Generally, injuries must arise out of the normal course of an individual’s working duties in order for them to be covered under Workers’ Compensation benefits. However, each state maintains a list of other types of injuries that may be compensated under Workers’ Compensation coverage.
Some categories of injuries that MAY or MAY NOT be compensated under Workers’ Compensation coverage include the following.
If employees are occasionally required to entertain business customers or associates or if the company benefits from the employee entertaining associates, injuries sustained during the course of entertaining customers or resulting from such entertainment are usually compensated under workers’ compensation laws.
For example, an employee who is injured while returning home from a baseball game at which he entertains some potential new customers is usually covered under workers’ compensation laws for those injuries.
If an employee sustains injuries while traveling to and from a fixed work site are generally not covered by workers’ compensation laws. However, there are many exceptions to this rule.
For example, if an employee is employed as a traveling salesperson and has no fixed work site, injuries incurred while traveling will likely be found compensable.
Comparatively, when there is a fixed work site and an employee is injured while traveling to and from the fixed site, the injury will be compensable if the following circumstances apply:
(1) the employer provides the employee’s transportation (e.g., the employee is provided with a company car); or
(2) the employee is paid wages for travel time or is reimbursed expenses for the travel.
An injury sustained while an employee is entering or exiting the employer’s premises, although not yet on the employer’s property (e.g., making a left turn into the employer’s parking lot across oncoming traffic), may also be compensated.
Injuries that occur away from the employment site while the employee is on standby or on call may be compensated if they occur because of a job-related risk.
However, injuries occurring off the employer’s premises have, in some instances, been deemed not to be compensated on the theory that the employee is not performing a service for the employer and that the employer has no control over the employee. On the other hand, Workers’ Compensation statutes sometimes expressly include within their coverage injuries occurring away from the employer’s premises.
A “zone of employment” test is applied in some jurisdictions to grant workers’ compensation coverage if the employee was injured other than at his or her place of duty, such as an employer-controlled parking lot; however, the zone of employment does not extend to territory not under the employer’s control.
Psychiatric conditions are compensated under almost all workers’ compensation laws. The most common stress claims involve some type of psychic trauma that has induced a specific psychiatric condition.
While the law may make mental stress claims compensated, it has become increasingly challenging for parties to determine the existence of the underlying psychiatric condition. One reason for this is the difficulty identifying “objective, observable, and easily accessible symptoms” with which to assess such claims.
The subjective nature of mental stress claims also increases the likelihood that disagreements will arise as to their compensability.