What Injuries are not covered by Worker’s Compensation Insurance?

As a rule of thumb, any injury sustained during an activity that benefits your employer renders you eligible for worker’s compensation insurance. However, if an injury can easily be healed with the contents of a first aid box, it means it is not severe enough to file a compensation claim; a minor bruise, cut, and a onetime headache do not qualify. However, circumstances of an accident can be unusual, so you never know where you stand. If you are confused regarding a workplace injury, you must consult a personal injury attorney to determine your fate. Worker’s compensation laws may differ from state to state, and there are exceptions to every situation. Personal Injury Attorney in Woodland Hills mentions the types of injuries that are normally not covered by worker’s compensation insurance:

Accidents during Commute to and from Work

If you get into a traffic accident while travelling to work or getting home from work, your injuries will not be reimbursed by the company’s worker’s compensation insurance. However, if you were using a company car and your job location I not fixed, you can claim for compensation. You can also qualify for insurance if you were running an errand for your boss on the way to work.

Injuries caused by Horseplay or a Fight at Work

Fooling around or quarrelling with a colleague at the workplace does not fall under the scope of employment; therefore, you cannot demand compensation for getting hurt due to your personal antics, competitions, or rivalries. On the contrary, you might qualify for reimbursement if you were an innocent bystander or your employer did not discourage the illicit behavior. 

Injuries resulting from Intoxication

If you show up at work drunk or are under the influence of a drug, the employer is not responsible for whatever trouble you get into. Intoxication boggles the mind and deteriorates coordination between the mind and body, so you become more susceptible to accidents. However, intoxication defenses are difficult for an employer to prove, unless you are forced to undergo a blood test on the spot.

Accidents occurred during Recreational Activities

Many employers arrange for recreational activities for the mental and physical wellbeing of the staff. These activities are optional, and may or not be executed on the work site. Injuries incurred during recreational activities are only compensable if they were carried out during working hours and your boss obligated you to participate. Moreover, you may also deserve reimbursement if the recreation included work related events, such as a presentation or discussion that is in the interests of the company.

Injuries incurred during Lunch Break

If you leave the work premises during lunch break to eat out or take care of some other personal business, you shall consider yourself outside the boundaries of employment. Your boss cannot be held liable for an accident that occurs while you are utilizing free time for something that doesn’t concern them. Compensation claims could be valid if you were hurt inside the office break room or cafeteria. As you were near and accessible to the employer during time off, it denotes mutual benefit.  

Offsite Injuries

If you are away from work for the sake of executing personal missions, it does not concern the employer. However, your injuries are covered by worker’s compensation if they happened while you were working from home, travelling between two work sites, involved in offsite education/training integral to the job, or engaged in a business trip.

Why Drivers Need Personal Injury Lawyers in an Accident

Being involved in a motor vehicle accident can be one of the most devastating things that you
will ever have to deal with in your life. Not only can you and another person get hurt in a car
accident, but the damage to your vehicle could be so great to the point that you actually have to
get it impounded and buy a new one. This is why so many people are interested in getting an
accident attorney who can work with them when they are involved in a motor vehicle accident.
The accident attorney will be able to take your case on for you and help you to get the
compensation that you both need and want in order to get on with your life.


The most important thing for you to consider is hiring a personal injury attorney so that they can
work with you want a case in order for you to get some type of compensation. A lot of people
who are involved in a motor vehicle accident get hurt and they may have to deal with medical
bills and medical issues for many years to come because of the fact that this accident happened
in the first place. This is why it is so important for you to consider working with a professional
los Angeles personal injury attorney so that they can take the case on for you and get you some
type of compensation in order for you to feel better about the outcome of the problem itself. 
What you would want to know about a professional accident lawyer is that they can take on a
motor vehicle injury case for you, but they will have to know all of the details about the injury
and accident before they are able to take you on as a client. This means that you may have to
indulge different types of medical issues to these professionals in order for them to get you the
help that you need in a secure and professional manner. They will be able to sit down with you
and discuss the different types of options that come if they were to take you on as a client and
what you should expect after going to a court of law for this case in general.


It is so important for you to consider working with a professional car accident lawyer like
Attorney Payam Shayani because of the fact that this is someone who specifically works on
motor vehicle accident cases each and every day. You can feel confident knowing that this is a
professional who will be able to walk you through the process of going to court because of the
fact that you were in an accident and were hurt or severely dealt with car damage because of a
result of this. The lawyer can walk you through this process so that you do not feel so out of
place when it comes to finally go into a court of law to have your case heard in front of a judge
with the lawyer by your side.

Different Types of Worker’s Compensation Fraud

Accidents can happen anywhere, including your workplace. Sometimes, the nature of work or the working environment can deteriorate one’s health. When an employee files a lawsuit against the employer, the company’s reputation is put at risk.

The Worker’s Compensation Insurance is a program designed to take care of work related injuries and illnesses among employees. With a sound insurance plan, business owners can prevent employees from suing and dragging them to court; the employees get the benefits they need and the employer is saved from paying the expenses out of pocket. Worker’s compensation covers medical bills and lost wages for an indefinite time period.  

While the program was established for the wellbeing of business owners and their staff, many individuals try to manipulate it for personal gains.  Wheat Ridge, CO Worker’s Compensation Lawyer state that worker’s compensation fraud comes in different forms; anyone among the employee, employer, or healthcare provider can be held liable. 

Worker’s Compensation Fraud by Employees

Worker’s compensation fraud by an employee is the most common of all three. Sometimes workers fake an injury or illness to get time off without deduction of salary. Pretending to have a fever and submitting a fake doctor’s certificate for leave is something that is witnessed frequently at offices and workstations.

At times accidents do occur and cause mild injuries to employees. The employee may exaggerate the injury or illness to avoid coming in for work. For example, ordinary leg cramps could be described as intolerable pain, which is keeping them from standing up or leaving bed.

Some workers utilize injuries that were not inflicted on the job. An injury encountered elsewhere is demonstrated as one caused at the workplace, so the company pays for their medical expenses and lost wages.

Worker’s Compensation Fraud by the Employer

Many business owners only buy worker’s compensation insurance because it is a requirement of the state. The interest of their employees does not concern them, so they seek shortcuts to minimize the payables.

Presenting employees as independent contractors, wrongly classifying workers, or showing a lesser number than the actual quantity of staff are a few widely used strategies. Many companies misinterpret the job requirement and lie about environmental safety to qualify for cheaper premiums.

Although this technique helps them save substantial payments in the beginning, they have to pay heavy fines and penalties when they get caught. In some cases, higher taxes are imposed and employees have to be paid more for ‘extra work’.

Worker’s Compensation Fraud by Healthcare Providers

Healthcare providers, including doctors, nurses, and hospital accountants tend to take advantage of the system. Physicians give an incorrect diagnosis or represent a minor injury as a serious medical condition. They overcharge for patient care and bill the company for treatment that was neither necessary, nor provided.

By fooling the injured employee and their employer, they are able to extract a good load of money from the insurance program. A wrong procedure or unsuitable medication that harms the patient shall be considered as medical malpractice. Medics that are accused of insurance frauds and medical malpractice can lose their operating license. Medical practice lawsuits ruin the reputation of healthcare facilities and sometimes cost them millions of dollars.

What is the Difference between Disability Benefits and Workers Compensation?

When an employee gets injured enough and is rendered unable to do the jobs he is assigned, he may be entitled to different types of financial support. These include:

  • Workers’ compensation
  • Disability benefits
  • Social Security Disability Insurance

Employees are entitled to different kinds of benefits depending upon their circumstances. The key difference between workers’ compensation and other disability benefits are given below:

Workers’ Compensation vs. Disability Benefits

An individual is eligible for workers’ compensation benefits when he or she gets injured at work. It is a requirement according to most states’ legislature that employers carry workers’ compensation in order to cover their injured employees. On the other hand, state disability benefits provide the individual with weekly reimbursements when he/she is not well enough to work at his/her usual or customary job. The main difference between the two benefits is that workers compensation insurances an employee for injuries for which the employer is responsible.On the other hand, disability benefits are not provided through the employer, but these benefits still reconcile for any lost wages.

An individual may be eligible to receive disability benefits while he or she is entitled to workers’ compensation benefits. This happens in cases when the state disability benefits are higher than the workers’ compensation benefits.

In cases where the employer or the insurance company do not agree with the fact that the employee should be provided workers’ compensation, the state may entitle him or her to state disability benefits till the time the dispute is brought to a conclusion. The state may ask for the return of the money when the employee is finally provided workers’ compensation.

Workers’ compensation temporary benefits are paid to an individual till the time their condition turns out to be permanent and inactive. In such cases, the injured individual may get to receive permanent disability benefits and medical care for a life-time. On the other hand, state disability benefits can be paid for a maximum of 52 weeks.

Sometimes, an injured employee is provided with both SSDI and workers’ compensation benefits. In order to be eligible for both simultaneously, certain conditions need to be fulfilled. If someone is expected to remain disabled for a period of at least a year, or is suffering from a deadly illness and has paid significant funds that make him eligible for social security disability system, the person may be entitled to both workers’ compensation (or state disability benefits) and SSDI at the same time. However, SSDI may get reduced by the workers’ compensation receipt or state disability benefits.

People are normally not entitled to unemployment benefits and temporary disability benefits (received through workers’ compensation) simultaneously. In cases where doctors find out that the individual is unable to continue work and the employer is unable to find a suitable job in their company that the injured individual can perform, the individual can be entitled to unemployment benefit. Theseunemployment benefits can only be paid for a maximum of six months.