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What is California’s Workers’ Compensation Exclusivity Rule?

Posted by Inna Gorin | Jun 03, 2023

If you're injured on the job, you're probably entitled to financial recovery through a workers' compensation claim. Under California law, employees injured during their employment-related activities can generally file a claim regardless of who was at fault for the injury.

In addition to workers' compensation, you might also be able to sue your employer in a civil court under certain circumstances. For example, civil suits for personal injury provide broader economic relief, whereas workers' compensation is limited to medical expenses and benefits for disability.

What is California’s Workers’ Compensation Exclusivity Rule?
If you are injured on the job, you may be able to sue your employer under certain circumstances.

To sue in civil court, however, you'll need to understand the workers' compensation exclusivity rule and the exceptions to this rule.

Regardless of where you work, there are some inherent dangers. For example, suppose you had a slip-and-fall accident in the office or a car accident in a company vehicle.  In that case, you can seek compensation if you are injured at work.

Simply put, when you are injured during working hours, you can seek compensation through a workers' compensation claim, but you must report the injury to your employer.

The company must pay for any medical treatment for injuries, your temporary and later calculated permanent disability, and potentially other benefits.

Suppose your worker's injury case involves the fault or partial fault of a third party other than your employer. In that case, you should consult with our Los Angeles personal injury lawyers to determine whether you should pursue a case.

What Are the Reasons for Workplace Accidents?

There are several common causes of workplace accidents, including the following:

  • Car or truck accidents while driving a company vehicle;
  • Slip and fall accidents at the office or carpal tunnel from typing;
  • Construction accidents, such as scaffolding falls, power tool accidents, asbestos exposure, struck-by-vehicle accident, and electrocution;
  • Factory accidents include heavy equipment injuries, burn injuries, and conveyor belt accidents.

What Are the California Legal Employment Rights?

All employers must carry workers' compensation insurance to cover you if you're injured on the job to pay for medical treatment and disability payments. In California, workers' compensation is a “no-fault” system, meaning that you are covered under the policy if you're on the job and injured, with some exceptions.

Suppose you are injured at work. In that case, you need to know your California legal employment rights, which include the right to:

  • File a workers' compensation claim;
  • Medical treatment;
  • Return to your job;
  • Temporary or permanent disability benefits;
  • Appeal decisions about your treatment;
  • Settle your case;
  • Choose your lawyer; and
  • Sue at-fault third parties in civil court directly.

Injury Under California's Workers' Compensation Act

The California Workers' Compensation Act defines the type of injuries that may justify a claim as including:

  • Section 3208 says, “Injury' includes any injury or disease arising out of the employment, including injuries to artificial members, dentures, hearing aids, eyeglasses and medical braces of all types...”
  • Section 3208.1 says, “An injury may be either: (a) ‘specific,' occurring as the result of one incident or exposure which causes disability or need for medical treatment; or (b) ‘cumulative,' occurring as repetitive mentally or physically traumatic activities extending over a period of time…. “

In some cases, even psychiatric injury may fall within the parameters of workers' compensation:

  • Section 3208.3 (a) says, “a psychiatric injury shall be compensable if it is a mental disorder which causes disability or needs for medical treatment, and it is diagnosed pursuant to procedures….”

Outside of the employee-employer relationship, these injuries would also be actionable in civil court, but as noted, civil action is often barred under the Workers' Compensation Act in California.

What is the Exclusivity Rule?

The Workers' Compensation Act provides employees with a benefit, namely that employees can pursue a claim regardless of who caused the injury.

Workers' Compensation Exclusivity Rule

This means that even if the employee caused their injury, they could still receive limited financial compensation.

However, this no-fault claim process comes at a price, and under the Exclusivity Rule, workers relinquish their right to sue their employers for work-related injuries.

This rule is set out in Section 3602 of the Workers' Compensation Act, which provides that “the right to recover compensation is...the sole and exclusive remedy of the employee or his or her dependents against the employer.”

Workers' compensation relief, while important, is limited. In some cases, employees should pursue larger compensation through civil action.

What Are the Exceptions to California Workers' Comp Exclusivity Rule?

Section 3602 of the Workers' Compensation Act also provides exceptions to the Exclusivity Rule. These exceptions include the following scenarios:

  • “(1) Where the employee's injury or death is proximately caused by a willful physical assault by the employer.”
  • “(2) Where the employee's injury is aggravated by the employer's fraudulent concealment of the existence of the injury and its connection with the employment….”

In this second exception, it's important to understand that the damages an employee can seek in a civil lawsuit will be proportionate to how much the fraudulent concealment aggravated the injury.

  • “(3) Where the employee's injury or death is proximately caused by a defective product manufactured by the employer and sold, leased, or otherwise transferred for valuable consideration to an independent third person, and that product is thereafter provided for the employee's use by a third person.”

The third exception is a product liability case, where a third party first purchased the defective product and then subsequently used by the employee.

To Whom Does the CA Exclusivity Rule Apply?

Workers' compensation applies to individuals who qualify as employees under California law. Employees include:

  • Section 3351 says, “Every person in the service of an employer under any appointment or contract of hire or apprenticeship, express or implied, oral or written, whether lawfully or unlawfully employed….”

Beginning July 1, 2020, certain independent contractors described under the new Section 2750.3 also began to fall under workers' compensation laws. An independent contractor may fit into this classification unless it's proven that:

  • “(A) The person is free from the control and direction of the hiring entity in connection with the performance of the work, both under the contract for the performance of the work and in fact.”
  • “(B) The person performs work outside the usual course of the hiring entity's business.”
  • “(C) The person is customarily engaged in an independently established trade, occupation, or business of the same nature as that involved in the work performed.”

Of course, there are exceptions, and you should always consult an experienced California workplace injury attorney to review your rights and options.

When Do You Need a Lawyer?

Sometimes, you will need a lawyer to challenge the insurance company in the following situations:

  • When your claim is denied;
  • If any benefits are withheld;
  • If the settlement does not cover expenses or wages;
  • If your condition prevents you from returning to work;
  • If you plan to apply for social security disability benefits;
  • If your employer retaliates against you;
  • If a third party was responsible for your injuries;
  • If you want to challenge the final injury report.

Depending on your accident and injury details, workers' compensation, personal injury, or both could provide the best results. But, again, our law firm can help you to pursue the most effective strategy in your case.

If you suffer a serious injury at work, you can seek compensation. In addition, we can help you decide your next move after a workplace accident.

If your employer has provided inadequate medical care, we might be able to help you get the care you need. If there is no recovery, there are no fees. We offer a free case consultation by phone or through the contact form. Injury Justice Law Firm is located in Los Angeles, CA.

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About the Author

Inna Gorin

Inna Gorin, the founding Partner of Injury Justice Law Firm modeled the Firm after her ideals and principles of what skilled, aggressive and tenacious representation of individual clients should embody. Ms. Gorin's mission is to level the playing field, and provide her clients with the same level...

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