Workers’ compensation is a complicated process, even when the injury and claim seem pretty basic. It gets even more complicated when we enter certain “gray areas” in the workers’ compensation process. Today, we’re going to take a closer look at some of these gray areas and explain how they may affect your claim eligibility.
The “At Work” Gray Areas
One of the most common gray areas that clients run into when they are in the process of seeking a work comp claim for their injury is whether or not they were injured “on the job” or “while at work.” You might be thinking, “Shouldn’t it be easy to determine if I was on the job at the time of the injury?” Well what if you are injured on your lunch break, on your paid break, at a company picnic or while commuting to your job? These are all gray areas, and we’ll dive a little deeper into each of them.
- Lunch Break – Generally, injuries that occur when punched out on your lunch break are not compensable. If you tripped on the sidewalk and broke your leg when walking over to Subway for lunch, you’re not going to be covered, even if you’re also picking up a sub for a couple of coworkers. That being said, if picking up food for employees or your boss is part of your regular duties, you may have a valid claim.
- Breaks – Many companies offer employees a shorter, paid 10-15 minute break during their shift. If you walk into the break room and slip on a patch of water and injure your back, you probably have a valid claim even though you were on your break at the time of injury. However, this can get even grayer if you leave company property during this short break.
- Company Christmas Party – It doesn’t matter whether it’s the company Christmas party or the Quarter Two Company Picnic, if you are expected to attend these events, you would likely be able to receive compensation for any injuries that occur that these places. Even if the party happens after business hours (i.e. you’re off the clock and not getting paid), you can still seek an injury claim in most cases.
- The Parking Lot – The company has a duty to keep its workers safe on their property even if they aren’t technically on the clock. If you slip on ice outside work or on a puddle of melted snow in the lobby, you will likely have a valid claim.
What About Your Commute?
The commute is another gray area when it comes to workers’ compensation. Unfortunately, most injuries that occur during a commute are non-compensable. Even though you are on your way to or from work, you are not technically an employee at this time. Although you may not like this, the line of logic makes sense, because if insurance companies paid employees for injuries during the process of getting to or leaving work, where would it all end? Could you argue that the burn from the curling iron or from slipping in the shower was technically a work injury, since you were getting ready for the job when it happened? This is the major reason why injuries during a commute to or from work are not compensable.
However, like in most cases, there are exceptions. An injured worker in California was awarded benefits after he got in a car accident while commuting to work outside of his normal hours to cover another employee’s shift, although that case was later overturned in the appeal’s court. The point is that there are extenuating circumstances in some commutes that may make you eligible for a claim. Were you on call? Were you getting paid during your commute? Were you in a company vehicle at the time, or driving to visit a potential client? None of those exceptions guarantee that you’ll be entitled to a claim, but a good workers’ compensation attorney can help build your case.
That last sentence is the take home point. Gray areas can be difficult to navigate in the workers’ compensation process, so let an experienced work comp lawyer make your case for you. They’ll know how to best present your claim and challenge any issues the insurance company may have. Call us today if you have any questions or want help with your work comp claim.
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