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Get the Facts About What Workers’ Compensation Covers – and What It Doesn’t Cover

Workers’ compensation is insurance that employers purchase to cover the costs of diseases and accidents that occur at work. The majority of states have laws requiring companies to have workers’ compensation insurance, however these laws vary from state to state. For instance, of all states, California has one of the most pro-worker workers’ compensation legislation.

Did you realize that workers’ compensation pays for much more than just medical expenses? Let’s find out what is covered under workers’ compensation. If you have questions or require help from a workers’ compensation attorney, contact PLBH at (800) 435-7542 for help.

Medical expenses

The main goal of workers’ compensation insurance is to cover the medical costs related to an illness or accident sustained on the job. Surgery, medicine, diagnostic testing, and emergency department visits all fall under the category of medical treatment. Workers may also request reimbursement to cover future medical costs, but before doing so, you should consult a workers’ compensation lawyer in California.

Lost wages

Workers’ compensation insurance aids sick and injured workers in recovering most, if not all, of the wages lost due to an incident at work, from missing a half-day of pay to losing salary for a month. The percentage required by state workers’ compensation regulations determines how much in pay can be recovered.

Funeral expenses

A worker’s family who passes away on the job may request workers’ compensation insurance to cover funeral costs. Workers’ compensation also provides death payments that are given to an employee’s beneficiaries in some states.


Serious injuries from industrial accidents can necessitate months or even years of intense rehabilitation. An employee who is deemed disabled should also apply for financial aid from the state workers’ compensation program, even though Social Security Disability Insurance (SDDI) is the main program that compensates disabled workers.

Examples of accidents that workers’ compensation insurance does not cover

Despite the fact that workers’ compensation covers a wide range of injuries, there are some situations where an employee who sustains a work-related illness or injury is not entitled to financial support. The best illustration is a worker who, after reporting a workplace mishap, failed a drug test.

Injuries not related to your job

The first requirement for eligibility is that an illness or accident must occur at work or be directly related to your job. For instance, exposure to a chemical at work may result in an illness, but symptoms might not show up until the employee gets home.

Self-Inflicted injuries

Self-inflicted refers to incidents where an employee’s activities resulted in an illness or injury. An excellent illustration of this exclusion is when a worker starts a fight at work and sustains one or more wounds.

Injuries caused by workers not obeying company safety regulations

To reduce workplace accidents, the majority of businesses develop safety regulations. If an employee disobeys a corporate rule and suffers harm as a result, they are not entitled to compensation.

Injuries caused during the commission of a crime

Employees are not eligible for workers’ compensation benefits if they engage in criminal activity at work that results in illness or injury.

Determine your California workers’ compensation status

Speak with a knowledgeable workers’ compensation attorney to learn how to get the most financial support for a work-related illness or injury. Use the handy online form to request a free case review with one of our California-licensed attorneys or give PLBH a call at (800) 435-7542 to make an appointment.