Workers’ compensation coverage and the “by accident” requirement, P.2

Last time, we began speaking about workers’ compensation coverage and the “by accident” requirement, under which a worker is only entitled to workers’ comp benefits if his or her injury was preceded and caused by a separate event that can be classified as an accident.

Under of the “by accident” requirement, as we noted last time, gradual injuries are generally not covered by workers’ compensation. In addition, injuries which occur in the ordinary course of work, and not as part of a separate incident that can be classified as an accident, may not be covered either. This can be a tricky point for injured workers’ to understand, and it isn’t always clear whether an accident technically occurred, so it is important for injured workers not to assume they will not be covered, and to always consult with an experienced attorney.

There are, under state law, two important exceptions to the “by accident” rule. The first applies to back injuries and hernias. Although these injuries often occur gradually, they are still supposed to be covered by workers’ compensation insurance as long as they are caused by a specific traumatic incident in the course of work, even when there is no accident preceding the injury. A traumatic incident, to be clear, is different than an accident, which is the ordinary requirement for coverage.

Another exception to the “by accident” requirement is for occupational diseases, which are diseases proven to be the result of causes and conditions “characteristic of a particular occupation or employment,” exposure to which is greater than in the general public outside the employment.

In our next post, we’ll explain this second exception more fully and why it is important to work with an experienced attorney when seeking workers’ comp benefits.

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