Criminal Charge and Workers Comp California: How Allegations Affect Your Claim

October 17, 2025

Table of Contents

Estimated reading time: 18 minutes

Key Takeaways

Criminal charges do not automatically bar California workers’ comp benefits; compensability turns on whether the injury “arises out of and in the course of employment” and whether a statutory exclusion applies under Labor Code §3600.
Two exclusions insurers frequently raise are intoxication and willful misconduct. The employer/insurer bears the burden to prove an exclusion by a preponderance of evidence (not “beyond a reasonable doubt”). See the Labor Code §3600 statutory framework.
Immediate steps if injured: seek medical care, report the injury, file a DWC‑1 claim form, preserve evidence, and consider counsel. Use the official DWC‑1 claim form and the DWC’s injured worker guidance.
Criminal proceedings and workers’ comp are separate. A conviction or acquittal may be evidence but is not dispositive of compensability in an administrative claim before the Workers’ Compensation Appeals Board (WCAB).

Criminal charge and workers comp California: employees and families often wonder whether a criminal allegation will automatically bar a workers’ compensation claim. This article explains how California law evaluates injuries that arise during workplace fights, DUI incidents while working, and injuries resulting from illegal activity—and how criminal allegations may affect medical, temporary, and permanent benefits. We cover statutory exclusions (like intoxication and willful misconduct), how criminal proceedings differ from workers’ comp claims, typical employer defenses, how to preserve evidence, and steps to appeal a denial. If you were DUI injured while working or injured in a workplace altercation, the information below can help you understand risks, rights, and next steps.

For a step-by-step overview of starting a claim, review our plain-English guide to filing a California workers’ comp claim.

How California workers’ compensation law evaluates criminal conduct

Under California law, for an injury to be compensable it must “arise out of and in the course of employment.” Certain statutory exclusions (for example, injuries caused by intoxication or willful misconduct) can bar or limit benefits—see California Labor Code §3600 for the statutory framework.

Intoxication and willful misconduct: what they mean

Intoxication exclusion. If an employee’s intoxication is the proximate cause of the injury, the employer may attempt to deny benefits. Example: a delivery driver becomes intoxicated during a shift, causes a crash while making deliveries, and the insurer tries to link intoxication to causation. California’s statute expressly recognizes intoxication-based denials in certain circumstances (again, see §3600).

Willful misconduct/illegal act exclusion. Injuries caused by intentional illegal acts are often excluded, especially if the conduct was outside the scope of work. Example: two coworkers engage in mutual combat unrelated to work duties; the insurer may assert willful misconduct and mutual combat to deny benefits.

Burden of proof and evidence standard

Insurers often imply criminal charges automatically disqualify a claim. They do not. The employer/insurer bears the burden to prove an exclusion applies and that the exclusion caused the injury, using the workers’ compensation standard of proof (preponderance of the evidence). Disputes are resolved in the administrative forum and may proceed through the DWC’s dispute process and the WCAB hearing system; see the DWC’s overview of dispute resolution for the process and standards.

Criminal cases vs. workers’ comp cases

Criminal charge and workers comp California are legally distinct. Criminal cases are prosecuted by the state, require proof beyond a reasonable doubt, and can result in fines, probation, or incarceration. Workers’ comp claims are administrative, use a lower evidentiary standard, and focus on whether the injury is compensable and what benefits are owed. An acquittal or conviction in criminal court is relevant evidence but does not automatically decide the workers’ compensation outcome before the WCAB.

Common scenarios: compensability analysis and evidence

Injured at work during fight with coworker

“Injured at work during fight with coworker” covers any physical harm sustained during an on-the-clock altercation between employees, whether mutual combat, self-defense, or trying to break up a fight.

Key factual patterns:

Mutual combat (both instigators): Insurers often assert willful misconduct and mutual combat. Expect a higher risk of denial and a careful causation analysis.
Provoked or attacked (non-aggressor): If you were not the aggressor, the injury is more likely to be found work-related and compensable.
Within scope of job (e.g., security breaking up fights): Injuries sustained while performing job duties—like de-escalation or protection—are more likely compensable.
Self-defense: The proportionality and context of your response matters. Self-defense can support compensability if you were not the aggressor and the conduct did not leave the scope of employment.

Evidence to collect and preserve: Witness names/contact info, employer incident reports, CCTV/body-cam video, time stamps, photographs of injuries, medical records created immediately after the incident, and police reports if law enforcement responded. The DWC’s page for injured workers is a helpful checklist for reporting and documentation, and the WCAB site outlines how disputes are handled if the carrier denies the claim.

Worried about deadlines and claim setup after a workplace altercation injury claim denial? Use our primer on the 90‑day rule and reporting windows.

DUI injured while working

“DUI injured while working” generally describes an employee who was driving for work while intoxicated and got hurt, or someone injured at work whose injury occurred while intoxicated.

Intoxication and causation. Insurers typically try to prove the employee’s intoxication was the proximate cause of the injury using toxicology reports, blood alcohol content, arrest records, and eyewitness accounts. California’s DUI statute, Vehicle Code §23152, defines the offense; but workers’ comp still requires a specific causation analysis under Labor Code §3600. A DUI arrest or conviction is evidence, not an automatic bar.

Common evidence carriers use: toxicology/lab results, arrest reports, dash-cam or GPS data, employer dispatch/trip logs, delivery manifests, and scene photos. The timing of testing relative to the crash can matter in causation arguments.

Job-duty distinctions. If driving is a core duty (e.g., delivery, sales, service calls), carriers will try to link intoxication to the crash as the proximate cause. If the employee was off-duty, on a break, or intoxication was unrelated to the mechanism of injury (e.g., struck by falling materials on-site), the exclusion may not apply. A thorough factual record is essential.

For a broader benefits roadmap during disputes about medical care or wage loss, see our guide to California workers’ compensation benefits.

Injury during illegal activity at work

“Injury during illegal activity at work” refers to injuries sustained while an employee is committing or participating in criminal acts (e.g., theft, assault, illegal drug activity) during work hours or on employer premises.

Legal principles and gray areas. Denials are more likely where the injury directly results from intentional, illegal acts unrelated to the employee’s duties. However, if the activity was minor, coerced, or—critically—if an employer ordered or condoned it, compensability arguments strengthen. Scope-of-employment and the employer’s role are central to the analysis.

Examples:

Injured while stealing merchandise: Expect a willful misconduct defense and closer scrutiny of causation and scope of employment.
Assaulted while obeying an employer’s unlawful directive: Evidence of coercion or direction by the employer can shift the compensability analysis back toward coverage.

Evidence to gather: Police reports, contemporaneous testimony showing coercion or employer involvement, surveillance video, employer emails or directions, and any discipline or HR records connecting the activity to job tasks.

Workplace altercation injury claim denial

“Workplace altercation injury claim denial” describes denials tied to fights or confrontations, often citing mutual combat or intoxication.

Common denial reasons: willful misconduct, mutual combat, intoxication causation, “did not arise out of employment,” or late reporting.

How to challenge a denial in California:

Request a written denial explanation and any evidence relied upon.
File the DWC‑1 claim form if not already filed, and seek treatment.
Open your case at the WCAB by filing an Application for Adjudication of Claim (see the WCAB’s overview at dir.ca.gov/WCAB).
Use DWC forms (e.g., Application for Adjudication, Declaration of Readiness) available on the DWC forms page to request a hearing and move your case forward.

For a structured, plain-English walkthrough of appeals and evidence, use our detailed guide to appealing a denied workers’ comp claim.

Evidence, investigations and employer tactics

Employers and insurers commonly rely on police reports, criminal charges, toxicology, witness statements, and video surveillance to justify denials—understanding their tactics helps you preserve and present counter-evidence.

What insurers collect

Police reports and arrest records (request copies through the relevant agency; many departments provide public record request portals).
Toxicology, blood alcohol content, and chain-of-custody documentation.
Surveillance/CCTV footage and employer incident reports.
Witness statements, prior disciplinary records, and performance write-ups.

How to preserve your evidence

Immediately write down your recollection while it’s fresh (date, time, location, participants, what was said, and actions taken).
Collect full names and contact info of witnesses; ask them to write and sign brief statements if possible.
Take photographs of your injuries and the scene; save messages, emails, and any video.
Ask your employer in writing for the incident report and any video; keep a copy of the request.
Request a copy of the police report when available and keep all medical records, bills, and proof of time off.
Do not delete messages or alter evidence.
File your official claim promptly using the state’s DWC‑1 claim form.

Interviews and questioning

With police or employer investigators, stick to basic facts (who, when, where). Do not speculate, apologize, or accept fault. Say you will provide a full account later or with counsel. If arrested or charged, consult criminal defense counsel before detailed statements; also consult a workers’ comp attorney to protect your benefits. For context on process and benefits during disputes, see our overview of workers’ compensation benefits in California.

Interaction between a criminal charge and your workers’ comp case

A criminal charge can be used as evidence in a workers’ comp case, but it is not dispositive; California law requires a specific factual causation analysis for compensability.

Credibility and timing. A charge or conviction may affect credibility arguments and settlement leverage, but benefit entitlement still depends on work-related causation and statutory exclusions, not on criminal outcomes alone.
Employer defenses. Expect carriers to point to a charge/conviction to argue intoxication or willful misconduct exclusions. The WCAB will examine whether the act fell within or outside scope of employment and whether intoxication, if any, was the proximate cause of injury. See the WCAB’s overview.
Acquittal or dismissed charges. Helpful but not conclusive. Insurers may still contest compensability on other grounds (e.g., late reporting, not in course of employment).
Settlement dynamics. Insurers sometimes lower offers when a criminal charge exists, citing litigation risk. Discuss options with counsel—settlements are negotiated outcomes reflecting risk on both sides. The DWC’s benefits page explains ongoing entitlement during the claim lifecycle (benefits overview).

Curious how long benefits can last if your claim remains accepted? Review our explainer on how long California workers’ comp benefits can run.

Medical care, benefits, and what can be denied

Medical treatment: reasonably required care related to the work injury.

Temporary Total Disability (TTD): wage replacement when you cannot work at all temporarily.

Temporary Partial Disability (TPD): partial wage replacement when you can work some but not all duties/hours.

Permanent Disability (PD): compensation for lasting impairment once you reach maximum medical improvement.

Vocational rehabilitation/job displacement: training or vouchers when you cannot return to your prior role.

Typical dispute patterns. Where criminal allegations exist, carriers often dispute indemnity (TTD/TPD/PD) by arguing an exclusion. Sometimes medical treatment proceeds while indemnity is delayed, but treatment can also be contested via utilization review. See the DWC’s overview of medical treatment and utilization review.

Practical tip: Even if indemnity is denied, seek immediate treatment and document everything—timely medical records powerfully support compensability and often decide close cases.

Fighting a denial—appeals, forms, and timeline

1) File the DWC‑1 promptly. If you haven’t yet, use the official DWC‑1 claim form and keep a copy.

2) Open your case at the WCAB. If any benefit is denied or delayed, file an Application for Adjudication of Claim to open a case number with the WCAB. Learn about the forum and procedures on the WCAB’s site (WCAB overview) and find required forms on the DWC forms page.

3) Exchange evidence and prepare for hearing. Your attorney may notice depositions, submit medical reports and declarations, and issue subpoenas. You may need an Agreed Medical Evaluator (AME) or Panel QME. A status conference or Mandatory Settlement Conference can narrow issues for trial.

4) Appeals and further review. After a trial, the judge issues a Findings and Award or Order. Parties can seek reconsideration at the WCAB and, in limited circumstances, judicial review at the Court of Appeal. Timelines are strict.

Deadlines matter. Missing insurer or WCAB deadlines can severely impact your rights. If you’re unsure of a deadline, consult counsel immediately. For a fast refresher on first steps after injury, read our practical guide on what to do if you’re injured on the job in California.

What to expect at a WCAB hearing

Parties present documentary evidence, medical reports, and testimony. Witnesses (including the employee and employer representatives) may be cross‑examined. Judges typically issue a written decision after taking the matter under submission. If settlement is possible, the judge may help facilitate discussions at a Mandatory Settlement Conference before trial.

Practical tips for employees facing criminal allegations or investigations

Seek immediate medical care and keep copies of all records and bills.
Report the injury to your employer as soon as possible and request the employer’s incident report.
File the DWC‑1 promptly (official form here: DWC‑1 claim form).
Preserve evidence: photos, video, witness info, police reports, and contemporaneous notes.
Do not admit fault or provide detailed statements to police/employer without counsel; politely assert the right to consult an attorney.
If charged, retain criminal defense counsel and a workers’ comp attorney—coordinate communications.
Keep records of missed work, pay stubs, and all insurer/employer communications.

Not sure whether your injury is covered or how benefits are calculated? Our explainer on the California workers’ comp system breaks down core rights and benefits.

When to get an attorney

Consider hiring counsel immediately if any of the following apply:

You were injured at work during a fight with a coworker and the insurer alleges mutual combat or willful misconduct.
You were DUI injured while working and the carrier points to intoxication as the sole cause.
You received a workplace altercation injury claim denial, or benefits were delayed or terminated.
Police or employer investigators are asking for detailed statements.

For a detailed appeal roadmap after a denial, see our guide to appealing denied workers’ comp benefits.

Phrases to avoid (“Do not say”)

“It was my fault” (workers’ comp is largely no‑fault; fault admissions are unnecessary and may complicate causation).
“I don’t need medical care” (always get evaluated; early records are critical evidence).
“I was drunk/high, so I know I can’t get benefits” (exclusions require proof of proximate cause under §3600 and are not automatic).

Sample mini case studies

Case A — Breaking up a coworker fight

Facts: A warehouse worker hears shouting, steps in to break up a fight near a loading dock, and is struck hard, suffering a shoulder injury.

Legal analysis: The conduct is within the scope of employment if de‑escalation and safety are part of the employee’s duties or reasonably incidental to the job. Likely compensable absent evidence of willful misconduct.

Evidence that helps the employee: CCTV footage, multiple witness statements, supervisor incident notes, medical records created immediately after the incident.

Typical insurer arguments: “Voluntary engagement in combat,” mutual combat, or willful misconduct. A detailed factual record usually undercuts these defenses.

More context on how altercations affect benefits appears in our overview of workers’ compensation benefits.

Case B — Delivery driver arrested for DUI causing an on‑the‑job crash

Facts: A route driver rear‑ends another vehicle. Police arrest the driver for DUI after a roadside test. The driver is injured and later files a comp claim.

Legal analysis: The carrier relies on Vehicle Code §23152 (DUI) and asserts the intoxication exclusion under Labor Code §3600. The determinative question is whether intoxication was the proximate cause of the injury, supported by reliable toxicology and timing evidence.

Evidence that helps the employee: Employer dispatch logs and telematics showing the route assignment, chain‑of‑custody for blood draws, expert toxicology analysis regarding timing, and independent eyewitness accounts about road conditions and braking.

Typical insurer arguments: Intoxication was the proximate cause; benefits excluded under §3600. The defense still must meet its burden with credible, properly handled evidence.

Case C — Employee injured while committing theft on premises

Facts: An employee is injured after climbing a stockroom shelf to remove items not purchased.

Legal analysis: The carrier asserts willful misconduct and illegal activity exclusions. If evidence shows the injury directly resulted from theft unrelated to job duties, denial is more likely.

Evidence that helps the employee: Proof of coercion or employer instruction, lack of intent, or video that contradicts the willful misconduct narrative.

Typical insurer arguments: Injury arose out of willful misconduct/illegal acts; not within scope of employment; deny benefits.

Resources and next steps

For a start‑to‑finish overview of claims, see our California guide to applying for workers’ comp benefits.

Conclusion

Criminal charge and workers comp California are related but legally distinct: allegations alone rarely end benefits. WCAB judges analyze whether the injury arose out of and in the course of employment and whether a statutory exclusion applies. Act quickly—get medical care, file the DWC‑1, preserve evidence, and consider experienced counsel if a denial or investigation is underway, especially if you were injured at work during fight with coworker or accused of DUI injured while working.

Need help now? Get a free and instant case evaluation by Visionary Law Group. See if your case qualifies within 30-seconds at https://eval.visionarylawgroup.com/work-comp.

FAQ

If I’m criminally charged, will workers’ comp be denied?

Not automatically. California focuses on whether the injury arose out of and in the course of employment and whether a statutory exclusion applies (see Labor Code §3600). File your DWC‑1 and consider counsel if the insurer raises exclusions.

Can an arrest or conviction be used against my claim?

Yes—as evidence—but it is not dispositive. Criminal findings are separate from workers’ comp adjudications before the WCAB, and the carrier still must prove any exclusion by a preponderance of evidence.

What if I was defending myself in a fight?

Self-defense can support compensability. Collect witness statements, any video, incident reports, and immediate medical records to show you were not the aggressor and that your actions remained within the scope of employment.

Can I get medical treatment while my claim is contested?

Often yes—medical treatment may be authorized even during disputes. File a DWC‑1, seek care, and document everything. See the DWC’s medical treatment guidance on utilization review and treatment authorization.

What if my altercation claim was denied?

Request the denial in writing, gather evidence, and open your case at the WCAB with an Application for Adjudication. Then request a conference or hearing using the forms on the DWC forms page. Our step‑by‑step appeal guide explains each stage of the process to overturn a denied workers’ comp claim.

Criminal Charge and Workers Comp California: How Allegations Affect Your Claim