Attorney Esequiel Solorio is a certified specialist in workers’ compensation law as certified by The State Bar of California Board of Legal Specialization.

What are the requirements for a workers’ compensation claim?

On Behalf of | May 3, 2023 | Blog, workers' compensation

When you file a claim for workers’ compensation benefits, you must meet certain criteria or else you will face a denial. Not every injury you have will qualify.

There are two main criteria you will need to meet to have a qualifying injury or illness.

Happened during work

The first important aspect of your injury is that it must have happened while you were working. If you break your leg after you get home from work, it is not a covered injury. If you develop chronic back issues from your woodworking hobby, then it is not a work injury.

Some situations may not be as clear as others, especially when it comes to illnesses, so you will need medical records that clearly state your medical issue was a result of something that you do at work.

Happened during the course of your duties

Having an injury or illness occurs at work is not enough to qualify for benefits. You also need to show it happened as you were doing actual work duties. For example, if you get into an auto accident on your lunch break, it does not fall under workers’ compensation because it did not happen during the course of your duties. On the other hand, if you fall from a ladder while getting supplies you need to work, you probably will have a qualifying injury.

Not every situaiton is clearcut. For this reason, you need to have proper documentation to prove that you got the illness or injury due to your working situation and during work time.