Workers’ compensation seems pretty simple on the surface: an employer pays for workers’ compensation to cover its employees’ work-related injuries, regardless of who was at fault. In return for this coverage, the employee is not permitted to sue the employer to pay for the injury. Instead, the employee makes a claim through the employer’s workers’ compensation insurance and is paid for his or her medical bills.
Unfortunately, it’s not that simple at all. Read on to learn the rules applied to determine whether or not an injury is covered by workers’ compensation.
The Work-related Rule
In order for an injury to be covered by workers’ compensation, several criteria have to be met. One of these is that the injury be work-related. That means that the employee was injured in the course of his or her employment (while the employee was performing the duties of his or her job).
If a construction worker drops a hammer on his foot while working at a construction site, this is a fairly clear-cut case of a work-related injury. If the same construction worker drops a hammer on his foot while hanging up a picture frame at home, he cannot make a workers’ compensation claim.
In many other cases, however, determining whether an injury was “work-related” can be tricky. Often, it is up to the court—making a decision based on the arguments of the attorneys involved—to decide whether an injury counts as work-related.
Take the example of an employee who gets into a car accident while on his or her way to work. You might think that any injuries sustained in the car accident are work-related (after all, the injured person was driving to work); however, in Ohio, accidents to and from work are not often covered by workers’ compensation. This is called the “going or coming” rule, which states that workers’ compensation doesn’t apply until the employee arrives at his or her workplace. Still, there are some exceptions to this rule. If the employee was injured in a car accident while traveling on a business trip, he or she would be covered. If an employee is injured while running an errand for his or her employer, he or she may be covered.
Another common injury is one that occurs while on the employee’s lunch break. Say that an employee trips and breaks an ankle while walking to a nearby restaurant for lunch. This injury wouldn’t be covered by workers’ compensation. However, if the employee had been walking to the restaurant to pick up lunch for everyone in the office, he or she might be covered. Similarly, if the employee sprains an ankle while in the employee cafeteria located on company premises, it’s possible that the injury will be covered.
Other potentially work-related injuries include those sustained while at a company picnic, retreat, or even a team-building softball tournament.
The On the Clock Rule
Another criterion that is important to workers’ compensation claims is whether the employee was “on the clock.”
Like the work-related requirement, the on-the-clock rule is not always straightforward. It does not mean that injuries are covered only if they happened during business hours or a scheduled shift. If an employee visits the office after business hours and injures himself, he would not be covered. However, if his boss knew of and approved the visit, the employee may have a claim. Further, in the examples given above, the employees that were traveling for work or getting lunch for the office were not “on the clock” in the traditional sense, but their actions were still done in the course of their employment—making it possible that their injuries would be covered by workers’ compensation.
If all this seems confusing, we understand. It can be extremely difficult—particularly when you are injured—to navigate the maze of rules, regulations, and exceptions involved in workers’ compensation law.
If you have been injured on the job, we strongly recommend contacting an attorney for advice. A good workers’ compensation attorney will determine if you have a claim, explain the process, and walk you through the steps. Having an attorney will also make it more likely that your claim is accepted and that your settlement is fair.
The attorneys at Casper & Casper have years of experience handling every aspect of workers’ compensation claims. Our attorneys are caring, dedicated professionals who will work with you beginning to end, from compiling your medical records to representing you at your workers’ compensation hearing. We want you to get the compensation you need and deserve.
Let us take care of your claim so that you can focus on getting better. Call us today at 1-800-784-2889 for a free consultation.