In most states, including California, worker's compensation is considered an “exclusive remedy” for workplace injuries. Under this rule, if you are injured at work, your employer's workers' compensation insurance automatically covers your medical expenses, lost wages, and other related expenses, regardless of your own negligence. In return, you forfeit your right to sue your employer.
But what happens if workers' compensation doesn't fully cover your losses? What if the pain and suffering caused to you and your family extend beyond just your physical injuries? If you take the “exclusive remedy” rule to heart, you're basically out of luck. The only compensation you're entitled to is whatever workers' compensation covers.
However, as with any rule, there are exceptions. The State of California recognizes five specific exceptions that enable you to fight the “exclusive remedy” rule. If your case includes one of these exceptions, you have the right to sue your employer for damages in addition to workers' compensation benefits. Let's take a closer look at these five exceptions.
Intentional Injury Exception
If your employer intentionally attacked or assaulted you, or if a fellow employee intentionally injured you with the knowledge and consent of the employer, then you are not bound by the “exclusive remedy” rule. You can file a personal injury lawsuit against your employer to seek compensation for pain and suffering, punitive damages, and other non-economic losses in addition to what workers' compensation covers.
To prove that your employer intentionally attacked or assaulted you, you will need to show that they had the specific intent to injure you. This can be difficult to do, especially without the help of a skilled personal injury attorney.
Fraudulent Concealment Exception
If your injury or illness stems from the fact that your employer fraudulently concealed information about a dangerous condition at work—or if they deliberately misrepresented the severity of an injury you sustained—then by California law, the employer is no longer protected by the “exclusive remedy” rule. You are permitted to sue your employer for damages in addition to workers' compensation.
To prove fraudulent concealment, you will need to present evidence that your employer knew about the dangerous conditions at work, that they intentionally hid this information from you, and that you suffered injury, illness, or loss as a result. Toxic exposure to work-related chemicals is one of the most common examples of fraudulent concealment that attorneys deal with.
Uninsured Employer Exception
The “exclusive remedy” rule for workers' compensation is completely contingent on your employer carrying workers' compensation. If your employer doesn't carry this coverage, not only are they violating California law, but they are not protected from personal injury lawsuits in the event of injuries. If your employer doesn't have workers' compensation insurance, you have the right to sue them for medical expenses, lost wages, pain and suffering, emotional distress, and other applicable damages. If your employer cannot pay your benefits out of pocket, you can also file a claim with the Uninsured Employers Benefits Trust Fund (UEBTF).
Dual Capacity Exception
Dual capacity applies when your injuries occur from a situation not directly related to your employment—in other words, in the course of a non-work-related connection with your employer. This may occur in one of two ways:
- If you were injured through normal interaction with your workplace but you were not “at work.” For example, if you work in a restaurant and you have a slip-and-fall injury while coming in to dine, the employer is subject to premises liability just as if you were a patron of the restaurant.
- If your employer manufactures a product that injures you in a non-work environment. For example, if your employer sold a defective product to a third party and you were injured while using that product, your employer may be subject to product liability.
Power Press Exception
The State of California recognizes a uniquely specific exception to the “exclusive remedy” rule in the form of power presses. If you work with a power press machine that your employer has modified to operate in an unsafe manner (e.g., removing a guard to make it run faster), you can bring a personal injury lawsuit against your employer if you are injured as a result. To prove that your employer is liable for damages, you will need to provide evidence that the machine was either modified or not set up to run safely and that your injuries resulted directly from the operation of this machine.