Employers are responsible for “accidents arising out of
employment” under most state workers’ compensation laws. What does this language really mean? The easiest way to interpret this language is
to consider whether the accident has a genuine connection to work or just
happens to occur at work.
Take for example someone who is sitting at work talking to a
colleague about a work matter when suddenly her jaw locks, causing severe pain
and leading to treatment. Would this be
a work accident covered under workers’ compensation? It happened at work, yes, but
what is the connection to work? The answer is that there is no bona fide connection
to work activities. Talking is something
we do all day and does not amount to an accident. If you consider the same scenario to have
happened at home, where a husband is speaking to his wife when his jaw locks,
one would certainly not call this a “home accident.” Just as the home did not cause this to occur,
neither would work be the cause of such an incident. Some events just happen to occur at home or at
work because we spend most of our time in these two locations. These kinds of events could just as easily
happen at the local supermarket or at a museum.
In much the same way, if one is walking from his den to his
kitchen at home when his knee locks, leading to a visit to a knee surgeon for
treatment, few would call this a “home accident” unless there was a fall on the
floor or a collision with an object. The
same would be true at work: feeling leg pain while just walking is not an
accident absent a fall or some other force acting on one’s body. Yet we all know that claims like this get
accepted all the time by employers because of a mistaken belief that something
is compensable in workers’ compensation just because it happened at work. The part of the equation that is often missed
is that there must be some genuine connection to work, such as a slip and fall
on a hard surface, a trip and stumble on a torn carpet, or a collision with an
object at work.
The definition of an accident is “an unexpected event.” So if a teacher is walking and a student
comes barreling down the hallway, not paying attention, and slams into the
teacher causing a hard fall and damage to the knee, that is an unexpected event
clearly connected to work. It both
happens at work and arises out of work and is therefore compensable.
It remains this practitioner’s opinion that many cases get accepted in workers’ compensation that really have no connection to work other than that the event just happens to occur at work. If you are at home, and you put on your overcoat on a cold day to go outside, when you feel a tear in your shoulder, you would not think that the home caused the tear in the shoulder. The same is true if this happened to occur at work. The reason such events often get accepted is that the employer sends the employee to a doctor, thinking the compensability decision depends on a doctor’s opinion. It doesn’t. The doctor then prepares a report and states the obvious: that putting on the coat caused a tear in the shoulder. But the issue is a legal one not a medical one: does it arise out of work, or is there a true work connection? We all put our coats on during cold weather several times a day. As a matter of law, not medicine, this tearing one’s shoulder while putting on one’s coat to go home is not an accident covered by workers’ compensation. There is no work connection at all, and it just so happens that at this point in one’s life a tear occurred while from a personal action.
We all know this concept is true because we all have heard of cases where someone is driving a car and suddenly has a stroke. Or someone is sitting at a chair at home or work when the stroke occurs. Where the stroke happens to occur is simply pure coincidence because there is just no way for medicine to predict when a person who has risk factors will have such a cerebrovascular event. But we do know that having a stroke sitting at one’s desk is not work related. Those claims get denied and are won by the employer. So think of “arising out of work” as meaning that there is a genuine “work connection.”
The post The Concept of “Work Connected” in New Jersey Workers’ Compensation appeared first on NJ Workers' Comp Blog.
