Are Employees Hurt at Home Eligible for Workers’ Compensation Benefits?

Are Employees Hurt at Home Eligible for Workers’ Compensation Benefits?

Home-based workers hurt at home may be eligible for workers’ comp if the injury is proved through a medical records review.

Claims could be denied too.

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Workers’ compensation insurance paid to workers injured on the job may be available for homebased workers too. Paid on the basis of a medical record analysis, these benefits are a lifeline for injured workers. Though all home-based employees may not be eligible for the benefits, and benefits can be difficult to get, there are certain occasions that may qualify a worker for workers’ compensation.

If the employer forced the employee to work from home, and the employee gets injured in the course of her job, she may be found eligible. A classic example is that of a person being asked to work from home because the company has been downsized for some reason and there is a shortage of room to accommodate staff. The employee may get hurt, such as through a trip and fall accident while carrying out her official duties. If this can be proved preferably using a video recording, the employee could secure benefits. However, it could be much more difficult than when working in the office.

Unfortunately, claim denials are a reality, even if similar cases exist that have been approved in the past. Let us consider a recent Florida state appeals court decision that a woman employee working from home is not eligible for workers’ compensation benefits. A Judge of Compensation claims had earlier ruled that the woman was entitled to benefits after she tripped over her dog while reaching for a coffee cup in her kitchen.

The accident happened in April 2016 when the woman worked as claims adjuster for a company that managed workers compensation claims. She worked from home and suffered knee, hip, and shoulder injuries in the fall. She filed a workers’ compensation claim but her employer denied it.

They argued the injuries were not work-related, but the Judge of Compensation disagreed with the employer and ruled in favor of the employee. Following this, the company took the case to the state’s 1st District Court of Appeal.

The full Appeals Court ruled 12-2 that the claim be rejected. The grounds for rejection were that the risk of the claimant tripping over her dog while reaching for a coffee cup existed whether the employee was at home working or whether she was at home not working. The risk existed before she took up the job and will exist after her employment ends, as long as she has a dog. The risk didn’t arise out of her employment.

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The dissenting judges said that the majority ruling reversed “decades of precedent regarding the compensability of workplace injuries under Florida’s workers compensation law.” They held the view that the claimant was injured in a trip and fall during work hours in her workplace (in this case her home), when she fell over personal property (her dog) while attending to her personal comfort.

The majority opinion said that though this particular claim was denied, work-at-home arrangements doesn’t immunize employers from workers’ compensation claims. They said that just as accidents on employer premises are compensable, work-at-home accidents can also be compensable. They clarified that the claimant would have had a feasible case if she had suffered an injury from a work-related risk such as a repetitive stress injury from typing all day, then the employer cannot argue that she was hurt in her own home and isn’t eligible for workers’ compensation benefits.

What bothered the dissenting judges was that the ruling could have broader implications for workers injured while on the job, including those who slip and fall or trip over personal belongings and get injured. They also drew attention to the employer in this case and others like them allowing employees to take “personal comfort breaks” such as getting cups of coffee. The claimant was on an authorized personal comfort break in a location in her home where a break was allowable and was engaging in a permissible activity (making a beverage) when the accident occurred. Such an accident and injury are generally compensable under the personal comfort rule.

Evidence regarding how the injury occurred is important in cases such as the above. Employees and employers could ideally arrange for video equipment that can monitor the worker performing his/her duties from their home. This is valuable in case an accident or injury occurs.

Legal advice is valuable in these types of cases. A good lawyer will put forth a reasonable argument and also present all medical evidence extracted via a detailed medical chart review to demonstrate the claimant’s eligibility.

www.mosmedicalrecordreview.com

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