Under normal circumstances, if you’re injured at work, workers’ compensation insurance will cover your medical bills, medications, transportation costs, and other reasonable out-of-pocket expenses. It should also cover about two-thirds of your lost wages. You may even get a lump sum settlement if you become disabled. In case of death, the benefits go to your surviving dependents.
When Employer Liabilty Begins and Ends
To be eligible for workers’ comp insurance benefits, a worker must be injured while “within the scope of their employment,” also referred to as “on the job,” or “on the clock.” So what does this include?
Defining the beginning and end of the work day is crucial in a workers’ comp claim. On-the-job activity can overlap with personal activities, making the lines hard to determine. Questions of liability are often raised when injuries occur during the commute to or from work, in parking lots, or at non-scheduled work activities.
Most states follow the “while in the course of employment” rule. The rule basically states that regardless of an employee’s physical location or the time of day she’s injured, if performing assigned job duties, the injury is considered a work place accident and is covered by workers’ compensation. While this rule seems clear, it remains the subject of thousands of legal disputes each year.
What’s Not Covered
Most states exclude injuries when a worker is traveling between home and work. This is often referred to as the “going or coming” rule, or as the U.S. Department of Labor calls it, the “portal to portal” rule. Under the portal to portal rule, workers’ comp coverage doesn’t begin until the employee arrives at his workplace. It ends when the he leaves at the end of his work day; but there are numerous exceptions.
Exceptions to the Portal to Portal Rule
1. Benefit to the Employer
A worker may be covered if he is injured commuting to or from work, when he is required to be away from his workplace or home to perform work duties that directly benefit his employer.
Example: Car Accident After Client Dinner
Adrian is a salesperson for a national corporation. Her primary job entails traveling to various states in her region to support customer relations. She usually flies into each city, checks into a hotel, and rents a car to travel back and forth to customers’ businesses.
One evening after dining with a client, Adrian was driving back to her hotel when a car ran a red light and crashed into her rental car. She was seriously injured in the accident. Although Adrian was commuting back and forth to her temporary home, she was covered by workers’ compensation. She was injured while performing duties that directly benefited her employer.
There is an exception to this exception. If Adrian had been arrested and convicted of driving while intoxicated, she would not be covered. Workers’ compensation does not extend to workers who are injured while committing a crime, and a conviction for DUI is a crime. In most cases this would be true whether the employee’s impaired state contributed to the accident or not.
2. Special Missions
A worker may be covered if he is injured commuting to or from work, when he interrupts his normal route to conduct a work task or special mission required by his employer.
Example: Slip and Fall While Running an Errand
Jodi works at a law firm. Her normal lunch hour is from noon to 1:00 p.m. Her employer asked if she would stop by the court house on her way back from lunch to file some legal documents with the court clerk. Jodi agreed. She stopped at the courthouse at 12:45 p.m. on her way back from lunch. While walking up the courthouse steps, Jodi slipped and fell, breaking her arm.
Even though Jodi was on her lunch hour, the detour to the court house was a “special mission” for her employer. From the moment Jodi pointed her car to the courthouse, through the time she returned to the law firm’s offices, she was within the scope of her employment. Jodi’s injury on the courthouse steps is considered to be a work place accident and is therefore covered by workers’ compensation.
3. Sidewalks and Parking Lots
In most cases, workers’ compensation coverage begins when an employee starts his workday by stepping onto his employer’s premises or an area controlled by his employer. It ends when a worker steps off his employer’s premises or an area controlled by his employer.
The term “controlled by” refers to property an employer either owns outright, pays a mortgage on, pays property taxes on, pays a third party (like landscapers) to maintain, or is designated as a common area for which the employer contributes rent along with other tenants.
An area controlled by an employer is considered an extension of the worker’s actual workplace. Examples of areas controlled by employers include sidewalks, grassy areas, parking lots, and any other property a worker traverses on his way to and from his actual workplace.
Example: Hit in a Parking Lot
Charlie is a cashier in a large grocery store. Management requires employees to park their cars at the rear of the parking lot so shoppers can use the main area in front of the store. One evening, as he crossed the store’s lot to leave work, Charlie was struck by a car backing out of its parking space. He was seriously injured.
Even though Charlie had punched out and left the grocery store, he’s covered by workers’ comp because the parking lot is under his employer’s control. His employer knew that Charlie had to traverse the parking lot to get to his car, and it is an “extension” of the grocery store.
Charlie also has a valid third-party claim against the driver of the car. He can sue the negligent driver for his injuries and resulting damages, including pain and suffering. (Workers’ comp doesn’t cover pain and suffering.)
4. Outside of Regular Business Hours
When a worker’s duties include a responsibility that falls outside of regular business hours, and the worker is injured while performing that duty, workers compensation normally covers injuries sustained during that time.
Example: Car Crash While Speaking with a Patient
Raquel is a nurse who works for a doctor’s private medical practice. Her employer wants someone to always be available to his patients, so business calls are forwarded to Raquel’s cell phone after the office closes.
Raquel was driving home one evening when her cell phone rang. It was one of the doctor’s patients. As she began to speak with the patient, Raquel dropped the phone, which caused her to momentarily take her eyes off the road. She crashed and was seriously injured.
Even though Raquel was negligent, she was still discharging her work duties while in the scope of her employment. This qualifies as a work place accident and is covered by workers’ comp. The same principle extends to business professionals who talk with clients on their cell phones while driving to and from work (if speaking with clients is part of their work duties).
5. After-Hours Visits to the Workplace
One of the more controversial coverage issues involves employees who aren’t scheduled to work, but come to the workplace to visit with coworkers or for other personal matters. In most cases, employees who aren’t scheduled to work are not covered by workers’ compensation if injured on work premises.
On the other hand, if the employer is aware that unscheduled workers come to the workplace to visit with coworkers, and the employer tacitly consents to the visits by not objecting, workers’ comp may be forced to provide coverage when a non-scheduled employee is injured on the premises.
Example: Basketball During Lunch Break
Steven works at a warehouse and is friends with several coworkers. They are on a company-sponsored basketball team and play against other local businesses’ employee basketball teams. Most days the workers practice during their lunch break on a basketball court their employer set up in a corner of the warehouse.
Steven wasn’t scheduled to work one day, but he wanted to practice for an upcoming game. Steven’s employer knew non-scheduled workers would come in some days to practice. Steven came and was injured during the practice game.
Although it was lunch hour, the accident happened on a court provided for employee recreation during their break. The employer knew his employees frequently came to the workplace on their days off to practice, and he never objected. His failure to object to Steven’s off-hours presence effectively validates it as a work place accident and makes Steven eligible to receive workers’ compensation benefits.
Workers’ Comp Attorneys
Many employers and their workers’ comp insurance companies will deny legitimate claims. They’ll say an injury isn’t work related because it happened off the employer’s property, while the worker was on break, or because the worker wasn’t acting within the scope of his employment.
If your work injury claim is denied based on these issues, you may want to consider speaking with an attorney with experience in work place accident claims. This is especially true if your injury falls within one of the exceptions listed above. Most workers’ comp attorneys do not charge for initial office consultations. They only receive a fee if they succeed in winning you a settlement or a court award.
Auto Mechanic Injured While Not on Shift
Do workers comp benefits still apply if an employee is covering another worker’s shift? What about if the employee is volunteering their time? These are some of the legal issues addressed in this case study.
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Visitor Questions on Issues with Work Injury Claims
Is my employer liable for my medical bills and time off after multiple on-the-job injuries? I sprained my ankle and tore ligaments while I was working. My supervisor took me to the emergency room and paid the bill. One week later, I was doing light office work and injured it again while at work. Two weeks later, while walking to my truck after clocking out but still on my employers... Read More >>
Injured leaving rented office space… I work at an office space rented by my employer. I was leaving the building coming down the elevator and stepped out on to a tile floor that had been recently wet mopped as well as the elevator. I slipped and fell on the wet tile. There were no signs alerting people to wet floors.... Read More >>
Can I file a workers’ comp claim if I was injured at a conference? I was traveling for 3 days to Tupelo, MS from South MS to attend a work conference. On Tuesday 4/5/17, after the conference, the convention hosted an after hours social for a couple of hours then everyone went out to eat. I was riding with another attendee of the conference. I got out at my... Read More >>
Liability for getting injured working in an RV park after hours? This last weekend a friend of mine was injured by falling off a ladder in an RV park. He has 2 compression fractures in his back and a mild concussion. He fell off the ladder while he was working off the clock in a secure stable work location that was locked. He had only been... Read More >>
Slipped on ice on way to restaurant… I had arrived at work, but left the office to go to the restaurant next door to buy breakfast. I slipped on ice and injured my shoulder in the parking lot. I went to the hospital and received treatment. I was unable to work the rest of the day and part of the following day.... Read More >>
Injured on the way out of the building after being terminated… I was cleaning my desk out after being terminated, and when leaving the office I was carrying a paper box with items from my desk. I went down the stairs because the elevator is very slow and I was embarrassed and didn’t want to interact with my previous coworkers. I tripped on the third step... Read More >>
Can I sue for personal injury damages walking in to work? There was a huge crack and heave in the cement sidewalk immediately in front of the entrance to work. It ran the entire length of the entranceway and was there for 6 – 8 weeks. There was a 3″ elevation and heave that was tripped over by many, but I was the one who actually... Read More >>
Fell on ice in a client’s driveway and injured before I clocked in? I work for a Home Health Agency agency, for which I go to clients’ homes and provide care. I go to several clients per day. I arrived at my first location and when I stepped out of my car I fell on ice at the client’s home (in their driveway). I had not clocked in... Read More >>
Is my employer liable if I’m injured while at lunch, but still on the clock? I do not have to punch in and out for lunch, but I do not get paid for lunch. I left during my lunch break to get something for lunch when I was injured. I slipped and fell as I was getting out of my car at a Subway, which is across the street. I... Read More >>
Facial damage from walking into a glass door at my workplace… I walked into a glass door entering the store where I work and suffered facial damage. The company is planning to controvert it because they rent the space from another store. (My company rents space for a small boutique located inside a different company’s store.) Would it be considered “on the property” if the accident... Read More >>
Accident while manager forced me to work after clocking out… After a full day shift I clocked out, but then my General Manager at the airport told me to unload all of the bags off the aircraft and take the bags to the baggage claim. I advised her that my shift was over a half hour ago, and that I was clocked out, and that... Read More >>
Liability for off the clock auto injury on employment premises? Me and my friend had finished our shift and clocked out for the night. When I got in my car to leave work I discovered my battery was dead. I asked my friend if he could help me jump my car. While in the process, I had the car in gear and when the car... Read More >>
Fell over a wheel stop after I was clocked out… I work swing shifts as a paramedic. While I was off there was some construction done on the inside of the building. There was a concrete wheel stop that was moved from the inside of the building to the outside. This wheel stop was not painted nor did it have any distinctive markings. There were... Read More >>
Does work insurance cover injuries outside of work? I was jogging at a park when I fainted and needed medical attention. My question is, will/should my work insurance cover the costs of my medical bills? Additional information: my job title is computer technician. It’s indoor work. In the past 5 years “other duties assigned” include outside physical duties which I have expressed concern... Read More >>
No benefits if injured on work premises before shift started? I work for a park reserve in Illinois. We sleep on the premises sometimes. I chose to sleep there this night as the job was to clear snow with snow plows. I wanted to make sure at least I was able to get out and plow when my shift started. There has never been a... Read More >>
Fractured wrist from fall on sidewalk while leaving work… As I was leaving work I tripped/stumbled on an area of the sidewalk that was higher than the surrounding areas and that had a wide expansion joint. I fractured my wrist from the fall, resulting in surgery and 4 months out of work. The workers comp insurer would not pay claim stating that the sidewalk... Read More >>
Who is liable for fall in a parking lot at work? Last night while walking to my car from work at the hospital I fell and hurt myself quite severely. I had a similar injury about three or four years ago. The first time, I reported it to the hospital administration and they said it was a workers comp issue and sent me to occupational health... Read More >>
Tripped Over a Parking Stop While Leaving Work… I was leaving work at a large national chain retail electronics store, and while I was walking out I tripped over a parking stop that was not painted. I have lost money from my job due to this injury. I am currently on workers compensation but I have also lost a lot of income because... Read More >>
Slip and Fall in Parking Lot at Work… I was walking on the pedestrian side of the handicapped parking lot at my work when I slipped and fell and landed on my left shoulder and hip. It’s been more than 5 days now and I haven’t seen by doctor due to worker’s compensation insurance taking so time. Meanwhile my hip has been bothering... Read More >>
Can I file a workers comp claim if I already clocked out for the day? I worked my shift and had already clocked out. After clocking out I was walking out of the building and tripped and fell in the parking lot, fracturing my ankle. My question is: Can I file a workers compensation claim if I had already clocked out of work? Thanks. Read More >>