The basis for workers’ compensation is that it provides benefits to an employee who is injured at work.
By definition, workers’ comp insurance is for people injured at their workplace or while performing duties related to their job. It’s been long held that workers’ compensation does not cover injuries suffered during a commute to or from work, on off-site breaks, or otherwise in situations unrelated to work and outside of the physical premises of your workplace.
But a recent decision by the Virginia Workers’ Compensation Commission (WCC) has changed this standard, to an extent, and it might have far-reaching implications for how other states handle workers’ comp claims, too.
WCC panel decision
A recent decision by the Virginia WCC changed some of what we expect for workers’ compensation benefits claims.
A worker was injured after she fell while walking to the restroom after completing her shift as a convenience store clerk. Her claim was initially denied because the accident was not during the course of her employment since it took place when she “remained on the premises to perform a purely personal act.” She had played the lottery when she clocked out of her shift, and then went to the bathroom.
Virginia law—along with many other states—specifies that the accident must arise out of and in the course of employment. “Arise out of” would mean the accident happened while performing duties related to your job if you were at an offsite location. “In the course of” means that the time, place, and circumstances of the accident are related to your job.
The panel determined that the claimant, Brenda Rankin, playing the lottery before using the restroom at the store where she worked was not a “personal frolic” and did not separate the situation from her place of work. Since the WCC determined that she was still within the course of her employment, it overturned the denial and awarded benefits.
Previous Virginia workers’ compensation cases
Previous cases that Virginia has relied upon in workers’ compensation lawsuits include these examples:
- The claimant was injured when he was hit by another employee’s vehicle in the employer’s parking lot as he approached the workplace to begin his day of work. The Supreme Court held that both parties were engaged in behavior anticipated by the employer, and was within a “reasonable margin of time and space” for traveling to and from the place where work would be performed. (Brown v. Reed, 1969)
- A cake decorator completed her shift in the bakery department and was doing personal shopping in the store where she worked at the time when she fell. The Supreme Court found that she was covered by workers’ compensation because the accident was within the course of her employment on the employer’s premises. Although she did not directly leave the premises at the end of her shift, the court said an employee has a “reasonable time” after finishing work to leave the workplace and does not need to make an “instantaneous exit” in order to qualify for workers’ compensation benefits. (Briley vs. Farm Fresh, Inc., 1990)
- The claimant was eating breakfast in a public cafeteria in the warehouse store where she worked, about 15 minutes prior to the beginning of her shift. She became injured and made a workers’ compensation claim. Similar to the Briley case, the WCC held that her injury would be considered “in the course of her employment, because it occurred on the employer’s premises, and she was engaging in anticipated behavior, which was beneficial to the employer and reasonably incidental to her employment.” (Lopez-Arias v. Shoppers Food Warehouse/Supervalu, 2010).
The personal comfort doctrine
In some states, an employee is covered under workers’ compensation while taking short breaks to get snacks, use the bathroom, or do other things that aren’t specifically related to their job—but they are arguably human needs that we all have, and we can’t just turn them off because we’re at work.
If you’re injured while taking a personal comfort break, your claim will rely on the specific facts and your state law.
People get hurt. It happens. One of the main advantages of workers’ compensation—regardless of what state you’re in—is that it’s no-fault insurance. In other words, you never need to prove negligence in order to receive benefits. You only need to prove that you were engaged in duties related to your job or at your workplace when the accident or illness happened.
If you’re in this situation, you can consult a workers’ compensation attorney near you. Your attorney will review the claim and guide you through the process of receiving benefits.