What Qualifies as a Workers’ Comp Injury in 2024?

For workers who get injured on the job, workers’ compensation is an insurance program that pays for medical bills and at least some lost wages. Before you get any benefits though, it’s important to report the injury to your employer and then file a claim. If you’re unsure whether your situation can qualify for benefits, you’re in the right place. We’ll explain what qualifies as a work-related injury under workers’ comp law and how you can get the benefits you deserve.

What counts as a work-related injury?

A work-related injury is any injury, illness, medical condition, or aggravation of a preexisting condition that’s caused by or results from doing your job duties.

Each state sets its own workers’ compensation laws, so the exact definition in your area will vary slightly. However, if you have a diagnosed health condition that you can prove is the result of doing your job, it can qualify as a work-related injury no matter where you live or work.

Department of Labor's work injury definition:

You must consider an injury or illness to be work-related if an event or exposure in the work environment either caused or contributed to the resulting condition or significantly aggravated a preexisting injury or illness.¹

Related article: Do All Employees Qualify for Workers’ Comp?

Common injuries that qualify for workers’ comp

Just about any work-related injury or illness that leaves you unable to do your job can qualify you for workers’ compensation benefits. It doesn’t matter whose fault the injury is because workers’ comp is a no-fault program. One-time events, repeated actions over time, aggravation of a preexisting condition, and exposure to chemicals or unsafe work environments can all qualify. So can injuries that you first notice or that first occur off of company property. For example, a car crash while driving to meet a client is part of your job duties and resulting injuries can qualify for benefits.

Here are some examples of covered workers’ comp injuries:

• Broken bones and fractures

• Crushed body parts

• Cuts, punctures, and lacerations

• Dislocations

• Loss of body parts

• Loss of sense, such as vision, hearing, or smell

• Muscle tears, strains or pulls

• Traumatic brain injuries and concussions

• Pinched nerves

• Sprains

Illnesses and ongoing conditions that could count for workers’ comp include:

• Hearing loss from exposure to loud noises at your job

• Asthma and other respiratory diseases caused by breathing in workplace chemicals

• Injuries caused by repetitive movements, like carpal tunnel disease

• Cancer from exposure to cancer-causing substances at your job

• Skin disease from exposure to irritating substances at work

• Mental health disorders like post-traumatic stress disorder (PTSD) caused by work stressors

What to do if you get injured at work

If you have a work-related injury, there are a few key steps to follow:

1. Report the injury to your employer. If you don’t report your injury within a certain number of days, you may not be able to get workers’ comp benefits. (Find your state’s reporting deadline.)

2. Get necessary medical care. Make sure to tell your doctor or medical provider that it’s a work injury, so they can bill your employer and not you. As long as your workers’ comp claim is approved later on, all care related to your injury should be covered by insurance — even if you got the care before you filed a claim yet.

3. File a workers’ comp claim. Once you report the injury to your employer, they should start the filing process. You may need to fill out a form, but you usually don’t have to file on your own.

For more detailed help, read our guide on steps to take after a work injury.

7 injuries that don’t qualify for workers’ comp

Most work-related injuries qualify for workers’ comp as long as you can prove that they were the result of doing your job. That means, for example, that injuries from a car crash while driving home from work won’t qualify because they weren’t sustained while doing your job duties. But injuries from a motor vehicle accident that happened while driving to meet a client during your shift, will qualify.

Below are seven types of work injuries that either won’t qualify for benefits or are harder to get benefits for:

• Self-inflicted injuries

• Injuries from a physical altercation you caused

• Injuries from actions outside of your job duties

• Injuries resulting from drug use, intoxication, or illegal behavior

• Injuries that happened while violating company policies

• Mental health and stress-related conditions (it’s possible but difficult)

• Infectious diseases (you need clear evidence it was caused by your work)

Finding clear evidence that your injury is caused by work isn’t always easy, but if you need help, that’s a situation where a workers’ comp lawyer can help you gather medical records, witness reports, or other evidence.

If you aren’t sure whether your injury will qualify, it’s worth filing a claim. There’s no cost to file for workers’ comp, your employer can’t fire you because you say you want to file a claim, and there’s no penalty if your claim is denied.

How to get benefits for repetitive-strain injuries

You can get workers’ compensation for injuries that result from cumulative strain over time, as long as you can prove that they were caused by your work. For example, carpal tunnel caused by typing at a computer for years can qualify. You’ll need a clear medical diagnosis and you may need to prove to the insurance company that your job duties could lead to your condition.

Need help proving your injury is work-related? Reach out to a workers’ comp lawyer. They can help you get evidence from a doctor and argue for your rights in court if needed.

When does mental health qualify for workers’ comp?

Mental health conditions and stress-related conditions are tricky to get workers’ comp benefits for. You’ll need to have very clear evidence that they are wholly or primarily the result of your job.

Since each state sets its own laws, it’s also harder to get benefits for mental health conditions in some areas.

For example, California workers’ comp law allows you to receive benefits if you can, “demonstrate by a preponderance of the evidence that actual events of employment were predominant as to all causes combined of the psychiatric injury.”² That definition allows for any mental health condition as long as you can prove it’s caused by work.

In Alabama, state law says “Injury does not include a mental disorder or mental injury that has neither been produced nor been proximately caused by some physical injury to the body.”³ This definition is quite limiting for mental health conditions because it requires that you first experience a physical injury. Some conditions still qualify, such as PTSD after receiving a gunshot wound while you were working.

It’s best to seek professional support from a workers’ compensation lawyer if you’re trying to file a claim for a mental health condition, especially if your claim was already denied.

Can COVID-19 qualify for workers’ compensation?

While it’s possible to get workers’ comp for COVID-19, you’ll likely have a difficult time proving that it was specifically caused while doing your job. The same is true for other infectious diseases or illnesses. So unless you can point to a specific incident or accident that clearly led to you getting COVID-19, workers’ comp may not be of much help.

Get a professional opinion on your injury

A wide range of injuries and illnesses fall under workers’ compensation coverage. Whether your specific condition is eligible may also depend on how well you can show that it’s caused by your job. If you’re not sure whether your injury counts, your claim was denied, or you’ve run into any other issues, a workers’ comp lawyer will help you advocate for your rights.

Take our free workers’ comp eligibility quiz to learn if you could have a case. If so, someone from our team will reach out to learn more about your situation and offer guidance. They can also connect you with an experienced lawyer who knows the laws in your area and can help you get the benefits you deserve. If you decide to sign with one of our lawyers, there are no upfront fees and you’ll only ever pay after you win benefits or get a settlement.