How to Tell When Injuries Occurring Offsite are Compensable Under Workers Comp

Please note that this will vary wildly with the jurisdiction and legal counsel should always be consulted before making a decision to accept or deny these claims.Below are a few examples and the questions that arise during the investigation of these claims.

The biggest and probably most important question is whether these employees are actually at these outings as a required part of employment as opposed to voluntarily attending these outings. Again, the biggest issue will be why this employee was attending in the first place.

1. Is this a required part of the job duties?
2. Did a manager tell an employee to attend this outing?
3. Is the entertaining of clients a listed duty in the job description?
4. If so, how does the event and injury fall within the scope of the employment?

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If the job is in marketing, and the employee is always out of the office on the road, it is a fairly easy decision. For instance, if the employee has an auto accident or fall (not due to intoxication of course!), being on the road could be stated as a job duty.

Again, circumstances vary and job duties become muddled when these outside-the-office injuries occur. Therefore, the first thing an employer needs to do is to state in the employee’s job description that outside client entertainment is indeed a part of the job duties. Consult the legal counsel on how this should be worded, what types of entertainment should be included, and what activities should be excluded.

Injuries During Golf Outings

Many companies entertain clients at golf outings since these outings can entertain many clients at once. And since golf is a popular sport enjoyed by many individuals, golf outings pop up on the social calendar this time of year But what happens if an employee is struck by an errant chip shot and sustains a head injury? Is this a covered injury?

The answer is determined by the employee’s job classification. Was the employee required to be there as part of the job? Certainly the company sponsoring the outings has to have employees there representing the company. But did the employee decide to govoluntarily, or did upper management require it? That decision alone will hold a lot of weight on the compensability of the claim. Obviously if a manager comes to an employee and says that the golf outing is mandatory, it becomes a fairly simple decision as attendance becomes part of the job duties for that day.

But what about other employees attending the event? Was there just a general sign-up sheet for people to attend this outing? If this is the case, then it could be viewed as voluntary without workers comp coverage for an injury. Again this varies by state, so be sure to consult counsel on the best way to approach employee attendance at these outings. If all else fails, maybe have the employees attending voluntarily sign a hold-harmless agreement then any injuries that occur are not the responsibility of the company.

Travel to Seminars and Conferences

Similar to the golf example, the main issue is why the employee attends and is it part of the stated job duties. Or did a manager directly order the attendance and participation as a job duty?

This statement will be key again. Should an injury occur as part of travel to said conference or seminar, this could be considered an injury within the course and scope of the employment. A hold-harmless agreement could again be used stating the employee is attending voluntarily, and any injuries or issues that occur are the employee’s responsibility. Again, application of certain workers comp statutes will vary per the jurisdiction. In any event, it should be made clear that all injuries that could occur, if any, should be reported to HR or a manager immediately to establish a paper trail.

Also important is where the injury occurred. Was it part of the travel plan and a direct route to the conference? Or did the accident occur off-course, and if so why was the employee off-track? Did the employee detour to visit a family member or friend? Or meet up with another employee to carpool to this even when the accident occurred? All of these questions will hold equal importance and need to be thoroughly investigated upon deciding the compensability on the claim.

After-hours Dinners, Professional Sporting Events, and Happy Hour Entertainment

Lastly, attendance with client at dinners, baseball games, NFL games, etc. need to be broken down to the reason for the employee to be in attendance and where the injury occurred. No matter what the event, should an incident occur that results in an injury, it needs to be reported right away and an adjuster needs to be on the file as soon as possible. The employer is responsible for giving the reason the employee attended, how it does or does not relate to the exact job duties. Was the employee told by a manager to attend? If so, a written statement should be obtained by that manager stating all information possible that can be helpful to the claim.

Summary

Warm weather typically means increased activity with events that fall outside of the walls of the employers work site. Injuries can occur and it is the responsibility of the employer to provide the carrier with all information requested as part of the investigation to decide if the injury is compensable or not. Consult counsel on questions before the event to be protected should an injury occur.

Please consult our Are All Injuries Compensable? resource article in our WC 101 Guide for more information

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.