Workers' compensation only caters to the financial needs of those that have incurred a workplace injury. The injured worker must ensure that their damages were incurred in their work and not in other activities unrelated to their job. It is the only way their compensation claim could be a success. However, there is a lot of confusion on exactly what a workplace injury entails. An injury at a workplace party would be considered for compensation but may not be covered under this insurance scheme if incurred while commuting to work.
If you or your loved one has incurred a workplace injury in Los Angeles, CA, and are not sure whether or not it is covered under the workers’ compensation, talk to an experienced workers’ compensation lawyer. You may need to understand the going and coming rule and how it might affect your situation. At The Workers Compensation Lawyer Law Firm, our team of competent lawyers will aggressively work on your case to ensure that you receive the compensation you deserve.
Understanding How Workers’ Compensation Works
Workers’ compensation is a crucial insurance scheme for workers and their employers. Work-related injuries are prevalent in all working environments, including offices, factories, and construction sites. An injury at work could result in significant financial losses for you and your employer, hence the need for insurance coverage.
Employers miss out on work for prolonged periods to recover from their injuries. Employers face the risk of lawsuits, which can be very expensive. But this insurance scheme ensures that injured workers receive monthly payments to cater to their medical needs and other costs resulting from the workplace injury. Injured workers receive adequate compensation in exchange for filing lawsuits against their employers. Therefore, the scheme also protects employers.
Workers’ compensation offers monetary benefits for all damages a worker might have incurred after a workplace accident. These benefits will include medical, disability, missed wage replacement, and death benefits. Those that qualify for workers’ compensation do not have to pay for their damages out of pocket or seek compensation from their employer through civil lawsuits. Once the worker recovers fully, they can go back to work. Workers' compensation benefits are not long-term, unless in specific cases where the injured worker needs long-term medical treatment for their injury. In that case, the worker must return to work as soon as they recover to continue earning a living.
However, the workers’ compensation scheme does not cover all injuries incurred by employees. Your injuries must be work-related. The plan mainly covers two types of workplace injuries:
- Single-event injuries
- Repeated-event injuries
A single-event injury will likely occur if you are involved in an accident in your workplace, for instance, a slip-and-fall accident. Injuries like these are least expected and will require immediate medical care. In that case, you will notify your employer or direct supervisor of your injuries and the need to seek medical treatment. You can file a claim for workers’ compensation with your employer any time after your treatment has commenced.
Repeated-event injuries are those that occur with time and after continuous exposure to a dangerous working environment. It could be prolonged sitting, lifting heavy objects, or inhaling harmful gases or dust. These injuries are discovered way after the first exposure to the danger. Proper diagnosis is required, and proof that the hazardous working environment contributed to your injuries, to receive compensation for your damages. An experienced workers’ compensation attorney will help you obtain the evidence you need to ensure that you will not miss out on the compensation you deserve.
The most significant issue with workplace injuries is whether an injury is work-related and covered under the workers’ compensation scheme. It is the first element of proof your employer and the insurance provider will need to approve your benefits claim. Workplace injuries are those that arise from or occur during a person’s job. These are the standards your employer and the insurance provider will use to establish whether your injury is work-related. If not, you might have to pay for your medical needs and other damages out of pocket.
A workplace injury is an injury that occurs while you are doing something that will benefit your job or employer. It doesn't necessarily mean that you were doing something you always do or within your job description. Even if what you are doing is not part of your regular job, a workers’ compensation plan will cover your injury.
Injuries that arise from a worker’s job are those the worker incurs while doing something related to his/her regular job but beneficial to the employer. For example, a construction worker incurs an injury after part of the building collapses. In that case, the construction worker is suitable for workers’ compensation benefits until his/her full recovery.
Workplace injuries that occur during employment may not necessarily be directly related to a worker’s everyday duties. The workers’ compensation program does not cover some of these injuries. That is why it is necessary to understand the coming and going rule and how it might affect your claim.
The ‘Going and Coming’ Rule
Employers in California must carry insurance coverage for all their employees to protect them against damages resulting from workplace injuries. The insurance coverage ensures that the injured worker has sufficient funds to cater to his/her medical and basic needs during the recovery period. The workplace injury must be work-related for the worker to receive benefits under this scheme. But, that doesn’t mean that the worker must have incurred an injury in the office or working site. An injury that occurs while the worker runs company errands or a company-sponsored party will be covered under the scheme. But damages incurred while commuting to and from work are not considered work-related and will not be compensated.
The going and coming rule of workers’ compensation limits compensation for injuries incurred while going to and from work. Even though someone will argue that commuting to and from work is work-related, the rule has been consistently applied, with specific exceptions. There are instances when commuting from one point to the other is considered work-related. For example, if you have to change shifts in between the day, you will be exempted from this rule and could be compensated if you incur injuries in the process.
That is why you must understand how workers’ compensation works especially for injuries that occur during employment. You may or may not be eligible for compensation under this scheme, depending on the circumstances of your situation. For instance, if you incur an injury during your tea or lunch break while performing an activity unrelated to your work, you will not be eligible for compensation. An experienced workers’ compensation attorney will help you understand the complexity of your case, if you qualify and how you can improve your chances of filing a successful benefits claim.
Specific Situations That Could Pose a Challenge When Applying for Workers’ Compensation
The term ‘work-related injuries’ is not as straightforward as it sounds. People that have had to pursue compensation for work-related injuries might understand its complexity and the need to seek the assistance of an experienced lawyer at the beginning of the case. Some injuries may appear work-related but are not. These might pose a challenge for you and your employer and could complicate your matter further. Let us look at some specific instances in which you might not be eligible for workers’ compensation, even when your injuries appear to be work-related.
Injuries During Lunch Breaks
Generally, your lunch and tea breaks are not part of your job. Therefore, any injury incurred during your tea or lunch break will typically not be covered. For instance, if you are hit by a speeding vehicle while walking to a nearby restaurant for lunch, or you slip and fall in a hotel while leaving after having lunch, your employer will not be responsible for your injuries. However, if you incurred the injuries while delivering lunch to your boss or colleagues under your employer’s instructions, your injuries are considered work-related.
You might be eligible for compensation if you incurred an injury within your workplace during your tea or lunch break. For instance, if you fell and broke a bone in the breakroom or collapsed on a company chair while having your lunch, your employer is responsible for your injuries. However, if you suffered an injury while playing or performing an activity that is not work-related, you will not be compensated even if the accident happened within your workplace.
Injuries During Company Events
Company events are generally work-related. Therefore, injuries incurred during events like those are covered under the workers’ compensation scheme. However, it will depend on the expectation and culture of your workplace.
If you were required to attend and participate in all activities, like team-building, an injury during activities like those would be considered work-related. However, if you engaged in other activities that were not part of the company event, and you incurred an injury during those activities, you may not be covered. Situations like these will depend on your employer. Therefore, speak to an experienced workers’ compensation attorney for the best way forward.
Injuries During Travels
The going and coming rule is mainly about injuries during travel. As a rule, the workers' compensation scheme doesn’t cover damages incurred when a worker is commuting to and from work, though with specific exceptions. But if the travels are directly related to your work, like traveling to see clients or run business-related errands, your injuries will be covered.
Injuries During Misconduct
You may not be eligible for compensation for injuries incurred within your workplace if the injuries directly result from misconduct or violation of company policies. Situations like these are also dealt with on a one-on-one basis. Therefore, it could help to seek the advice of an experienced workers’ compensation attorney for a clear guideline and the way forward.
The Going and Coming Rule — Exceptions
The going and coming rule does not apply in all situations. Some travel-related injuries could be covered under the workers’ compensation if they are considered work-related. Commuting to and from work is mainly what is considered going and coming. But other work-related travels could be covered under the workers’ compensation.
Traveling in a Company Car
Injuries sustained while commuting to and from work could be covered under the workers’ compensation if traveling in a company car. The going and coming rule applies when a worker is using a personal or public vehicle. However, some cases will require the said company car to be traveling from one fixed location to another. If you incurred an injury while the vehicle was traveling to or from an unauthorized place, you might not receive compensation, and your situation could be considered a violation of company policies.
Note that some companies use completely branded company vehicles, while others do not. You must demonstrate that the said vehicle is indeed a company vehicle to be considered for compensation.
Commuting as Part of Duty
Workers whose main job requires traveling would be eligible for compensation if they incurred a work-related injury in their travels. Traveling as part of duty goes beyond everyday commuting to and from work. Some workers are on the road and air all day, including pilots, bus drivers, truck drivers, and state troopers. However, you must provide proof that you incurred your injury in the line of your duty.
For example, a bus driver that incurs an injury while going home on another bus, or traveling in a personal vehicle for his/her shift, might not be covered.
Note that injuries incurred in railroads are handled by the Federal Employers’ Liability Act and not workers’ compensation.
Traveling to and From Different Job Sites
Some workers do not have a specific job site and might have to travel from one job site to the other throughout the day to accomplish their tasks. Those travels are considered work-related and are exempt from the ‘going and going’ rule. You will be covered even if you use your vehicle or public transport to commute from one job site to the other.
Note that employers and insurance companies investigate cases like these to determine the exact nature of your injury. Therefore, you may be disqualified from workers’ compensation if you incurred the injury while traveling to another location during the time you were supposed to be traveling to another site.
Commercial Traveling
Commercial travelers are also exempt from the going and coming rule. Commercial traveling includes taking business trips or moving from one location to another for advertising or sales. These types of travels are considered work-related. Therefore, injuries incurred during commercial travels are covered under workers’ compensation. The time a worker spends away from the office on a business-related trip is considered within their scope of employment. Even if you only travel for a five-hour conference, the time you spend traveling to the venue will be considered work-related.
Traveling on a Special Mission
Special missions within and out of your workplace are work-related and exempted from the going and coming rule. For instance, if your supervisor sends you to the store to buy a few supplies in the middle of your working shift, you will be performing a work-related or special mission. Special missions might include purchasing lunch for your colleagues, visiting a sick colleague in the hospital, or even running a few errands for your manager.
Some specific tasks might not be related to your job, like walking your boss’ dog or watching your manager’s children while she attends a crucial meeting. You will receive compensation if you incur an injury while performing a special mission in any of these cases.
Factors Considered When Determining a Case’s Suitability for Compensation
There is no direct rule on the going and coming rule and its exceptions. Insurance companies treat workplace injury cases on a one-on-one basis, based on factors like:
Employer Control
The main factor of consideration when establishing a worker’s eligibility for workers’ compensation is employer control. The difference between a permanent and contractual employee is in the amount of control the employer exercises in their discharge of duty. If your employer controls yor working time, how much you work within a particular time, and the quality of work you deliver, you are considered a permanent employee, covered under the workers’ compensation.
Employer control is also considered when determining if a worker is affected by the going and coming rule. For instance, if your employer controls your travels to and from work, or other missions, you may be exempted under this rule.
Is Your Commute Time Compensated?
If your company compensates for your commute to work, special missions, or other work-related travels, your injuries could be considered for compensation if they occurred during those commutes. However, it may depend on whether your employer compensates for your travel time or travel expenses. If your employer reimburses for your travel time, your commute may be exempt from the going and coming rule, and you could receive compensation if injured while traveling. But if your employer only reimburses your travel expenses, you may not be covered under the workers’ compensation scheme.
Compensation for Foreseeable Activities
Sometimes you could be eligible for workers’ compensation for engaging in a foreseeable activity within a work-related activity or event. For instance, if an employer offered alcohol to his/her employees during a party held for employees, and employees are injured due to intoxication, the employer might be liable for the resulting damages. Remember that a company event is considered work-related. The employer should have thought about the consequences of offering alcohol in an event where more activities are involved. That is why injuries incurred in situations like these could be covered under workers’ compensation.
The same could apply to an injured worker involved in another accident while traveling home or to the hospital after a work-related injury. The employer will be responsible for the damages incurred in both situations.
Injuries in Parking Lots
If a worker is injured in the parking lot owned by his/her employer or near his/her employer’s building, the injury might be considered work-related. It could be covered under the workers’ compensation. A parking lot within your workplace is controlled by your employer. Your duties as an employee start once you enter your employer’s property. Thus, it is possible that you will be covered. But, like in many cases discussed above, compensation depends on the facts or circumstances of your case. That is why it is advisable to hire a workers’ compensation attorney.
An experienced workers’ compensation lawyer will study the facts of your case to determine its eligibility for compensation under the workers’ compensation. He/she will gather sufficient evidence, interview witnesses, and call in experts to strengthen your case. You improve your chances of filing a successful claim when working alongside a competent lawyer.
An experienced workers’ compensation lawyer will also negotiate for total compensation for all your damages on your behalf. Insurance companies are always unwilling to offer total compensation even in deserving situations. They will use tricks to cause you to accept a lower settlement than you deserve. An aggressive lawyer will protect your interests and only advise you to accept a fair payment. If not, your lawyer will plan and file a compelling lawsuit in court.
Find a Competent Workers Compensation Lawyer Near Me
Have you or your loved one incurred an injury while commuting to and from work or work-related activity?
It helps to understand how the going and coming rule applies and how it might affect your situation. You may not qualify for compensation if you are traveling to or from work. But you could be eligible for compensation if you incurred an injury in other work-related travels. Let a competent workers’ compensation lawyer study your case for a more informed decision. If in Los Angeles, contact The Workers Compensation Lawyer Law Firm on 424-501-9228. Our team of competent lawyers will work on your case tirelessly to obtain a favorable outcome from your claim.