What types of injuries and illnesses are covered by workers’ compensation? - Pie Insurance

Compensable and non-compensable injuries

As a small business owner, you may have wondered what types of work-related injuries and illnesses workers’ compensation insurance generally covers. We’re here to help with an overview of compensable versus non-compensable injuries.

What is a compensable injury?

A “compensable injury” is a work-related injury that qualifies an employee to receive workers’ compensation benefits. The types of injuries or illnesses that are covered by workers’ compensation vary by state and situation. As always, consult with your insurance provider, state workers’ compensation board, and/or legal counsel regarding individual workers’ compensation claims.

While every situation is different, there are some general guidelines for what types of injuries and illness are covered by workers’ compensation. First, to be considered compensable, injuries must have happened to an employee, have happened during the course of employment as a result of work-related duties, and result in impairment and/or lost wages.

What types of injuries does workers’ comp cover?

Depending on your state and your policy, work-related injuries that may be covered by workers’ compensation can include:

• Repetitive stress injuries (e.g., carpal tunnel syndrome, bursitis, tendonitis)
• Occupational illnesses (e.g., sunstroke, hearing loss, asbestosis, silicosis)
• Mental stress injuries (e.g., post-traumatic stress disorder, anxiety, emotional distress)
• Fatality (e.g., chemical exposure, fall from scaffolding)

What types of injuries are not covered under workers’ comp?

Just like compensable injuries, non-compensable injuries can vary by state and policy. However, injured employees typically won’t be covered by workers’ compensation insurance if they were:

• Engaging in horseplay or fighting
• Under the influence of drugs or alcohol
• Commuting to or from work in a private vehicle and not engaged in work activity
• Participating in a voluntary, unsponsored social gathering with coworkers
• Taking a work break off-site

Look up the workers’ compensation laws in your state

To find out more about what your workers’ compensation policy covers, check with your insurance provider or look up the workers’ compensation laws in your state.

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