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Exceptions to Workers Compensation Coverage

California workers compensation is designed to be a broad remedy for injured workers that provides much-needed benefits regardless of individual fault. However, this does not mean that every injury is compensable. Beyond the general rule that injuries must be “work-related,” even work-related injuries may not be subject to compensation under a limited number of exceptions.

Luckily for injured workers, these exceptions are extremely narrow and only apply in a very small minority of cases. Section 3600 of the California Labor Code states that injured workers are not able to collect compensation benefits in cases where:

  • The injured worker was intoxicated or under the influence of a controlled substance at the time of the injury and said intoxication was the cause of the injury
  • The employee willfully and deliberately caused his or her own death or injury
  • The injury was incurred during a physical altercation in which the injured employee was the initial physical aggressor
  • The employee was engaged in the commission of a felony and that said activity is the cause of the injury

There are also some special rules and evidentiary requirements applicable in situations where an employee files a workers compensation claim after receiving notice of termination or layoff for an injury that occurred prior to receiving such notice. This is to prevent outgoing employees from manufacturing claims. However, the added burdens are generally reasonable and easy to meet in most cases. An experienced Orange County workers compensation attorney can evaluate your case to determine if any of these exceptions may apply.

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