TL;DR: If you injure yourself and cannot work, eligibility depends on whether the injury happened on the job. Workplace injuries trigger workers’ compensation without proving fault, while injuries outside work require disability benefits or evidence that another party caused harm, changing proof standards and timing risks.
Highlights:
- Seek immediate medical treatment and document your condition.
- Report your injury to your employer within 30 days for workers’ compensation.
- Organize relevant records, including medical bills and communication with employers.
- Continue medical care and follow your doctor’s recommendations.
- Consider whether you qualify for workers’ compensation or disability benefits.
- Consult a lawyer if you believe a third party is responsible for your injury.
Tip: Keep thorough records of your treatment and communications to strengthen your claim.
Table of Contents
If you injure yourself and cannot work, California law provides different benefit systems depending on whether the injury happened on the job or outside of work.
- Work-related injuries usually fall under workers’ compensation.
- Non-work injuries may qualify for State Disability Insurance or federal disability programs.
- In limited situations, a third party may be responsible, which can open the door to a personal injury claim.
The severity of the injury matters, but eligibility depends more on where and how the injury occurred than on how painful or disruptive it feels.
Work Injury Vs. Non-Work Injury: Why The Difference Matters
Understanding this distinction early helps avoid delays or denials. It also helps determine which benefits apply, who pays medical bills, and whether fault matters.
Injuries That Happen At Work
Workers’ compensation generally applies when:
- The injury occurs while performing job duties.
- The injury happens on employer-controlled property.
- The injury occurs during required work activities, travel, or assignments.
Workers’ compensation is a no-fault system, meaning you may qualify even if you caused the accident.
Injuries That Happen Outside Of Work
If the injury occurs:
- At home.
- During recreational activities.
- While commuting to or from work.
- In public places unrelated to job duties.
Workers’ compensation usually does not apply. Instead, you may need to rely on disability benefits or, in some cases, a personal injury claim against the responsible party.
What To Do After Getting Injured
An injury can throw your entire life off balance in an instant. One moment you’re doing your work, the next you’re in pain and uncertain about your future. The steps you take after the accident can directly affect your ability to recover compensation and protect your legal rights.
Many people begin looking into their options at this stage, often because medical bills are piling up and they have no income.
- Continue Medical Treatment and Document Your Condition — If you have already received initial treatment, continue following your doctor’s recommendations. Ongoing care helps both your recovery and your claim.
Medical treatment may include:
- Follow-up visits with your primary doctor or specialists.
- Physical therapy or chiropractic care when medically appropriate.
- Diagnostic testing to evaluate the full extent of your injuries.
Medical records help establish:
- When the injury occurred.
- How the injury limits your ability to work.
- Whether the condition is improving, worsening, or permanent.
Gaps in treatment or incomplete records often lead insurers to question the seriousness of an injury.
- Report the Injury Properly — Report your injuries as soon as possible because you only have 30 days to notify your employer. Missing this deadline can hurt your case. In California, most work injuries must be reported within 30 days.
Proper reporting helps ensure:
- There is an official record of the incident.
- You can file a workers’ compensation claim.
- You are protected against retaliation for asserting your rights.
Missing the reporting deadline does not automatically bar a claim, but it can complicate the process and affect how the insurer evaluates it.
Notify your direct supervisor, a manager, or someone in human resources. This notice creates an official record and requires your employer to provide a workers’ compensation claim form (DWC-1).
- Organize Records That Affect a Potential Claim — At this stage, documentation becomes especially important, particularly for people asking whether they need a personal injury lawyer or help with a denied or delayed claim.
Relevant records may include:
- Medical reports, bills, and treatment notes.
- Prescriptions and rehabilitation plans.
- Communications from employers or insurance carriers.
- Mileage or out-of-pocket expense records.
- Photos of injuries or the accident location.
- A written summary of how the injury affects daily activities and work capacity.
Having these materials organized makes it easier to evaluate liability, eligibility for benefits, and potential next steps, tasks which a workers’ compensation lawyer can do when reviewing your case.
Workers’ Compensation Benefits If You Can’t Work
Workers’ compensation may provide several types of disability benefits depending on your condition.
- Temporary Total Disability — Temporary Total Disability applies when a doctor certifies that you cannot work at all for a limited time due to a work-related injury.
In California:
- Benefits may last up to 104 weeks within five years of the injury.
- Part-time, seasonal, and undocumented workers may still qualify.
- Benefits generally replace a portion of lost wages, not full income.
- Permanent Partial Disability (PPD) — Permanent Partial Disability applies when an injury causes lasting limitations but does not prevent all work.
The benefit amount and duration depend on:
- Disability Rating — This rating is based on the doctor’s assessment of the injury.
- Age and Occupation — The worker’s age at the time of the accident and occupation are considered. These factors can impact how the disability affects the worker’s ability to complete job tasks and earn money.
- Weekly Earnings — The worker’s average weekly earnings before the injury are used to calculate the benefit amount.
Benefits are determined after the condition reaches Maximum Medical Improvement.
- Permanent Total Disability (PTD) — Permanent Total Disability applies when an injury prevents any meaningful employment.
Eligibility generally requires:
- A 100% disability rating.
- Medical evaluations and supporting reports.
- Evidence that no suitable work exists within medical limitations.
When Workers’ Compensation Does Not Apply
Workers’ compensation is a no-fault system. This means employees get benefits regardless of who caused the accident. However, one significant limitation is that the injury must occur during work activities.
In certain situations, even if an accident happened at work, a person may be the cause of their own harm and not be eligible for workers’ compensation. Some of the exclusions are:
- Injuries caused by intoxication.
- Willful self-harm.
- Injuries sustained in fights in which the worker was the aggressor.
- Injuries during serious criminal conduct.
- Certain recreational or horseplay activities.
Legal Rights And Responsibilities After Getting Injured At Work
Injuries at work can have a significant impact on your life. When an employer fails to treat you fairly, it doesn’t just hurt your income; it affects your dignity, stability, and future.
State law protects injured workers by requiring employers and insurers to provide benefits and follow specific procedural rules, regardless of who caused the injury.
Your Right To Medical Treatment
In California, employers and insurers must cover reasonable medical care for work-related injuries. This may include:
- Visits to doctors and specialists, such as chiropractors.
- Surgery and hospitalization.
- Physical therapy and rehabilitation.
- Mental health support (if related to the injury).
- Medications and medical devices.
- Reimbursement for mileage to and from appointments.
In most workers’ compensation cases, the insurance carrier manages medical care through a Medical Provider Network. Injured workers usually start treatment within that network, but may change doctors and challenge restrictions when the law allows.
Employment Protections During Recovery
Some injured workers also qualify for job-protected leave under laws like the Family and Medical Leave Act or the California Family Rights Act. These laws do not provide wage replacement, but they may protect your position while you recover if you meet eligibility requirements. Job protection depends on factors such as employer size, length of employment, and medical certification, and it operates separately from workers’ compensation or disability benefits.
What Happens If A Workers’ Compensation Decision Is Delayed?
Workers’ compensation decisions in California do not always move quickly. Insurers often delay claims while they review medical records, investigate whether the injury qualifies as work-related, or request additional documentation. Administrative backlogs and internal disputes also contribute to slow decisions.
If an insurance carrier does not accept or deny a claim within 90 days, California law generally presumes the claim approved. At that point, the insurer may have to pay medical treatment and disability benefits related to the injury.
Common reasons for delayed decisions include:
- Disputes over whether the injury occurred at work.
- Incomplete or inconsistent medical records.
- Questions about injury severity or work restrictions.
- Processing delays within the insurance system.
When delays continue, injured workers can take specific steps to protect their rights and keep the claim moving forward:
- Contact the Division of Workers’ Compensation (DWC). The DWC can review unreasonable delays, answer procedural questions, and, in some cases, help push the claim toward resolution.
- Request a hearing before the Workers’ Compensation Appeals Board (WCAB). If the insurer stalls or disputes eligibility, a hearing allows a judge to review the delay and address benefit issues.
- Appeal a denial within the required deadline. If the insurer denies the claim after a delay, you must file an appeal on time to preserve your right to challenge the decision.
- Organize and preserve all claim-related records. Clear documentation of medical treatment, communications, and deadlines helps support the claim and respond to insurer challenges.
When delays drag on, a missed deadline or incorrect response can affect a claim. At that stage, many injured workers choose to speak with workers’ compensation lawyers at Arash Law to understand their options better and ensure the process stays on track.
Deadline And Statute Of Limitations For A Workers’ Compensation Claim
In California, a workplace injury must be reported within 30 days of the accident, while the deadline for workers’ comp claims is one year from the date of injury, the last payment for temporary or permanent disability, or the date when any medical or hospital benefits were last provided.
While this may seem like a long time, dealing with the aftermath of an accident can be overwhelming. If you miss a deadline, it could mean losing your right to file a workers’ compensation claim.
What Happens To Your Job If You’re Injured Outside Of Work?
When an injury happens outside of work, how it affects your job usually depends on a few key factors, not on who caused the injury:
- How long your injury keeps you from working.
- Whether any job-protection laws apply to your situation.
- Your employer’s size and your length of employment.
In most cases, employers do not have to pay wages or provide workers’ compensation benefits for non-work injuries.
Some injured workers may qualify for job-protected leave, including under:
- The Family and Medical Leave Act (FMLA)
- The California Family Rights Act (CFRA)
These laws may protect your position for a limited time if you meet eligibility requirements, but they do not replace lost wages. Eligibility often depends on:
- Employer size
- How long you have worked for the employer
- Medical certification confirming your inability to work
If job-protection laws do not apply, an employer may not be required to hold your position open indefinitely. In those situations, income support typically comes from:
- California State Disability Insurance (SDI) — Provides short-term partial wage replacement if a doctor confirms you cannot work.
- Social Security Disability Insurance (SSDI) — Provides monthly benefits for people with a qualifying disability and sufficient work history.
- Supplemental Security Income (SSI) — Helps people with disabilities who have limited income or resources and do not qualify for SSDI.
Some employers may offer accommodations or internal benefits for non-work injuries, but these options vary and are not guaranteed by law.
A personal injury claim may apply if another party caused the injury. Unlike disability benefits, a personal injury claim focuses on fault. It may allow recovery for losses tied to being unable to work, such as lost income, medical expenses, and ongoing limitations.
Why Some Injuries Turn Into Personal Injury Claims
Not every injury that prevents someone from working qualifies for workers’ compensation or disability benefits. Sometimes, another person or company causes the accident. For example, you might get hurt while doing construction work on someone else’s property. In this scenario, the property owner might be responsible for your injuries, not your employer.
Similar situations that can turn into personal injury claims include:
- A car or truck crash.
- Getting hit while walking or riding a bike.
- Slipping on unsafe property.
- Using a product that didn’t work the way it should.
When someone else causes the injury, benefit programs may not cover everything, especially lost income and long-term limits. That difference is why many people reach a point where they think, “I need a personal injury lawyer,” just to understand whether someone else may be responsible.
Whether a personal injury claim applies depends on what actually happened, what evidence exists, and which insurance policies are involved. Not every accident leads to a claim, but when another party causes the injury, it can change the options available.
Frequently Asked Questions (FAQs)
It can be challenging to deal with injuries after an accident, especially if they keep you from going back to your job. You may be wondering what to do if you can’t work and earn money to pay for your medical bills. Here are answers to questions victims frequently ask when injuries stop them from working:
How Much Are California Workers’ Compensation Settlements?
In California, workers’ compensation settlements can vary widely depending on the circumstances of the injury. The value of your case may be influenced by factors such as the type of injury, level of disability, and future medical needs.
How Much Do Workers’ Compensation Lawyers Charge?
Each case is unique, and a wide range of factors can affect lawyers’ fees. Our attorneys, like other professionals, work on a contingency fee basis. Legal fees are only paid if we win or settle your case.
Under this payment structure, victims can get legal help without paying anything up front. Instead, lawyers receive their fees if they obtain compensation for you. You can reach out to our lawyers and get a deeper understanding of this pay structure.
Can You Lose Your Job Because Of An Injury Outside Of Work?
In some cases, your employer might let you go for non-work-related injuries if you can’t perform your job. However, some workers may have job protection. If you lose your job as a result of an off-the-job injury, you may be eligible to file for unemployment benefits. You may also seek compensation from the party that caused your injury.
Can I Receive Both Workers’ Compensation And Disability Benefits?
Yes, it’s possible. However, this may only happen in limited situations, as SSDI benefits aren’t always available. Social Security agents often use strict criteria to determine whether a workplace injury is severe enough to have caused a permanent or temporary disability. If your impairment lasts a year or more, or if it severely disrupts your daily life, you might get approved for Social Security disability benefits sooner.
Contact Our Lawyers To Know Your Rights And Options If You Were Injured And Can’t Work
If you were injured and can’t work, California law may give you access to different benefits depending on how the injury happened and how long it affects you. Work injuries often involve workers’ compensation. Longer-term disabilities, whether work-related or not, may qualify for Social Security disability benefits. State disability benefits can also help, but they usually replace only part of your income.
Serious injuries often bring ongoing medical needs and long recovery periods. When benefits fall short or claims stall, it helps to understand the options available and the rules that apply to your situation.
In these cases, you may be seeking free accident lawyer advice. If you need help reviewing a claim or understanding your next steps, you can speak with an Arash Law attorney. Our attorneys can clarify whether workers’ compensation, disability benefits, or a personal injury claim may apply. Call AK Law at (888) 488-1391 to schedule a free initial consultation.
