What Types of Injuries Are Covered Under Workers’ Compensation?

Have you ever gotten hurt on the job? Maybe you tripped and fell while carrying files, or perhaps you developed carpal tunnel syndrome after years at a computer. These are common work injuries covered by workers' compensation. Have you wondered what types of injuries are covered under workers’ compensation? 

It’s a system you hope you never need, but what happens when you do? This can be a confusing time, so let’s break down what types of injuries workers' compensation covers and how to navigate the system. 

You'll also see what it takes to pursue and receive the workers' compensation benefits you deserve. In this article, we want you to have the information you need about Workers’ Compensation.

What Is Workers' Compensation?

Before we get into the specifics, it's important to understand the basics. Workers' compensation is a type of insurance program that provides medical benefits and wage replacement to employees injured at work. This system aims to protect employees who experience a workplace injury or illness.

The program varies by state but generally operates under a "no-fault" system. This means an employee can receive benefits regardless of who is at fault for the injury. However, this doesn't mean every workplace incident is covered.

An injured worker may not receive benefits if they were intoxicated or under the influence of drugs during the time of the incident. The same goes for self-inflicted injuries. 

Engaging in unlawful activities and disobeying safety rules or company policy are also grounds for denial of a workers’ compensation claim. If these situations sound familiar, you may want to consult a lawyer experienced in workers’ compensation law to find out where you stand.

Common Workplace Injuries Covered by Workers' Compensation

Workers' compensation claims cover a wide range of injuries, some more frequent than others. If your job requires you to perform the same physical task repeatedly, the risk for repetitive stress injury (RSI) is high. This is true even for those in less physically demanding roles. The most commonly reported workplace injuries include:

1. Slips, Trips, and Falls

These may sound minor, but they're among the top causes of workplace injuries across various industries. Examples of these include wet floors, loose carpeting, uneven surfaces, and cluttered walkways.

These hazards can lead to serious work injuries, such as broken bones, spinal cord damage, and traumatic brain injuries. Employers should ensure a safe work environment to prevent these incidents.

2. Muscle Sprains and Strains

Strains are stretched or torn muscles and tendons, while sprains are stretched or torn ligaments. These very common injuries happen from things like lifting heavy objects improperly or overexertion.

Construction workers and warehouse employees are particularly vulnerable to these injuries. Nurses and aides who frequently move patients and delivery personnel who carry packages may also be at risk.

3. Cuts and Lacerations

Cuts are common in industries involving sharp objects, such as construction and manufacturing. Employers and safety managers can implement strict protocols for handling sharp tools.

They should also make sure proper safety gear, like cut-resistant gloves, is readily available and consistently used. Even though workers' comp covers these types of injuries, these procedures help ensure worker safety.

4. Fractures

Broken bones can happen in any industry; however, those involving heavy machinery or physically demanding tasks often see a higher incidence. Proper training and ergonomics go a long way to prevent fractures.

Spotters or increased supervision can reduce occurrences in environments where moving heavy equipment is routine. These measures help create a safer workplace and reduce workers' compensation claims.

5. Burns

Workers in restaurants, chemical plants, and metalworking shops are especially at risk for burn injuries. Burns vary in type and severity. Businesses that expose employees to heat sources and chemicals should train workers in specific protocols.

Internal burns happen from inhaling toxic fumes or smoke. Proper ventilation and respiratory protection are crucial in preventing these injuries.

6. Eye Injuries

Protecting workers from this type of injury, whether from chemical, environmental, radiological, or mechanical hazards, begins with an adequate workplace hazard assessment. Once you’ve identified potential eye dangers, provide safety training to any worker requiring eye and face protection to anticipate and avoid eye injuries.

7. Cumulative Trauma Injuries

Also known as repetitive motion injuries, these develop over time. The demands placed on a worker's body, typically through repetitive tasks or prolonged exposure to a specific stressor, take a gradual toll. Some occupations that involve repetitive motions can cause injury by their very nature.

Think about the demands on a factory worker, home health aide, or even a coder or graphic designer who spends their shifts repeating the same strenuous motions hundreds or thousands of times. Those motions, over time, lead to injuries such as carpal tunnel syndrome.

Even employees working around loud noises are susceptible. Holding an item a certain way for long periods to complete tasks, such as a cashier using a scanner or a mechanic changing tires all day, can cause similar strains. 

Workers' compensation law considers a medical condition that develops not from one incident but from performing regular job duties over time an occupational disease. Other occupational diseases besides carpal tunnel include hearing loss and various diseases of the body’s joints.

Early detection is critical to minimizing the impact of cumulative trauma injuries. For anyone suspecting their symptoms stem from cumulative trauma, it's time to seek medical attention and report it. When you see your doctor, having as much information on hand as possible increases the likelihood of a proper diagnosis.

Consider bringing along a copy of your written job description if you have one. If not, detailed notes on how you typically spend your days can help your doctor understand if your work caused the problem.

Don't forget to write down details when discussing your concerns. Include how often you repeat certain movements, including the average number of times per hour and day. And include if your job requires a certain amount of force. 

Thinking in terms of numbers makes this part easier. Once your doctor determines the condition is work-related, report this in writing to your employer.

8. Occupational Diseases

Exposure to hazardous materials or conditions in the workplace sometimes leads to the development of occupational diseases. An occupational disease is a medical condition or disorder caused by exposure to environmental factors associated with a particular occupation.

Conditions such as respiratory problems from inhaling dust or fumes, certain cancers linked to asbestos exposure, or hearing loss from prolonged exposure to loud noise all qualify as occupational illnesses.

9. Psychological or Mental Health Conditions

Psychological conditions related to workplace stressors and traumatic experiences are increasingly recognized as a significant concern. While this area of workers’ compensation law can be complicated and varies by state, mental and psychological injuries are real and, in some instances, warrant a workers' comp claim.

Situations involving workplace violence or harassment, leading to anxiety, depression, or post-traumatic stress disorder (PTSD), are just a few situations where an employee could seek compensation. These often fall under physical-mental injuries or mental-physical injuries.

The American Institute of Stress found that 83% of U.S. workers report job-related stress. And a quarter of those folks said their job is their main source of stress. However, psychological claims are often harder to prove, as proving a direct link to employment can be challenging.

Workers' Compensation Benefits

The types of benefits an employee receives vary depending on factors, including the nature and severity of their injuries and the applicable state laws. Some benefits, but not all, that may be covered include:

Which Injuries Are Not Covered?

Workers’ compensation has limitations. Generally, the injury needs to arise out of and within the course of employment. That said, not every injury sustained at work is a work-related injury in the eyes of the law. An attorney well-versed in workers’ compensation laws can help clear this up and advocate on your behalf.

The following examples aren't covered. This isn't an exhaustive list:

• Injuries that occur while commuting to or from work.
• Self-inflicted injuries or those stemming from personal disputes outside the scope of employment.
• Mental health conditions resulting from “lawful personnel decisions” as determined by an employer.

Steps to Take if You're Injured at Work

Having an accident at work is stressful. You’re in pain, confused, and don’t know what to do. Knowing the proper steps to take ensures receiving appropriate medical treatment. Here are some guidelines:

1. Report the Injury to Your Employer

Don’t wait to do this. The longer you wait, the less believable it sounds. Tell your boss or supervisor immediately and include as much detail as you recall about how the injury happened.

2. Seek Medical Treatment if Needed

Employers provide employees with information about where to seek treatment. For minor injuries, your regular doctor might suffice. But some circumstances, such as when it’s an emergency or when the injury is severe, necessitate immediate treatment. 

The employer must allow you to get emergency care without delay and tell you where to go. When describing the situation to medical staff at a hospital, clinic, or doctor’s office, be clear your injuries are job-related.

3. Document Everything

This means creating a paper trail beginning the minute the incident happened. You may need to remind yourself to do this, particularly if your injury leaves you in significant pain or with an impairment impacting your cognitive function. That said, be thorough. 

Accurate documentation is your best friend should your claim come under scrutiny or denial. Note the date and time. Write down where the accident occurred with a brief but clear description. 

If applicable, take pictures or videos with your smartphone or another recording device. Also, write down the names and contact information of anyone witnessing your accident, particularly coworkers.

4. File for Benefits

In most states, your employer handles reporting your accident. Your employer's workers' compensation insurance provider will then review your claim and determine your eligibility for benefits.  

A Lawyer Can Help You Navigate the System

It’s essential to take an active role in your workers’ comp case and to understand your rights. For example, most employers cannot retaliate against you for suffering an injury or for requesting benefits. 

Some injured workers choose to have a workers’ compensation attorney on their side, advocating for their rights if a dispute arises or if you have questions along the way. An experienced attorney can provide sound advice and step in if your employer or their insurer denies the claim, refuses treatment, or won’t approve time off from work.

According to the Bureau of Labor Statistics, in 2020, there were 2.7 million nonfatal workplace injuries. These injuries can leave employees with intense, chronic pain, life-altering disabilities, permanent disfigurement, debilitating anxiety, and, in many situations, the inability to earn a living. The effects last well beyond the initial injury.

FAQ About What Types Of Injuries Are Covered Under Workers' Compensation?

FAQ 1: Which Injuries Are Not Covered By Workers' Compensation Insurance?

Situations involving alcohol or drug use during the time of the injury, self-inflicted wounds, or injuries from activities not related to job duties typically don't qualify. Additionally, if an injury is determined to have occurred due to an employee’s willful disregard for safety regulations, coverage could be denied. 

Independent contractors aren't covered by an employer's workers' comp, either. So, if this is you, check into obtaining coverage through a private insurance company specializing in coverage for independent contractors. Mental health claims, in some states, may also fall outside the protection of this system.

Every state has different rules, but injuries unrelated to your job duties usually won't qualify. If your claim was denied for one of these reasons, you might want to consult an attorney to explore options.

FAQ 2: What Is The Most Common Workers' Comp Claim?

You might assume injuries from heavy machinery top the list, but those aren't the most frequent occurrences. It's the everyday mishaps like slips, trips, and falls that cause the lion's share of workers' comp claims. 

These can happen anywhere at work, from slippery floors and uneven sidewalks to loose carpeting and clutter. These accidents often lead to sprains and strains, which also rank high on the claim list.

FAQ 3: Are Contractors Covered By Workers’ Comp?

Independent contractors are not covered by an employer's workers' comp. If you’re an independent contractor, check into obtaining coverage through a private insurance company specializing in coverage.

The Law Offices of Timothy D. Welborn: Your Workers’ Compensation Partner

Because of the complexity of the law and its limitations on claims, it can be difficult for employees to pursue and receive workers' compensation benefits after an injury. An attorney experienced in workers’ compensation law can help ensure injured employees get the benefits they are eligible to receive.

If you are navigating a potential workers’ compensation claim, reach out to us today for help.