GQ Corner
Q. The employee is a machine operator and the employer has on video that the employee climbed up onto a machine to clear a jam. She was not using a ladder or forceps. When she stepped down to the ground, she twisted her knee. She is seen holding her knee. This employee tells the employer, medical provider and our office that she injured herself that day when she slipped on a piece of board left on the floor. She is diagnosed with a knee tear and is currently prevented from returning back to work. Can this information be used to dispute the claim?
A. It certainly raises some serious questions. I would first make the effort to attempt to clarify with the claimant what the mechanism of injury is and perhaps even inform her of the video’s existence. The reason is that if you deny the claim and it goes to a CCH, the issue certified will be, “Did the claimant sustain a compensable injury in the course and scope of employment on [DATE]?” The answer to which is yes, she did. Only if she continues to double down and lie about the mechanism would I consider denying it, especially if she does so on the recorded statement.
Q. A claimant was driving from his employer’s location to his residence in a work vehicle, but was not on company time. He was rear-ended and encountered bodily injury. Would this claim be compensable under workers’ compensation?
A. Based on the information provided, under what is commonly referred to as the “coming and going rule”, since he was traveling from work to home he is considered to have been on a personal errand. His injuries are arguably, therefore, not sustained in the course and scope of employment. The fact that he was in a company vehicle would not change that analysis in this situation.
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