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California workers comp attorneyNo one wants to end up in a position where they need to rely on Workers’ Compensation. You would almost certainly prefer that the workplace accident or incident that left you injured had never happened. Being sidelined due to a workplace injury can bring a lot of new anxieties and struggles into your life. On top of trying to recover physically and emotionally, you are probably worried about recovering financially as well. The expenses associated with a workplace injury can add up very quickly when you stop to think about it. The good news here is that Workers’ Compensation should cover most if not all of your expenses related to the accident - including future costs you may not even be thinking about yet. A Workers’ Compensation attorney can help you come up with a complete list of your accident-related costs that could be compensable. 

Compensable Expenses After a Workplace Accident

Generally speaking, just about any expense or loss you incur as a result of your workplace injury should be compensable. It is important to have an attorney help you take a thorough accounting of your costs related to the accident. You probably know that your current medical bills and some lost wages can be recovered, but you could also be compensated for: 

  • Future medical care - Rarely can a major workplace injury be treated in just one trip to the ER or Urgent Care. You may not have a complete understanding of what kind of medical care you will need going forward yet. In some cases, you will need to wait and see if an injury improves with conservative treatment before more drastic interventions like surgery are decided on. 
  • Job training - If you will not be able to return to the job you had due to your injuries, but you are not totally disabled, you could potentially receive funding to help pay for vocational training or education that can help you start a new career. 
  • Disability - Whether you are permanently, temporarily, partially, or totally disabled, you can receive compensation for your lost present and future earnings due to the disability. An attorney can help you calculate the amount of income you would have earned going forward before and after the accident. 

These are just a few costs and losses you could be compensated for through workers’ compensation. Make sure that you speak to an attorney before you consider accepting a settlement offer. 

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California workplace injury lawyerWorkplace accidents can happen when you least expect them. What starts out as a perfectly normal day at work can end in a disaster. Whether your job is largely considered “dangerous,” like types of construction work, or mostly safe, like retail work, the fact is that a workplace injury can happen to anyone. Even people with desk jobs have been injured at work. This is why it is so important for everyone to know exactly how to respond just in case it does happen to you. The way you handle the situation as it unfolds can be extremely important later. Making a mistake could harm your case when it comes time to seek compensation, while handling everything correctly could make it much more difficult for your employer to deny your claim. One of the most important things you can possibly do after a workplace injury is to contact an attorney who can offer you further guidance. 

The Moments After the Accident Matter

Everything you do from the second the accident happens counts. While the most important thing is to prevent further harm and get to safety, some other helpful tips for reacting to a workplace accident include: 

  • Follow procedures - If your company has a policy or procedure to follow during this type of accident or incident, like “if a fire starts, hit the emergency shutoff and clear the floor,” follow it. Failing to follow your company’s safety protocols can be used against you to argue that you made your injury worse by not taking the right steps. 
  • Stay down - Unless you absolutely need to move to get out of harm’s way, it is generally best to remain as still as possible until first responders arrive and tell you otherwise. Back and neck injuries can be worsened, sometimes drastically, if you get up too quickly. 
  • Watch your words - Avoid saying things like, “I am okay,” or “It was not your fault.” It is generally best to avoid making any sort of assertion about your physical condition or how the accident happened until you have met with an attorney. 
  • Get care - Even if you do not think your injuries are particularly serious, it is best to let a doctor check you out. Adrenaline, the chemical involved in your body’s fight-or-flight response, can act as a natural painkiller so that you do not realize how badly you have been hurt right away. Besides, your workers’ compensation should cover your initial medical bills, so you have little or nothing to lose by seeking prompt care. 
  • Take notes - Try to remember and make at least a mental note about everything that happened before and during the accident. 

Once you safely can, it is a good idea to get in contact with a qualified workers’ compensation lawyer. Even if you anticipate a relatively smooth claims process, having a lawyer handle it for you can give you some much-needed time to rest and recover. 

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Santa Clara County workers compensation attorney

Originally published: March 31, 2021 -- Updated: April 27, 2022

UPDATE: In cases where workers experience mental disorders, they may struggle to perform work and meet all the requirements of employment. Because of this, they may experience negative consequences, and they could even lose their jobs. However, California law allows workers to pursue workers’ compensation claims in these situations even after the termination of employment, as long as the circumstances that led to the injury occurred before the termination took place.

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b2ap3_thumbnail_gilroy-workers-comp-attorney.jpgA workplace accident or injury can lead to multiple types of difficulties that may affect a victim’s personal and professional life. While workers’ compensation benefits will usually be available to anyone who has suffered a work-related injury, there are some situations where workers may be hesitant to pursue these benefits out of fear that they will face consequences at their job. However, worker’s are protected against workers’ compensation discrimination, and they should be sure to understand their rights in these cases. This can ensure that they will be able to receive the benefits they deserve while preventing their employer from taking illegal actions against them.

What Is Workers’ Compensation Discrimination?

Every employee has the right to file a workers’ compensation claim and receive medical benefits, temporary or permanent disability benefits, or other applicable benefits following a work-related injury. It is illegal for an employer to penalize an employee for filing a workers’ comp claim, reporting a work injury, or otherwise asserting their rights. 

Workers’ compensation discrimination can take multiple forms, including:

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b2ap3_thumbnail_santa-clara-county-workers-comp-lawyer.jpgWhen a person is injured in a workplace accident or experiences injuries, illnesses, or other health issues that arose out of the work they had performed, they will usually be able to receive workers’ compensation benefits. Most of the time, these benefits will be available no matter who was responsible for an injury. An employee will not need to show that their employer acted negligently or otherwise caused them to suffer harm, and as long as they can show that their injuries were work-related, they will be able to receive medical benefits and temporary or permanent disability benefits. However, there are some situations where an employee may be able to receive additional compensation if they can demonstrate that they were injured because of “serious and willful” misconduct by their employer. 

What Is Serious and Willful Misconduct?

If an employer knowingly acted in a way that put their employees at a significant risk of harm, an injured employee may file a serious and willful misconduct petition with the Department of Workers’ Compensation (DWC). These types of claims may only be filed if a person has an open appeals case with the Workers’ Compensation Appeals Board (WCAB). If a person can show that their employer engaged in misconduct that was considered to be serious and willful, the amount of workers’ comp benefits they can receive will be increased by 50. For example, if the total amount of a person’s benefits for a work-related injury were calculated to be $100,000, their employer would be required to pay an additional $50,000 in benefits on top of the original $100,000.

Showing that an employer’s actions were considered to be serious and willful can often be difficult. While these cases may involve situations where an employer purposely acted in a way meant to cause a person to suffer an injury or other forms of harm, most of the time, an employee’s claims will be based on safety violations by an employer. There are multiple types of violations that may occur, and to show that a specific violation was serious and willful, an employee will often need to provide evidence that the employer violated regulations put in place by the Division of Occupational Safety and Health (Cal/OSHA). 

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For people who are injured while at work, workers’ compensation can provide them with benefits that address the effects of their injuries. To ensure that they will be able to make a full recovery, medical benefits will fully cover all expenses related to the treatment a person receives. If a person will miss work or lose income because of their injuries, they may qualify for temporary disability benefits while they are recovering, or they may receive permanent disability benefits to address an injury that will affect their ability to work and earn income in the future. While these benefits will be available for injuries that are considered to be work-related, some confusion may arise about whether a specific type of injury is covered by workers’ comp.

Understanding Work-Related Injuries

Generally, a person will qualify for workers’ compensation if they suffer an injury that occurred while they were working. Work-related injuries include:

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b2ap3_thumbnail_shutterstock_1167692650.jpg Truck drivers and delivery drivers are an increasingly important part of our economy. The volume of trucks on the road has been increasing in California and is projected to continue to grow. If you drive for a living or driving is part of your job, you know the risks you run every time you get behind the wheel. You can face danger not just from other vehicles on the road but also from the repetitive stresses of driving and from loading or unloading cargo.

Types of Injuries Truck Drivers and Delivery Drivers Suffer

 Traffic-related accidents account for most of the serious work-related injuries and deaths of truck drivers. If you are involved in a traffic accident, your injuries may have a wide range of severity, including:

  • Minor cuts and bruises

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gilroy work injury lawyerWhen a person suffers a work-related injury, they will usually be able to receive workers’ compensation benefits. Employers are required to maintain workers’ compensation insurance, and their policies provide coverage for all employees who are injured in workplace accidents or for other reasons that are related to the work they have performed. Workers’ comp provides multiple types of benefits, including medical benefits that pay for all treatment a person receives following an injury, as well as disability benefits that address their loss of income. In many cases, disability benefits are temporary, and they will allow a person to continue receiving pay while they are recovering from their injuries. However, in cases where injuries will affect a person for the rest of their life, permanent disability benefits may be paid.

When Will a Person Receive Permanent Disability Benefits?

While a person is recovering from a work-related injury, they may receive temporary disability benefits, and these benefits will generally pay two-thirds of the wages that they earned before they were injured. A person can receive temporary disability (TD) until they reach the point of maximum medical improvement (MMI) or their doctor determines that their condition is permanent and stationary (P&S). If the person’s injuries will continue to affect them after reaching this point, their doctor will submit a report to the workers’ compensation claims administrator stating that they have a permanent disability, and the person will be able to begin receiving permanent disability (PD) benefits.

How Are Permanent Disability Benefits Calculated?

After receiving a report of permanent disability, the Disability Evaluation Unit (DEU) will review reports from the doctor or another qualified medical examiner and determine the person’s PD rating, which will be used to calculate the amount of benefits they will receive. A PD rating is determined using multiple complex formulas, and these formulas will take into account the part of the body that was injured, the extent of impairment affecting that body part, how the injury will affect a person’s future earning capacity (FEC), the person’s occupation, and their age. If multiple parts of the body were injured, the ratings for each body part will be combined to determine a total PD rating.

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california work accident lawyerThere are many different types of accidents that may happen in the workplace, and in these situations, workers will need to understand their rights and options. Slip and fall accidents are among the most common causes of work-related injuries. Even though these may seem like minor incidents that will not result in long-lasting harm, they can cause a variety of injuries that may affect a person in the days and weeks following an accident. In some cases, they can result in ongoing health issues or permanent disabilities. Workers who are injured in fall accidents will need to understand the types of workers’ compensation benefits they can receive to address the effects of their injuries.

Common Slip and Fall Injuries

There are many reasons why slip and fall accidents may occur, including wet floors, damaged sidewalks, potholes in parking lots, or tripping hazards such as torn carpets or extension cords in an office or other locations. A person who slips and falls may experience injuries such as:

  • Broken bones - The impact of a fall may lead to fractures in different parts of the body. Bones in the arms or wrists may be broken when a person braces themselves against a fall. Fractures may also occur in the hips, ankles, or ribs. While a person may not require extensive treatment for relatively mild fractures, more serious cases may involve shattered bones or damage to the surrounding tissues, and surgery may be required to repair the damage. While a broken bone is healing, a person’s ability to complete work-related tasks may be significantly impaired.

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b2ap3_thumbnail_shutterstock_744694156.jpgThere are many reasons why work injuries occur. While some injuries may be the fault of an employee who did not follow the correct safety practices, many are caused by the negligence of other parties. In some cases, an employer may fail to provide employees with the proper safety equipment or training, or they may fail to ensure that equipment is properly maintained. Equipment-related injuries may also occur due to design or manufacturing defects. Fortunately for people who are injured by faulty or defective equipment while on the job, workers’ compensation benefits will usually be available to address their medical expenses and any temporary or permanent disabilities. By understanding the types of equipment-related injuries that can occur and the steps they can take following an injury, a person can make sure they will be able to receive the benefits they deserve.

Common Work Injuries Caused by Defective Equipment

Breakdowns can sometimes be prevented by enduring that equipment is properly maintained, but there are some situations where it may be difficult or impossible to predict and prevent equipment failures. Some common types of tools and equipment that may cause injuries include:

  • Ladders and scaffolding - Construction workers will often need to work above the ground, and they need strong, sturdy surfaces when doing so. Old, worn-out ladders may collapse, or they may fall over because they were placed on uneven surfaces without support. Scaffolding may collapse because of faulty components or because it was not assembled properly. These issues can lead to dangerous fall injuries.

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gilroy workers comp lawyerFor those who are injured while on the job, workers’ compensation can provide essential benefits, ensuring that their medical care will be paid for and that they will be compensated for some of the income they have lost. However, there are some situations where workers’ comp claims may be denied. In these cases, injured workers will need to understand their options for filing an appeal, including when their case may be heard by the California Workers’ Compensation Appeals Board (WCAB).

Requests for Reconsideration Before the WCAB

While all work-related injuries should be covered by workers’ compensation, regardless of who was at fault, there are a variety of reasons why a person may be denied benefits. An employer or their insurance company may believe that a person’s injuries were not work-related, or they may claim that certain types of medical treatment are not necessary. Disputes may also arise regarding whether an injury has resulted in a disability, and a worker may be denied temporary or permanent benefits that should address the loss of income they have experienced.

If a workers’ compensation claim is denied, a person will need to go through a specific process as they respond to this denial and request a review of their case. In some cases, a person may be able to resolve disputes by working with their claims administrator, or they may be able to negotiate a settlement with their employer. If a case cannot be resolved through these methods, a trial may be held before a workers’ compensation judge, who will review evidence and testimony and make a decision about whether benefits should be granted.

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gilroy workers comp lawyerA serious injury can cause a great deal of difficulty in a person’s life, but those who are injured while working will often be eligible for workers’ compensation benefits that can ease some of the burden. When an injury is serious enough that it limits a person’s ability to work while they are recovering, temporary disability benefits will provide the person with compensation for some of the income they have lost. However, as the name implies, these benefits will only last for a certain amount of time, and workers who are subject to limitations on the work they can perform following an injury will need to understand how long they can receive benefits.

Understanding the Limits on TTD and TPD Benefits

A person will be eligible for temporary disability benefits if they require overnight hospitalization following an injury or if the doctor who provides treatment following an injury determines that they will be unable to return to work for at least three days. Temporary disability benefits will provide compensation for the income lost due to the inability to work at the level that would allow a person to earn the wages they received before they were injured.

Two different types of temporary disability benefits will be available depending on whether a person will be able to work at all while they are recovering. A person may receive temporary total disability (TTD) benefits if they are completely unable to work, or they may receive temporary partial disability (TPD) benefits if their employer offers them the opportunity to work at a reduced capacity, such as working for fewer hours or in a lower-impact position that pays less than what they previously earned.

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b2ap3_thumbnail_shutterstock_709171012.jpgWhen people think of workplace injuries, they are likely to picture serious accidents that result in significant bodily harm. While the need for workers’ compensation benefits may be evident in these cases, there are a variety of other injuries that workers can experience. Even though working in an office is not considered to be a high-risk occupation, office workers can be injured in multiple ways. These workers may experience repetitive stress injuries that may be caused by several different factors. Fortunately, all employees are eligible to receive workers’ comp for injuries that arose out of the work they have performed. By understanding the different types of repetitive stress injuries that may occur, office workers can make sure they provide the correct information to qualify for benefits.

Types of Repetitive Stress Injuries Affecting Office Workers

Repetitive stress injuries are caused by repeated motions or other factors that put stress on different parts of the body while a person is working. As office workers sit at desks, work on computers, and perform other daily tasks, they may experience injuries such as:

  • Carpal tunnel syndrome - Regular use of the hands and fingers can place pressure on the nerves that run through the wrists. Damage to these nerves may lead to numbness, tingling, pain, or loss of control in the fingers and thumbs. Regular typing throughout the day can increase the likelihood of this condition, especially if a person holds their arms and hands in a position that places pressure on the wrists.

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gilroy workers compensation lawyerWhile there are multiple types of workplace accidents that occur on a daily basis, falls are some of the most common causes of injuries for workers. While these accidents can be especially serious for people in certain occupations, such as construction workers, they can affect employees in any industry. Fortunately, workers who are injured due to a fall that took place while they are working will usually qualify for workers’ compensation, even if they were responsible for their own injuries. By understanding the reasons that falls can occur in the workplace, workers can take the proper steps to avoid being injured while also ensuring that they will be able to receive benefits for any injuries that do occur.

Slips, Trips, and Other Types of Fall Accidents

While falls are more likely to be fatal for construction workers, since they may fall from a greater height and suffer more serious injuries, workers in other occupations are also at risk of being injured. These include people who work in healthcare, building cleaning and maintenance, transportation and delivery of goods and materials, and office workers. Some common causes of falls include:

  • Wet or slippery floors - Liquids spilled on floors may lead to slip and fall accidents, and this can be an issue at hospitals or medical facilities, restaurants, or grocery stores. Wet floors can also be a safety hazard if a building does not use the proper floor mats at entrances to keep water from being tracked in from outside.

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b2ap3_thumbnail_shutterstock_195100124.jpgWorkplace accidents can occur for a variety of reasons, and when these accidents result in injuries, a person will usually be eligible to receive workers’ compensation benefits. Brain and head injuries can be especially harmful, and those who experience these types of injuries will want to be sure they take the correct steps to receive the proper medical treatment. They will also want to determine how they can receive benefits that address the ways an injury has affected their ability to work in the future.

Benefits for Workplace Brain Injuries

There are a variety of situations where workplace accidents may cause a person to experience a blow to the head that results in a traumatic brain injury (TBI). Fall accidents, including those involving a slip and fall due to a wet floor or a fall from a defective ladder or scaffolding, may cause a person to strike their head on the floor or other objects. Brain injuries may also occur if a person is struck on the head by falling objects at a construction site or in a car accident that occurs while a person is working.

Workers’ compensation will pay for the costs of all medical treatment for a work-related brain injury. This includes any emergency treatment that is necessary, such as transportation in an ambulance, treatment at an emergency room, hospitalization, or surgery. A person may also need ongoing treatment, such as medications, physical or rehabilitative therapy, or psychological treatment to address mood disorders or post-traumatic stress disorder (PTSD), and these should be fully covered by workers’ comp.

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b2ap3_thumbnail_shutterstock_1190997985.jpgFollowing a work-related injury, an employee will usually qualify for workers’ compensation benefits. These include medical benefits that will pay for all treatment that is needed, including emergency care, doctor visits, medications, surgery, and long-term or ongoing services such as physical therapy or psychological treatment. The California Division of Workers’ Compensation requires reviews to be performed to ensure that the medical treatment a person receives is necessary to treat their injuries or illnesses. This type of review is known as a utilization review, and workers will need to understand how a review will affect the benefits they receive.

Different Types of Utilization Reviews

All forms of medical treatment that are covered by workers’ compensation are subject to review. A physician or provider will submit a request for authorization (RFA), and this request may be reviewed by a claims adjuster, physician reviewer, or non-physician reviewer. Requests may be fully authorized, partially authorized, or denied. Reviews will generally fall into one of the following categories:

  • Prospective review - In many cases, requests will be sent before medical treatment is provided. After an RFA is submitted, a decision must be made within five business days, and the provider must be notified of the decision by phone or fax within 24 hours. If additional information is needed, the provider must be notified within five business days, and a decision must be made within 14 calendar days after the RFA was originally submitted. If the provider is not notified of the decision or a request for additional information within five business days, they will be allowed to proceed with the requested treatment. In some cases, companies may create utilization review plans that provide prior authorization for certain types of treatment, and in these cases, a provider will not be required to submit an RFA.

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b2ap3_thumbnail_shutterstock_2002074008.jpgFor people who are injured in the workplace, workers’ compensation can provide crucial benefits that will allow them to receive the proper medical care and support themselves while they are recovering. In many cases, injured workers will suffer from temporary setbacks, and they will be able to return to their previous positions after they have fully recovered. However, there are some situations where a person may suffer from permanent impairments that make it difficult or impossible to continue doing the work they had done in the past. While permanent disability benefits may provide assistance in these cases, a person will likely be looking to find work in the future that will fit within their limitations. However, doing so can be difficult, especially if a person has limited experience outside of their previous position or if they do not have the skills to pursue other types of work. Fortunately, certain workers may qualify for vocational rehabilitation that will allow them to receive training and pursue employment in new fields.

Receiving Supplemental Job Displacement Benefits

When a work injury results in a permanent partial disability, a person may qualify for supplemental job displacement benefits (SJDB). In these cases, a person will receive a voucher for $6,000 that may be spent on job training and other forms of vocational rehabilitation. Up to $1,000 may be put toward the purchase of computer equipment that may be used during job training and job searches. $600 may be spent on vocational counseling, and $500 may be used to pay for miscellaneous expenses. The remainder of the voucher may be used to pay for training programs from one or more state-approved providers or for expenses related to obtaining a professional license, including exam fees, license application fees, and licensing exam preparation courses.

A person can only qualify for SJDB if they have not received an applicable job offer from their former employer. In some cases, an employer may offer a position with modified work that fits within a person’s limitations. If this offer is for a position that will last at least one year and will pay at least 85 percent of the wages the person earned before being injured, the person will not qualify for SJDB. If a qualifying job offer is not made within 60 days after a claims administrator receives a return-to-work report from the person’s doctor, the person will be able to receive an SJDB voucher.

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b2ap3_thumbnail_shutterstock_1492492898.jpgIn many cases, people who are injured while on the job will qualify for workers’ compensation benefits that will address their medical expenses and ensure that they receive a certain percentage of their income while they are recovering from their injuries. While workers’ comp laws apply to all employees, people in high-risk occupations may be able to receive some additional benefits and protections to ensure that they will have the financial resources they need as they address work-related injuries. Police officers will want to understand the laws that apply to them in these situations, and they can take steps to ensure that they receive the full benefits they deserve following an injury or work-related health condition.

Full Disability Benefits for California Police Officers

For most workers, temporary or permanent disability benefits provide compensation for a percentage of the income that a person is unable to earn while recovering from their injuries. However, California law states that police officers are entitled to receive their full salary when taking a temporary leave of absence to recover from an injury or illness that arose out of their duties. This leave of absence can last for up to one year, and after that period, an officer may continue to receive workers’ compensation disability benefits.

The following types of officers are eligible for full disability benefits:

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gilroy workers comp lawyerEmployees who experience work-related injuries are entitled to workers’ compensation benefits. These benefits, including coverage for medical treatment and partial compensation for income lost due to a temporary or permanent disability, are available regardless of who was at fault for an injury. If a person can show that they were injured in a workplace accident or otherwise suffered injuries or health issues that arose out of the work they performed, they will qualify for workers’ comp benefits. However, workers should also be aware of the potential for workers’ compensation fraud, including situations where employees or employers may be accused of committing fraud.

What Is Workers’ Compensation Fraud?

There are a variety of fraudulent activities related to workers’ compensation that may be committed by employers or employees. An employee may be accused of making a false workers’ comp claim in order to receive benefits. For example, if a person suffered a back injury after falling down while at home, they may contact their employer and falsely state that the injury occurred while lifting heavy objects at work. By doing so, they may hope to receive coverage for medical treatment, and they may plan to take time off work while recovering and receive temporary disability benefits.

Employers may commit multiple types of workers’ compensation fraud. In some cases, fraud will involve misclassifying workers as independent contractors rather than employees to avoid paying workers’ compensation benefits. Employers may also commit fraud by discouraging employees from making workers’ comp claims. For example, they may state that a particular type of work-related injury is not covered or that an employee does not qualify for benefits because they were at fault for a workplace accident.

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san benito county workers' compensation attorneyEmployers will often offer their employees the opportunity to work from home. This has been a significant benefit for many workers during the COVID-19 pandemic, since remaining in the home can help employees prevent possible infections while still ensuring that they are able to accomplish their daily tasks. However, as more and more people telecommute, situations may arise where employees may experience work-related accidents or injuries even when they are not in an office or a location that would typically be considered a workplace. In these cases, employees may be unsure about whether they are eligible for workers’ compensation benefits.

Eligibility for Workers’ Comp Following an Injury When Working From Home

Workers’ compensation provides benefits in most situations where an employee is injured in the workplace. Even though a person’s home is a separate location from the premises owned or leased by an employer, it is still considered a workplace if a person performs work there. Generally, an employee is eligible for workers’ comp if they were injured during the course of their employment, and the injury arose out of the work they performed. Eligibility is not affected by who was responsible for an injury; even if an injury occurred because of an employee’s mistake, the person will still be eligible for workers’ compensation benefits, as long as the injury was work-related.

Determining whether an injury that occurred in a home office or other areas of a person’s home was work-related will depend on whether the injury arose out of the work that the person performed. Injuries or illnesses that were directly or indirectly caused by work will be covered, but injuries caused by hazards in the home that were not related to work will usually not be covered.

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