When is an at-work injury covered by workers' comp?

June 08, 2013

The Colorado Industrial Claim Appeals Panel recently reviewed a worker's compensation case in which it had to decide whether an employee injured while at work was entitled to workers' comp benefits. This case raises an interesting question: when is an on-the-job injury not covered under Colorado's workers' compensation law?

"Workplace injury"

To be compensable under Colorado workers' compensation law, an injury sustained while at work must be a "workplace injury." A "workplace injury" is one that occurs both in the course of employment and was proximately caused by a work-related function.
- In the course of employment. For an injury or death to be within the scope of Colorado's workers' compensation law, a person must be performing a service "arising out of and in the course of" his or her employment at the time of the injury. In general, this means the injury must occur during work hours, on the employer's premises or other location at which a worker is located by virtue of his or her employment, and in the exercise of an activity that has some connection to a work-related activity.
- Proximately caused. It is not enough for an injury to occur in the course of employment. It must also be "proximately caused by an injury or occupational disease arising out of and in the course of the employee's employment and is not intentionally self-inflicted." In other words, the injury must be sufficiently related to work-related activities. An injury that originates from a work-related function is typically sufficient to show a direct causal connection between the injury and employment. An employee's pre-existing condition which when combined with a "special hazard" of employment results in injury is also typically sufficient to show a direct causal connection.

Workers' comp claimant's injury was not a "workplace injury"

The claimant in the workers' comp case recently before the Colorado Industrial Claim Appeals Panel ("Panel") was a woman employed as a meat cutter who suffered back and neck injuries after falling while at work. According to the record on which the initial application for workers' comp was denied, the woman told her employer's on-site nurse immediately after the accident that she was three months pregnant, had become dizzy and then fell backwards off a stool on which she was standing. Based on that version of events, the Panel ruled that the woman was not entitled to workers' compensation benefits for her injury.

First, the Panel found that the injury did not arise out of or in the course of employment because the claimant was not engaged in a work-related activity at the time of the injury but simply standing on a stool. Second, the Panel determined that the injury was not proximately caused by a work-related activity; rather, in the opinion of the Panel, the claimant's pregnancy was the most likely cause of her dizziness and subsequent fall. The Panel also concluded that the "special hazard" exception did not apply because the claimant could not identify a "special hazard" of her employment that when combined with her pregnancy caused her injury.

Speak to a workers' comp attorney

This case illustrates the complexity of Colorado workers' compensation law and the extent to which individual facts and circumstances affect the outcome of a workers' compensation claim. Working with an experienced workers' compensation lawyer could mean the difference between a successful or denied workers' comp claim. If you were injured while at work, contact a workers' compensation attorney as soon as possible.

Article provided by The Law Firm of Janice M. Greening, LLC
Visit us at www.greening-law.com