3 Little Known Work Injury Claims Eligible Under The Workers’ Compensation System
A physical injury while working is the most common reason workers file workers’ compensation claims in California. But there are several little-known reasons workers can file a claim related to work injuries.
It’s important to note that workers’ comp. is based on a no-fault system, which means that an injured or ill employee does not need to prove that the injury or illness was someone else’s fault in order to receive workers’ compensation benefits. And employers in California are required by law to pay for workers’ compensation benefits. For more detailed information, please see the “Workers’ Compensation in California” guidebook, which is meant to help workers with job injuries understand their basic legal rights, the steps to take to request workers’ compensation benefits, and where to seek further information and help if necessary. And if you believe you have a case, please contact the work injury lawyers at Chain | Cohn | Clark for a free consultation.
Chain | Cohn | Clark work injury lawyer Beatriz Trejo highlights in a new video three little known basic claims eligible under the workers’ compensation system.
1) STRESS RELATED WORK INJURY
A work injury that is purely psychological is sometimes referred to as a “stress claim.” In these cases, an employee has suffered mental or emotional injuries, usually as a result of stressful conditions at work. These injuries may force workers to take time off work and may leave them unable to perform tasks that require them to concentrate or communicate. Examples include: mental breakdown after being overworked to the point of exhaustion, subjected to threats at work,
However, the California workers’ comp system treats psychiatric injuries differently than physical injuries. In fact, you must meet all of the following requirements in order to receive benefits for a psychiatric injury:
- You must have a “mental disorder” that’s been diagnosed under accepted procedures.
- As a result of your mental disorder, you must have required medical treatment or experienced disability (meaning that you had to miss work or couldn’t do some of your work tasks).
- You must have worked for your employer for at least six months, unless your psychiatric injury resulted from a sudden, extraordinary condition at work.
- You must prove that actual events of employment were the “predominant” cause of your psychiatric injury. This means that when all the causes are taken into account, working conditions were at least 51% responsible. (Note: The standard is 35% to 40% if you were a victim of violence at work or you were directly exposed to a “significant violent act.”
- The last requirement essentially means you need to show that other, personal struggles in your life weren’t the main cause of your emotional or psychological condition. That means your private life will be scrutinized by the insurance company or independent medical evaluators digging for anything else that could have contributed to your condition.
2) VALLEY FEVER
Employers in affected areas can take steps to protect workers from breathing in the fungal spores that cause Valley Fever. These include controlling dust, providing worker training, and suspending outdoor work during heavy winds. It’s important for employers of outdoor workers to post resources for preventing work-related Valley Fever. Each year, more than 1,000 Californians receive hospital treatment for Valley Fever, and about eight of every 100 people hospitalized die from the infection annually.
Workers who dig or otherwise disturb soil containing the fungus are at risk for getting the illness. The fungus lives in the soil in parts of California, particularly the Central Valley. When people inhale the fungal spores released when the soil is disturbed, they may get Valley Fever. Some workers at higher risk for Valley Fever include wildland firefighters, construction workers, archaeologists, military personnel, and workers in mining, gas, and oil extraction jobs.
Here are some steps employers and employees can take to prevent the spread of Valley Fever:
- Determine if your worksite is in an endemic area.
- Adopt site plans and work practices that reduce workers’ exposure, which may include minimizing the area of soil disturbed; using water, appropriate soil stabilizers, and/or re-vegetation to reduce airborne dust; stabilizing all spoils piles by tarping or other methods; providing air conditioned cabs for vehicles that generate heavy dust and make sure workers keep windows and vents closed; suspending work during heavy winds; placing any onsite sleeping quarters, if provided, away from sources of dust.
- Employers must develop and implement a respiratory protection program in accordance with Cal/OSHA’s Respiratory Protection standard.
- Take measures to reduce transporting spores offsite, such as cleaning tools, equipment, and vehicles before transporting offsite; providing coveralls and change rooms, and showers where possible if workers’ clothing is likely to be heavily contaminated with dust.
- Train workers and supervisors about the risk of Valley Fever, the work activities that may increase the risk, and the measures used onsite to reduce exposure. Also train on how to recognize Valley Fever symptoms.
- Encourage workers to report Valley Fever symptoms promptly to a supervisor.
3) OFF-THE-CLOCK INJURY
To be eligible for workers’ compensation insurance benefits, a worker must be injured while “within the scope of their employment.” While worker’s compensation doesn’t usually cover injuries when you’re “off-the-clock,” a few exceptions to this rule do exist. Here are examples of some of the exceptions:
- Sidewalks and Parking Lots: In many cases, work starts when you step foot on your employer’s premises, not necessarily when you punch in on your time clock. These premises include sidewalks, parking lots, and grassy areas controlled by your employer. These areas are an extension of the workplace. Slipping on an icy or sidewalk your company neglected to maintain may qualify for worker’s compensation.
- Employer Benefits: If your employer requires you to perform a duty that directly benefits the company, then you’re still covered with worker’s compensation. For example, your boss wants you to attend an evening work event. If after the event on your way home a vehicle runs a red light and crashes into your vehicle, you would still qualify for worker’s compensation because you were doing a task that specifically benefited your employer.
- Running Errands: If your employer asks you to run an errand on a break, or before or after work, and you are injured in the process, you may qualify for workers’ compensation.
If you or somebody you know suffers an injury at work but is having trouble securing workers’ compensation benefits, please contact a lawyer who specializes in workers’ compensation to examine every aspect of the case, gather the evidence, and negotiate with insurance carriers to recover rightful compensation. The Bakersfield-based accident, injury and workers’ compensation law firm Chain | Cohn | Clark is home to two lawyers who are state certified as specialists in workers’ compensation law, awarded to legal professionals who have gone beyond the standard licensing requirements — attorney Beatriz Trejo and James Yoro.