As the Covid-19 pandemic continues organizations have been forced to adopt or further expand work-from-home policies. Have you worried at all about your workers compensation insurance? Now would be a good time to review your workers compensation coverage and your processes.

Fully understanding which injuries your workers compensation might cover, adapting your safety program, and making current updates to your claims reporting process can help your business handle injury claims efficiently in this new age of remote work.

What Is Regarded As A Work-Related Injury At Home?

First, it is important to understand that employee injuries at home may be covered by workers compensation. However, precisely determining what is considered a work related injury can be tricky. That is because each state has its own laws and interpretations of each injury claim.

To have a compensable claim that will be accepted by your company’s workers compensation carrier, the employee must be in the course and scope of their job AND the accident must arise from job-related activity. Examples:

  • An employee who has put in a long day at the computer feels a strain in their wrist at the end of the day may have a compensable claim, depending on the state, because they can claim the injury occurred while performing their job.
  • An employee who has a work-related package delivered to their house, picks it up and strains their back may have a claim, because they can claim the injury occurred while performing their job.

However, not every injury that happens at home during work hours will result in a successful workers compensation claim. Examples:

  • An employee gets heads to the kitchen for a quick snack and trips over their dog and gets injured may not have a valid claim. This situation is considered a “gray area” and will likely be decided in court.
  • An employee takes a lunch break and goes for a ride on their exercise bike, pulls a leg muscle, will likely not be able to claim workers compensation for their injury.

It is very important to keep in mind that it is not up to the employer to determine whether an injured employee has a valid claim. Each claim is subject to an investigation that complies with your states employment laws.

Tips To Promote Workplace Safety When Your Staff Is Remote

It sort of goes without saying, but fewer injuries translates to fewer workers compensation claims. This is a primary reason that organizations build and utilize workplace safety programs.

With one, five, or all employees shifted to remote work, your workplace safety program may not be applicable to employees at home. Example:

  • An employee who works in a records office is likely to face hazards related to accessing and moving paper records and boxes, so your safety program would be focused on best practices for lifting. When the landscape changes and employees are accessing records remotely from home, the risk factor can change, they can now only be accessing digital copies.

It is almost impossible to know what specific hazards might be present in each employees home, and it would be impractical and intrusive to ask. The best course of action is to focus on the injury risks that most remote workers face regardless of their industry. Examples:

  • Repetitive motion stress
  • Injuries related to poor posture and ergonomic injuries

These pose a particular risk lately as employees in some cases have had to abruptly shift to working remotely from home. Some employees may not have a proper desk and chair and are working from a kitchen table or even worse, the couch. That may be doable for a day or two, but over the long run it significantly raises the risk of neck, back and arm injuries. As long as you have people working remote, your workplace safety program should heavily focus on proper posture, and other ergonomic best practices.

What To Do When An Employee Reports That They’ve Been Hurt On The Job At Home

Despite your emphasis on work-from-home safety, injuries may happen. In those cases, from a legal and compliance standpoint, your organization’s role is to gather as many details as you can about how the injury happened. Examples:

  • The time and date when the employee was hurt
  • The activity that preceded the injury
  • The nature of the injury

It’s best to collect the employee’s report about their injury as soon as possible after the incident and to pass it along to your insurance carrier right away. Doing so allows the insurance adjuster and the employee to have their follow-up discussions while the facts are still fresh.

Once you collect the employee’s initial report and file it with your workers compensation insurance carrier, the matter goes to their adjuster. This is the person who has the resources and knowledge to decide if a claim is work-related or not, based on their investigation and the law in the state where the injury happened.

What Is Involved In A Workers Compensation Investigation?

The claims adjuster will get in touch with the employee to conduct a detailed interview and to collect any supporting documentation. In most cases the adjuster will:

  • Get a recorded or written statement from the employee describing the injury and how it happened.
  • Request that the employee sign a medical release authorization form to get copies of any medical records related to the injury.
  • Conduct an interview with the employer to verify that the employee’s statements to them and to the adjuster are in alignment.

With that information, the adjuster may decide the case is clearly work-related or clearly not a result of work activities.

If the claim falls into a gray area, your company’s insurance carrier may seek a legal opinion from an attorney with experience in the state’s workers’ compensation law on:

  • Whether the claim should be accepted or denied
  • How strong their case would be if a denial is challenged in court

If the claim does go to court, your state’s written laws plus existing case law – how previous similar claims have been judged – will determine the outcome of the case.

How To Ensure Your Policy Addresses Workers Compensation For Remote Workers

Every state (except Texas) requires employers to have workers’ compensation insurance, although the details vary from state to state. It’s smart to regularly review your workers’ compensation policy to make sure that your coverage is optimal for the way your business is evolving. Now is also a wise time to review your claims management and reporting system, to ensure that it addresses workers compensation for remote employees.

To learn more about workers compensation and other business compliance requirements, contact us for a free no-obligation discussion.

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