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What Workers’ Compenation Doesn’t Cover

By January 27, 2020 Business Insurance
Workers' Compensation

Course and Scope

In order to talk about what isn’t covered by workers compensation, first we have to talk about what IS covered.

Workers compensation covers employees who are injured or become sick while in the course and scope of their employment.  That means you have to be working or at work, and doing something work related.  Simple enough, right?

On your way to the office

While you’re on your way to work, are you in the course and scope of your job?  Well, maybe.

Let’s say you work at an office.  So you’re traveling to the same place of employment every day.  Workers compensation probably won’t apply during your commute.

However, if your boss sends you to a conference, on a special assignment outside the office, or other special circumstance, then you will probably be covered by workers’ comp.  Also, let’s say you slip on ice in the office parking lot before work.  That’s probably a covered claim.  It’s within the scope of your employment that you park there and walk to your office.

On your way to today’s location

If you don’t have a fixed office, then that’s a different story.

Let’s say do undercover audits for retailers.  So every day you’re going to a different location to do your job.  Then traveling to those locations is in the scope of your job.  So that means you’re probably covered by workers compensation while going to work.

Now if you decide to run some errands on the way, then a claim might be denied.  Picking up your laundry isn’t within the course and scope of employment.

Foolin’ Around

You keep seeing the same term over and over:  Course and scope of employment.

Obviously horseplay isn’t in many people’s job description.  So if you’re injured while riding a skateboard in the warehouse, you can probably expect workers’ comp to deny the claim.

Now, there is an exception to that rule.  Coverage is generally provided for innocent bystanders.

Let’s go back to our skateboarding example above.  You’re minding your business and doing your actual job.  Tony Hawk there is trying to do a sick heel flip and sends his board flying at you.  When that board smashes you in the face, you can probably file a workers’ comp claim.  Tony.. not so much.

Workers’ Compensation for Remote Employees

If you work at home, are you always at work?

Actually, kinda yeah.

When are you not at work?

Generally speaking, workers’ compensation will cover employees during business hours.  But any time you’re working you can be covered.  So when you log into a late meeting because your client is in Tokyo, you’re now within the course and scope of employment.

Booze

Being drunk or otherwise intoxicated isn’t necessarily grounds for claim denial.  In fact, there may be situations where drinking is acceptable.

For instance, if you have a glass of wine during a dinner meeting with a new client.  Having a glass of wine is probably within the course and scope of employment.

What was the cause?

Let’s be clear.  I’m not advocating drinking on the job.  I’m just saying there are times it’s appropriate.

Workers’ compensation will generally deny claims if intoxication contributed to the cause of the injury.

For instance, let’s say that glass of wine turns into a bottle.  Now you crash on the way home.  In this case, the intoxication lead to the injury and therefore the claim will likely be denied.

The Rule to Remember about Workers’ Compensation

So the big takeaway…  Course and scope of employment.  There it is again.  This is a great place to start, but of course there is more to consider.

Want to learn more about workers comp coverage?  Click here!