When a new injury claim comes in from the jobsite, the first question that should be asked is simple: what happened? The answer is usually a simple retelling of how someone managed to injure themselves. They dropped a cinderblock; their glove got caught in something it probably shouldn’t have been near; a piece of debris fell from above; or even “I just turned to get in the vehicle.” All of these can be a prelude to what may be a compensable situation. However, on occasion the answer will begin with something a little more sensational. Stories that start with “I was minding my own business when…” or “I was driving down the street when suddenly…” often get a little more attention, not only from co-workers, but also from the lawyers and claims managers who review these claims. Eventually, the question changes from “what happened” to “how did it happen?”
From a Workers’ Compensation Claim perspective, the “how” becomes very important. We must look at not only what happened in this instance, but how it happened, and then whether it relates to the actual employment at issue. To put it another way, did this incident arise out of conduct that was within the course of employment?** Was there an actual risk; that is, did the course of employment create or expose the employee to some particular danger, and did that danger cause the injury? This means there must be some manner of causal connection between the injury and the working conditions under which the employer requires the work to be performed. For example, if an employee is required to climb a ladder to enter a vehicle, and they manage to twist their knee doing so, that ladder may be responsible for the injury. By contrast, if an employee is making a routine delivery, and is physically assaulted at a traffic light, that injury may not be a compensable claim. It comes down to a question of whether or not the injury is because of the work and the work environment. Another case [Hill City Trucking v. Christian 238 Va 735, S.E. 2d 377 (1989)] involved a truck driver who was making a delivery - he was robbed and shot. In that specific case no one could say that he was robbed and shot because he was a delivery driver or making that specific delivery, and the claim was dismissed. Every case will be different, but you can make sure you are starting off on the right foot by getting a firm foundation by getting the facts. The issue will fall back to those first questions asked: “what happened” and “how did it happen.”
Workers’ Compensation claims can cover a wide range of incidents, but all of them deserve your full attention. You may need help to determine if you are asking the right questions, and to make sure you are properly developing the factual record of your claims. If you have any questions about this article or about workers’ compensation issues in general, please contact John Stacy (email@example.com) at (804) 377-1263, or Steve Setliff (firstname.lastname@example.org) at (804) 377-1261.
**In the Virginia Workers’ Compensation definitions:“Injury” means only injury by accident arising out of and in the course of the employment or occupational disease as defined in Chapter 4 (§ 65.2-400 et seq.) and does not include a disease in any form, except when it results naturally and unavoidably from either of the foregoing causes. Va. Code Ann. § 65.2-101 (Lexis Advance through 2022 Regular Session acts effective April 11, 2022) Emphasis added