Can I Still Receive Workers’ Compensation Benefits if the Accident Was My Fault?

In short, yes, you can still receive workers’ compensation benefits in California if the accident was your fault. California workers’ compensation benefits are part of a no-fault benefits system. An injured worker does not have to prove that their employer’s negligence or wrongdoing caused their injury to receive benefits. The worker must only prove that the injury occurred during the scope and course of employment. That means employees can generally receive workers’ compensation benefits even if they caused their own injury during the scope of employment without any employer negligence.

California’s No-Fault Benefits System Explained

In a no-fault system, workers’ compensation benefits typically cover an employee’s injuries regardless of who was at fault for the injury itself or the conditions that caused the incident. A related effect of this system is that employees who do find themselves injured by their employer’s negligence may receive less compensation than those in a state that uses a fault-based benefits system.

Disadvantages of a No-Fault Benefits System

As a result of nearly all workplace injury victims in California being eligible to receive benefits, the quantity of workplace claims is higher. Since there are so many more claims in no-fault states, the compensation received per injured employee tends to be lower than it would be in a state that uses a fault-based system.

Advantages of a No-Fault System

From an employer’s perspective, a no-fault system can be beneficial in the way that the employer receives immunity from the threat of a civil lawsuit based on their negligence, as long as their conduct was less than serious and willful misconduct. 

In the event that an employee is injured or harmed by their employer’s serious and willful misconduct or negligence, they may receive an increased rate of workers’ compensation benefits, even in a no-fault state.

Are There Exceptions to California’s No-Fault System for Workers’ Comp Benefits?

A no-fault system for injured workers does not mean that exceptions and rules do not apply. One limitation is that the injury must arise out of the scope of employment. There are certain instances where an employee can cause their own injury and not receive workers’ compensation for it, even if the injury happened at work. These exceptions include:

• Injuries caused by the employee’s intoxication
• Workplace injuries caused by a fight in which the claimant was the aggressor
• Injuries caused by horseplay or recreational play

Injuries received in these manners do not satisfy the criteria of injuries that arose out of the scope of the employee’s job duties. There are situations where employers or insurance companies may unfairly deny legitimate claims for workers’ compensation benefits. If you have any questions about your workers’ compensation eligibility or why your claim was denied, a knowledgeable workers’ compensation attorney can answer your questions and protect your legal rights.

What Are My Settlement Options in California Workers’ Compensation Cases?

There are three ways you can settle your workers’ compensation claim:

1) Compromise and Release: This option agreed upon by the injured worker and the insurance company settles the case forever in exchange for a lump sum settlement.

2) Stipulation with Request for Award: Injured workers receive weekly monetary payments in the form of permanent disability benefits and will receive lifetime future medical care to treat their work-related injuries.

3) Trial: If the parties cannot agree to a settlement form, the case will be tried before a workers’ compensation judge, who will then decide the case. If the judge rules in favor of the injured worker, the judge will issue a Findings and Award.

Note that a Findings and Award is similar to a Stipulated Award. The difference is that the judge determines the number and amount of monetary permanent disability benefits and will award a lifetime medical care award for those injuries determined to be work-related. A Stipulated Award is a settlement form agreed upon by the insurance company and injured worker, not by a judge. Additionally, a judge cannot award a Compromise and Release a lump sum amount of money to the injured worker.

Once the case is either settled or decided at trial, all issues are considered resolved, and a workers’ compensation settlement is entered into the court’s records.

Consult Top-Rated Glendale Workers’ Compensation Attorneys for Free Today

For more information on workers’ compensation benefits if the accident was your own fault, get in touch with KCNS Law Group, LLP’s professional team of skilled California workers’ compensation lawyers. Our attorneys have over 40 years of combined legal experience and are committed to providing individual and strategic representation customized to our client’s needs. Get the information and legal answers you seek and talk to our experienced workers’ compensation attorneys about your situation for free. Schedule your free consultation at our Glendale, California law office by completing a contact form or calling (818) 937-9255 today.