Gray Areas in Worker’s Comp Coverage

If you are seeking worker’s compensation benefits, as an injured employee you will have to show that your injury or illness is work-related. In most cases, if you were doing something for the benefit of your employer and you were injured or became ill as a result, then your injury or illness is work-related and you are eligible to receive worker’s compensation benefits as long as you have the criteria required for eligibility. This article will discuss some situations that may be tricky to determine if they fall into work-related illness or injury.


While the work-related requirement for worker’s compensation benefits may seem pretty cut and dry, it can get tricky. In some situations you may find that your injury or illness falls into a gray area. When this occurs you will need to consult with an attorney in Anchorage to find out whether you will be eligible for benefits. Some gray areas include the following:
 

• Lunch breaks - in most cases injuries or illnesses that occur during an employee’s lunch break are not covered under worker’s compensation. For example, if you sprained your ankle while walking into a deli to pick up your lunch then you probably cannot claim compensation for that. However, if you were also picking up lunch for your boss then the injury might be covered.
  
  Another scenario is where an employee sprained his or her ankle in a cafeteria on the company’s premises. In such a situation the injury might be covered by worker’s compensation as using a company cafeteria saves you time, which leaves more time for work therefore, making your use of the cafeteria benefits your employer.
  

 

• Company events - a number of companies sponsor special events like parties, retreats or baseball games. If an injury or illness occurs at these events they are usually covered by worker’s compensation. For example, at a company party, Jacob has had too much to drink and decides to twirl Agatha over his head while they are dancing. Unfortunately, Jacob drops Agatha and they both fall. Agatha breaks her arm and Jacob suffers a severe strained neck. While Jacob’s actions resulted in the injuries, both injuries will probably covered by worker’s compensation.

 

• Travel - if an employee is injured on his way commuting to or from work it is likely that these injuries will not be covered by worker’s compensation. However, they are a number of situations when injuries during travel are covered. For example, where an employee is traveling for work but not to his or her fixed worksite then the injuries will probably be covered. Or if an employee is injured during his regular commute but is driving a company vehicle, then his injuries will probably be covered.
  
  
• Misconduct - if an employee is injured while breaking a workplace safety rule or while doing something that his employer has prohibited, the injury sustained may still be covered by worker’s compensation depending on the level of misconduct. The worker’s compensation bargain is: ‘employees do not have the right to sue the employer for work-related injuries but those injuries are covered by worker’s compensation regardless of fault’.
  

Report this Page