What Injuries Are Covered by Workers’ Compensation in the USA? (2026 Guide)
Introduction
After a workplace accident, one of the first questions injured employees ask is: “Is my injury covered by workers’ compensation?” The answer depends on the nature of the injury, how it occurred, and whether it is connected to job duties.
This detailed guide explains what injuries are covered by workers’ compensation, including physical injuries, occupational illnesses, repetitive stress injuries, and mental health claims—along with important differences in California, Texas, and monopolistic workers’ compensation states.
The Core Rule: Work-Related Injuries and Illnesses
Workers’ compensation generally covers injuries and illnesses that:
Arise out of employment, and
Occur in the course of employment
This means the injury must be reasonably connected to your job duties or work environment.
Common Physical Injuries Covered by Workers’ Compensation
Most workplace physical injuries are covered, including:
Slips, trips, and falls
Back, neck, and spine injuries
Broken bones and fractures
Cuts, burns, and lacerations
Crush injuries and amputations
Machinery and equipment accidents
Even injuries caused by employee mistakes are typically covered under the no-fault system.
Repetitive Stress and Cumulative Trauma Injuries
Not all injuries happen in a single accident. Many develop over time due to repeated motions or strain.
Common repetitive injuries include:
Carpal tunnel syndrome
Tendinitis
Rotator cuff injuries
Chronic back pain
Knee and joint degeneration
These injuries are fully compensable if medical evidence links them to work activities.
Occupational Illnesses and Exposure Claims
Workers’ compensation also covers diseases caused by workplace exposure.
Examples include:
Respiratory illnesses from dust or chemicals
Hearing loss from prolonged noise exposure
Skin conditions from chemical contact
Occupational cancers
Infectious diseases contracted at work
Exposure claims often require stronger medical documentation than accident claims.
Mental Health and Stress-Related Claims
Mental health injuries are increasingly recognized—but coverage varies widely by state.
Covered Mental Health Claims May Include:
Post-traumatic stress disorder (PTSD)
Work-related anxiety or depression
Trauma following violent workplace incidents
Many states require proof of a physical injury or extraordinary work event.
Injuries Aggravating Pre-Existing Conditions
Workers’ compensation may cover injuries that worsen pre-existing conditions.
Examples:
A prior back injury aggravated by lifting at work
Arthritis worsened by repetitive job duties
Employers take workers as they find them—pre-existing conditions do not automatically disqualify claims.
Injuries That Occur Outside the Workplace
Covered Off-Site Injuries
Injuries during work travel
Accidents at job-required off-site locations
Injuries while attending employer-mandated events
Typically Not Covered
Injuries during normal commuting
Injuries during personal errands
Exceptions may apply under the “special mission” rule.
Injuries That Are Usually NOT Covered
Workers’ compensation generally does not cover:
Self-inflicted injuries
Injuries caused by intoxication or illegal drug use
Injuries during horseplay
Injuries during criminal acts
Injuries unrelated to work duties
Each case depends on specific facts and state law.
California Workers’ Compensation Injury Coverage
California provides broad injury coverage, including:
Repetitive stress injuries
Aggravation of pre-existing conditions
Certain mental health claims
California also recognizes cumulative trauma claims, which may involve multiple employers.
Texas Workers’ Compensation Injury Coverage
In Texas:
Coverage applies only if the employer subscribes
Mental health claims are more limited
Non-subscribers expose employers to lawsuits
Injury classification significantly affects benefit eligibility.
Injury Coverage in Monopolistic Workers’ Compensation States
Monopolistic states typically offer standardized coverage through state funds.
Key features:
Strict reporting and documentation rules
Uniform benefit structures
Limited private insurance involvement
States include Ohio, Washington, Wyoming, and North Dakota.
What to Do If Your Injury Is Denied
If your injury claim is denied:
Request a written explanation
Gather medical documentation
File an appeal within deadlines
Seek legal guidance if needed
Many denials are overturned on appeal.
Frequently Asked Questions (FAQs)
Are minor injuries covered?
Yes, even small injuries may qualify and should be reported.
Are stress and anxiety claims covered?
Sometimes, depending on state law and medical evidence.
Does workers’ comp cover COVID-19?
In certain occupations and states, yes.
Related FAQs
Who Is Covered Under Workers’ Compensation Insurance?
What Injuries Are NOT Covered by Workers’ Compensation?
How Long Do You Have to Report a Work Injury?