s the kind of factual dispute that a workers’ compensation lawyer can help Santa Rosa employees resolve.