Injuries that happen at work are complicated. Determining who is responsible for a single incident is just as complicated, and this complexity is one of the reasons why fault doesn’t matter in California’s workers’ compensation system.
Often considered a “no-fault” system, workers’ compensation in California doesn’t deal with fault for a workplace injury: neither the employer nor the employee must prove the other is responsible for the injury.
Instead, the injured party is responsible for proving that their injury or illness happened during the “course and scope” of their employment. In other words, they were injured at work while performing work-related duties.
So, if you were worried that making a mistake that resulted in an injury would put your workers’ comp benefits in jeopardy, you probably don’t have much to worry about. Although you should be vigilant with your claim, even incidents that you might consider to be “your fault” are probably covered – that said, never admit fault for an incident that resulted in your injury.
Exceptions When Your Fault Matters
While your “fault” or contribution to an incident that led to your injury shouldn’t matter under normal circumstances, there are situations in which it will. These are situations in which your fault could be attributed to some sort of negligence.
You may not be eligible for workers’ comp if your injuries resulted from an accident caused by:
- Your Intoxication – If you are under the influence of drugs or alcohol at work and are injured at work, you will not be eligible for workers’ comp benefits. To be denied benefits, though, it must be proven that you were actually intoxicated, and your intoxication was mostly responsible for the incident.
- Fighting – If you are involved in a fight at work, you will more than likely be denied workers’ comp benefits. You may be able to claim them if you can prove that you were acting in self-defense, but this can be difficult if there is insufficient evidence.
- Participation in Horseplay – If you are goofing off, engaging in horseplay, or otherwise engaging in unnecessary behavior at work that puts you at risk of an injury, you may not be eligible for workers’ comp if you actually become injured.
- Intentional Infliction – People might want to hurt themselves at work for all sorts of reasons, but if you intentionally inflict an injury upon yourself, you will be denied workers’ comp benefits.
Conclusion
Workers’ compensation in California is a “no-fault” system that doesn’t require you or your employer to prove fault for a workplace injury for you to receive benefits. Although there are some situations where reckless and negligent behavior would deny someone benefits, most situations in which someone might consider themselves “at fault” for their own injuries are still covered by workers’ comp in California.
If you want help with your workers’ comp insurance claim, reach out to our attorneys at Smolich and Smolich today for help.