Defining California Workers' Compensation Injury
California Workers Compensation Industrial Injury Defined – An industrial injury is any incident that an individual faces resulting in his/her suffering from a medical condition or need for medical treatment due to any exposure or incident at work. It does not have to be anticipated by the employer in order for the worker to receive compensation. Compensable injuries do not have to be physical, they can be emotional as long as they are disabling. California is one of the few states that allows for mental harm to be compensated. Special rules apply to obtain benefits for mental or psychiatric harm.
Industrial vs. Nonindustrial injuries: The former refers to those that occur in the workplace and is immediately caused by employment; the latter refers to types of physical or mental harm that occurs outside the workplace and may not necessarily be caused by it. To have an industrial accident, the following must be met:
- It must be a result of employment, occur on the job, and during the course of employment.
- Damage occurring to artificial members such as artificial legs, braces, eyeglasses and even hearing aids only if they substitute a natural body part.
- Damage must NOT be to personal property.
Types of Industrial Accident Injuries
The Labor Code divides work related injuries into two kinds: 1) specific, that occur at a certain period, and 2) cumulative trauma that occur over an extended period of time due to repetitive work activities. The California Supreme Court divides compensability into a few parts:
- Specific: when disability or need for medical treatment occurs due to an incident the effects of which are immediately realized or realized at a later date.
- Continuous Cumulative Traumatic: when a number of minor strains occur over a period of time resulting in an eventual disability.
- Cumulative: when continuous exposure to harmful substances results in disability.
Definitions and Conditions of Industrial Causes
While there are specific definitions for both types, the way an injury is treated (specific or cumulative) is a decision determined by the Appeals board. The WCAB judge requires that the applicant provide:
- Specific injuries are specific in their timely nature, and therefore often result in no disputes between parties. The incident takes place at a certain time but needed no medical treatment and resulted in no disability is also considered specific but no compensation is owing under the law.
Cumulative Injuries are also referred to as cumulative trauma or continuous trauma; and are treated in a similar fashion to occupational disease. Some examples are back, neck and knee problems, carpal tunnel syndrome due to hands and wrists’ overuse as well as psyche and brain issues and diseases captured due to exposure. A result of “repetitive mentally or physically traumatic activities extending over a period of time” causing a need for medical treatment and/or disability. (LC 3208.1) A result of “a number of minor strains over a period of time”. These strains are considered traumas that eventually consequent in disability. (California Sup. Court) A result of “repetitive events, occurring during each day’s work” and with their combination, a need for treatment and missed time from work is created. (The Court of appeal).
Further Considerations For Defining Injury
Determining Date of Injury: Because continuous trauma occur over an extended period of time, their date determination is a function of: 1) The employee’s first suffered disability, often found by the first day of missed work; 2) The employee either knew or should have known (exercising reasonable diligence) that his/her injury was a result of his/her employment;: Sufficient evidence often provided by a physician (not required in all cases). The forgoing is determined by the WCAB on a case by case basis after receiving evidence including testimony at trial
Aggravation: The 2004 Senate Bill 899 and the Eggshell Plaintiff Rule provide that an injury that aggravates a non-work related health condition or a previously existing medical condition is compensable and the employer is liable. But if the workplace does not aggravate a pre-existing condition but may have called for attention, it not compensable and the worker does not receive compensation benefits. This happens when need for medical care arises but with treatment the employee returns to their pre-accident state. In other words, the aggrevation is only temporary leading to no monetary award.
Apportionment: In the compensation benefits, the employer is fully liable when an event occurs in the workplace resulting in a disability or aggravates a pre-existing condition. However, in the case of permanent impairment, the employer is liable for only a portion of the benefits after proving the impairment was due to a pre-existing health condition.
Get Help From an Job Accident Attorney
The law allows hurt employees to seek out and hire job accident lawyers for guidance and representation. Anyone who has or believes they have a claim under workers' comp. should consult with a lawyer about their rights. The Napolin Law Firm has successfully recovered millions of dollars on behalf of their clients. Call and speak with attorney Alexander D. Napolin for a free workers' compensation case evaluation.