GQ Corner
Q. I have a claimant who works at a convenience store/gas station part time. After his shift ended around 8:00 p.m., he was in the parking lot of insured’s premises and was struck by a vehicle. The insured states the claimant was not on the clock and they do not know what he was doing as he had been off the clock for 15-30 minutes. I believe it would still be compensable, but wanted to run it by you since insured questions.
A. I agree the claim is compensable. The Access Doctrine would apply to this case. This doctrine expands in time and space, to a reasonable degree. The claimant was still on the premises and it was 15-30 minutes after his shift had ended, which could be considered “reasonable time” after work.
Q. I have a death claim where the child is 22 years old. She has only submitted a DWC-42 and her birth certificate. She did not check the box that asked if she is a full-time student. If she is a full-time student, what information needs to be submitted for her to receive the death benefits?
A. Rule 132.4(f) states that: “A child who is a full-time student at the time of the employee’s death and is less than 25 years old, shall submit evidence of enrollment at an accredited educational institution. A child shall only be considered a full-time student if the child meets the educational institution’s requirements for a full-time student in the child’s course of study.” She should re-submit the DWC-42 with the box checked for full-time student status along with her birth certificate and proof that she is enrolled full-time at an accredited educational institution. Please note that the carrier has a duty to determine eligibility of a potential beneficiary. The carrier shall either begin the payments of death benefits or file a notice of dispute of eligibility no later than the 15th day after the latest of: (1) Receiving the DWC-42; (2) Final adjudication of the carrier’s PLN-1, if one is filed; or (3) The expiration of the carrier’s right to deny compensability/liability.
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