Find out how your work-related injury can qualify for workers’ compensation benefits even when you’re off-the-clock.
The whole idea behind workers’ compensation is pretty simple. Employees injured on the job are entitled to compensation for their medical bills, medications, out-of-pocket expenses, and part of their lost wages.
The fight starts when an injured worker is denied coverage by the employer or the workers’ comp insurance company on the basis that the injury didn’t happen during business hours, or within the scope of the worker’s job duties.
The Department of Labor definition of being on the job is “portal to portal” meaning when the employee arrives at work and leaves each day, but that definition is subject to interpretation.
Standard Eligibility for Workers’ Compensation
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 workday 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 raised when injuries occur during the commute to or from work, in parking lots, or at non-scheduled work activities.
Workers are Covered While Performing Assigned Duties
Most states follow the “while in the course of employment” rule. The rule states that regardless of an employee’s physical location or the time of day the person is injured, if performing assigned job duties, the injury is considered a workplace accident and is covered by workers’ compensation.
While this rule seems clear, it remains the subject of thousands of legal disputes each year.
Workers Usually Aren’t Covered While Commuting
Most states exclude injuries when a worker is traveling between home and work. This is often called 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 employee leaves at the end of his workday, but there are exceptions.
Worker’s Comp Off-the-Clock Exceptions
Traveling for Duties that Benefit the Employer
A worker may be eligible for workers’ comp if they are injured commuting to or from work when they are required to be away from their regular workplace or home to perform work duties that directly benefit the 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 to her temporary home, she was covered by workers’ compensation. She was injured while performing duties that directly benefited her employer.
Employees on Special Missions
A worker may be eligible for workers’ compensation if the injury occurs while commuting to or from work when the employee interrupts their normal route to conduct a work task or special mission required by the 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 courthouse 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 courthouse 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 a work-related accident covered by workers’ compensation.
Workplace Sidewalks and Parking Lots
In most cases, workers’ compensation coverage begins when an employee starts the workday by stepping onto the employer’s premises or an area controlled by the employer. It ends when a worker steps off the employer’s premises or an area controlled by the 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 at 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 hit 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 walk through the parking lot to get to his car, so it’s 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.)
Job Duties 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 always to 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 take her eyes off the road momentarily. She crashed and was seriously injured.
Even though Raquel was partially to blame for using her cell phone while driving, she was still discharging her work duties while in the scope of her employment. This qualifies as a work-related injury and is covered by workers’ comp.
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 co-workers, 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 co-workers. 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 the 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-related injury and makes Steven eligible to receive workers’ compensation benefits.
Workers’ Compensation for Occupational Illness
If you’re suffering from a chronic illness caused by exposure to environmental toxins or substances on the job, you deserve to receive workers’ compensation medical benefits and wage replacement payments.
Well-known examples of occupational illnesses are black lung disease affecting coal miners, carpal tunnel syndrome from repeated motions like typing, and mesothelioma caused by asbestos exposure in some industries.
Occupational exposure to unhealthy environments can affect almost any body system from hearing loss to skin conditions to infertility. Before you are approved for compensation, you’ll have to prove your condition is related to your employment.
Unfortunately, even if you’re suffering from a condition known to be common to employees in your line of work, you may not get all the benefits you deserve without the help of an experienced personal injury attorney.
Work-Related Mental Health Issues
Generally, to qualify for workers’ compensation the injury or illness must be directly caused by the day-to-day activities of your employment. It’s easier to relate physical injuries to your job duties, like a back injury from lifting, or carpal tunnel syndrome from daily typing.
Disabling mental health issues like anxiety, depression, and PTSD may be covered by your state’s workers’ compensation rules, but you’ll have to prove the condition was caused by work factors, rather than personal ones.
If your mental health issues existed prior to your employment, you’d have to show that your work environment aggravated a previously stable condition.
Proving that your mental health issues are directly caused by your employment will be challenging. You’ll need detailed psychiatric documentation and the expertise of a good personal injury attorney.
Don’t Take “No” for an Answer
Many employers and their workers’ comp insurance companies will deny legitimate workers’ comp 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 you’re denied workers’ compensation for a severe work-related injury or illness, don’t take “No” for an answer. It won’t cost anything to discuss your case with a personal injury attorney experienced in handling workers’ compensation cases like yours.
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