If you’re injured on the job in California, you may wonder if you’re covered. So, who is eligible for workers’ compensation in California?
Most employees hired or regularly working in California are eligible for workers’ compensation if they suffer a job-related injury or illness—regardless of their employer’s business location.
At Scher, Bassett & Hames, we’ve helped countless injured workers across California secure their benefits. Below is everything you need to know about who qualifies, who doesn’t, and what steps to take if you’ve been hurt at work. Workers’ compensation insurance offers medical care and wage benefits to employees who suffer work-related injuries or illnesses. These benefits may include temporary disability payments, medical expenses, and permanent disability awards.
Who Qualifies for Workers’ Compensation in California?
To qualify for workers’ compensation in California, you must be an employee with a work-related injury or illness and your employer must carry valid workers’ comp insurance. Employers are required to purchase workers’ compensation insurance from a licensed insurance company or through the State Compensation Insurance Fund.
Additionally, employers must post the ‘notice to employees’ poster in a conspicuous place at the work site regarding workers’ compensation coverage.
Key Eligibility Criteria:
- Employee Status: You must be considered an employee under California labor law. This includes full-time, part-time, seasonal, and undocumented workers.
- Work-Related Injury or Illness: Your condition must arise out of and in the course of your employment.
- Employer Insurance: Your employer must carry workers’ compensation coverage or be legally self-insured.
- Timely Reporting: You must report your injury to your employer within 30 days and file a claim form (DWC-1) promptly.
California workers’ compensation laws apply regardless of where your employer is headquartered, as long as you are hired or regularly working in the state.
Who Is Excluded from Workers’ Compensation in California?
Not every worker is eligible for workers’ compensation. Certain categories are excluded under California law. Independent contractors, volunteers, and freelancers usually do not qualify for workers’ compensation benefits in California.
Common Exclusions:
- Independent Contractors: These individuals are typically excluded unless they are misclassified. California uses the ABC test to determine employment status.
- Volunteers: Most volunteers are not eligible unless covered by specific rules (e.g., volunteer firefighters).
- Self-Employed Individuals: Unless they purchase a policy themselves, they are not covered.
- Non–Work-Related Injuries: Injuries that occur off the job or are unrelated to your employment duties do not qualify.
If you’re unsure whether you’re classified correctly, speak to an attorney. Misclassification is a common issue.
What Are the Three Fundamental Requirements for Workers’ Compensation Benefits?
To receive workers’ compensation benefits in California, three basic conditions must be met:
- You must be classified as an employee
Not a contractor, freelancer, or volunteer (with limited exceptions). - Your injury or illness must be work-related
This means it happened during work activities or arose due to job duties. - You must report and file on time
Inform your employer within 30 days and file a claim form to start the process.
Failing to meet any of these requirements may jeopardize your claim.
Who Determines Workers’ Compensation Eligibility Rules in California?
Eligibility rules are determined by California labor law, regulated by the Division of Workers’ Compensation (DWC), and enforced through the California Labor Code. All California employers are required to provide workers’ compensation benefits to their employees in accordance with California Labor Code Section 3700.
Your eligibility is based on:
- How you’re classified under the law
- Whether your employer complies with insurance mandates
- The facts surrounding your injury or illness
Failing to have workers’ compensation coverage is a criminal offense in California. Employers can also face civil lawsuits if they do not carry mandatory workers’ compensation insurance and an employee is injured. Employers who are illegally uninsured may be fined up to $100,000 under California law. The amount of workers’ compensation benefits is based on an employee’s average weekly wage.
The DWC oversees claim procedures, while the Workers’ Compensation Appeals Board (WCAB) handles disputes. Employers who break California workers’ compensation laws may be subject to fines and penalties. Failure to provide the required notice to employees about workers’ compensation coverage is a misdemeanor punishable by civil penalty. Claims that result in disputes may need to be escalated to the California Department of Insurance for investigation.
What Types of Workers Are Covered?
California has one of the most inclusive workers’ compensation systems in the country.
You may be eligible if you are a:
- Full-time or part-time employee
- Seasonal or temporary worker
- Undocumented worker
- Minor working legally
- Remote employee, if injured during work tasks
- Employee of an out-of-state company, working regularly in California
If you’re issued a W-2, you are likely covered under California workers’ compensation.
What Kinds of Injuries or Illnesses Are Covered?
Only injuries and illnesses that are job-related are covered.
Covered Conditions Include:
- Traumatic injuries (e.g., falls, burns, lifting injuries)
- Repetitive motion injuries (e.g., carpal tunnel, back strain)
- Exposure-related illnesses (e.g., chemical exposure, hearing loss)
- Psychological conditions (e.g., PTSD or anxiety from work stressors)
When employees are injured on the job, they may be treated by a healthcare provider from a Medical Provider Network set by their employer.
You must prove that your injury arose out of your employment and occurred during the course of your duties. The employer must investigate the accident and determine the exact cause of the injury.
How to Report and File a Workers’ Comp Claim in California
If you’re eligible, filing properly and promptly is essential.
Steps to Take:
- Report your injury to your employer within 30 days
Failure to do so may result in a loss of benefits. - Request and complete Form DWC-1
This officially begins the claim process. Employers must provide employees with a workers’ compensation claim form within one working day after being notified of an injury. - See an approved medical provider
Get treatment and maintain detailed records. - Keep documentation
Include medical records, time off work, and all communications. - Contact an attorney if your claim is denied or delayed
A workers’ comp lawyer can appeal decisions and help secure full benefits. For injuries or illnesses caused by repeated exposure, the filing deadline extends to one year from the date the employee first notices symptoms.If an employee does not respond to a job offer for modified or alternative work within 30 days, or if they reject the offer, they may forfeit their right to supplemental job displacement benefits.
What to Do If You’re Denied Coverage
If your employer claims you’re an independent contractor or denies your claim entirely, you have legal options. Most workers’ comp claims are resolved smoothly, but disputes can arise if the employer believes the injury or illness did not happen at work.
At Scher, Bassett & Hames, we:
- Challenge improper classifications
- Represent clients in DWC hearings
- Appeal denied claims
- Pursue benefits through the Uninsured Employers Benefits Trust Fund if necessary
What Should You Do If You’ve Been Injured at Work?
If you’ve suffered a job-related injury or illness in California, don’t wait. Missing a deadline or misunderstanding your rights could cost you the benefits you deserve.
At Scher, Bassett & Hames, we help injured workers get the compensation they need to recover and move forward. We handle every step of the process and fight for your full legal rights.
Call 408-739-5300 now for a free consultation
No fee unless we win your case
Further Reading:
- Are Workers’ Compensation Benefits Taxable in California?
- How to File a Workers’ Compensation Claim in California
- What Benefits Can You Get From Workers’ Compensation in California?
- How Long Does It Take for a Workers Comp Settlement in California?
- Resources:
- California Department of Industrial Relations – Division of Workers’ Compensation
Official state resource for filing claims, accessing forms, and understanding your rights under California workers’ comp laws. - California Labor & Workforce Development Agency – Employee or Independent Contractor?
Clear guidance on employee classification under California’s ABC test, crucial for determining eligibility. - CA Department of Industrial Relations – Workers’ Comp FAQs
Frequently asked questions directly from the California DWC about benefits, timelines, and coverage. - U.S. Department of Labor – Workers’ Compensation Overview
Federal overview of how workers’ comp functions across the U.S., including key distinctions by state.
