Workers’ Compensation: Defining Industrial Injury

In California, employers are required to have workers’ compensation insurance to cover employee injuries, also called industrial injuries.  How can an employer or employee identify when an industrial injury has occurred through occupational labor?  Sometimes it is easy to identify an industrial injury (ex: office worker slips and falls, construction worker falls off a ladder, etc.)  Other times, an industrial injury is not easy to identify.

On one hand, I have sat down with employers who are surprised to learn that an employee has filed a claim for workers’ compensation benefits since the employee performs his/her job without any visible complications.  On the other hand, I have interviewed employees who have a difficult time describing how or why he/she was injured on the job, but believe it came as a result of performing his/her job.

California recognizes two types of industrial injuries: the specific injury and the cumulative injury.  I will generally discuss the cumulative injury.  Cumulative injury or repetitive trauma refers to gradual onset of injury to some part of the body caused by repeated job activities.  The cumulative injury or repetitive trauma is difficult to identify because it is not always an apparent injury.  You cannot connect the cumulative injury to a specific event or a specific date of injury.  A good approach to evaluating whether an employee has sustained disability from a cumulative injury should include evaluating the complaints/symptoms of the employee, the job requirements as performed by a particular employee, and the medical diagnoses.

Even if an employer or employee believes that the claim may be related to a cumulative injury or repetitive trauma, such claims are not resolved expeditiously.  More often than not, the claims process will require more than one physician to comment on the existence of a cumulative injury.