Which party bears the burden of proof to demonstrate that a workers’ compensation claim is legitimate?

• A. The employer
• B. The injured employee
• C. The insurance company
• D. The WCAB

Answer: (B)

In a workers' compensation claim, the burden of proof rests with the injured employee to demonstrate that their claim is legitimate. This means that the employee must provide evidence showing that an injury occurred in the course and scope of their employment, and that the injury directly resulted from work-related activities.

The rationale behind this requirement is that the workers' compensation system is designed to provide benefits to employees who are genuinely injured while performing their job duties. By placing the burden of proof on the employee, it encourages accountability and ensures that claims are substantiated by credible evidence, such as medical records, witness statements, or other relevant documentation.

While the employer and the insurance company play significant roles in the overall claims process—in evaluating the claim, providing defenses, and making payouts—the primary responsibility for proving the legitimacy of the claim lies with the employee. This establishes a clear expectation that only valid claims receive benefits, thus maintaining the integrity of the workers' compensation system.