What Injuries Are Covered by Workers’ Comp? | Workers' Comp 101

An injury that can be covered by workers’ compensation insurance is also called a “compensable injury.” It is a work-related injury sustained by an employee that qualifies the employee to receive workers’ compensation benefits. These benefits may help cover costs for medical bills, lost wages, disability, or rehabilitation services. Workers’ compensation may also help provide death benefits to an employee’s dependents if the employee is killed in a work-related incident.

If you own a small business, it’s important to have a general understanding of what is considered a compensable injury. Consult your insurance company, state workers’ compensation state board, and/or a workers’ compensation attorney for specific qualifications and coverage details. In the following sections, we’ll share general guidelines to help give you an idea of what qualifies as a compensable injury.

What counts as a workers’ comp injury?

Depending on the laws in your state, to be considered compensable and therefore eligible for workers’ compensation, injuries must:

• have happened to an employee (not a vendor or independent contractor),
• be the result of a workplace injury or illness during employment, and
• cause impairment and/or lost wages.

What types of injuries are covered by workers’ comp?

Some examples of work-related injuries that may be covered by workers’ compensation insurance are:

• Repetitive stress injuries like tendonitis, carpal tunnel syndrome, or bursitis

• Occupational illnesses like silicosis, asbestosis, hearing loss, or sunstroke

• Mental stress injuries like anxiety, PTSD, or emotional distress

• Fatality from accidents like chemical exposure or falling from scaffolding

What injuries are not covered by workers’ comp?

Workers’ compensation insurance typically does not cover injuries that occur when an employee is:

• Engaged in horseplay or fighting

• Under the influence of drugs or alcohol

• Participating in a voluntary, unsponsored social gathering with coworkers

• Taking a work break offsite

• Commuting to or from work in a private vehicle and not engaged in work activity

It is important to note that every situation is different and workers’ compensation laws vary considerably by state. Employers should do plenty of research as an employer and speak with a trusted advisor.

How does workers’ comp protect businesses?

In addition to helping your employees and their families, workers’ compensation insurance also can help protect your small business. This type of insurance helps protect your business from liability and from having to pay directly out of pocket for a workplace injury.

Thanks for reading! Please note that this content is intended for educational purposes only. As laws change regularly, you should refer to your state legislation and/or an advisor for specific legal counsel. If you’re a small business owner, learn more about workers’ compensation insurance or check your current rate in 3 minutes.