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Worker’s Comp: Rules & Regulations

An injury falls under worker’s comp if it occurs in the course and scope of employment, but what does that mean?  We have successfully obtained workers comp benefits for a claimant injured while at a company softball game.  These situations are similar to injuries that may occur in the company lunchroom or bathroom, in the company parking lot, etc.

In the past considerations such as the purpose of the event were taken into account, but recent court of appeals decisions have made these cases more difficult.  Under recent rulings, it appears an injured worker must prove that he or she was required to be at a company outing in order to recover under worker’s comp for an injury occurring at the event. Was it a mandatory event and were you performing an action that may have benefitted the company? Then you may have a claim.

A decision recently came out from the North Carolina Court of Appeals regarding modifications to a Work Comp claimant’s home.  Insurance companies are not required to pay for “ordinary life expenses”, which are considered to include things like mowing the lawn, basic home improvements, etc.  But the Court ruled that a claimant who lives in a 3rd floor apartment and needs to move to a 1st floor apartment for medical reasons can be entitled to compensation for the move and difference in rent.

In addition, the Court also said he can be entitled to a larger apartment if needed for medical reasons.  This ruling could be very important for WC claimants, as it may open the door to other medically significant housing modifications.


This entry was posted in Worker’s Compensation.