Injuries at home may be covered by workers’ comp

Chase Marable: A judge will determine whether an injury at home is eligible for workers' comp.

The uptick in remote work looks to be a permanent after-effect of pandemic life.

In a June survey of nearly 18,000 full-time workers in the United States, WFH Research found 12% were fully remote and 29% were in a hybrid arrangement. By comparison, the U.S. Census Bureau reported less than 6% of workers operating primarily from home in 2019.

Respondents to Springfield Business Journal’s 2023 Economic Growth Survey reported 66% of local employees are permitted to work from home sometimes, and 13% work from home all the time. Some 47% of survey respondents said they are responding to the current labor challenge by allowing more work-from-home opportunities, though 20% expect to allow less remote work in the coming year.

With more work activity happening at home, there is also a stronger likelihood of a worker sustaining job-related injuries off company grounds. But even in the home, injuries sustained on the job may be covered by workers’ compensation, according to Chase Marable, a risk management consultant and partner with Higginbotham Insurance Agency Inc.

Marable literally wrote the book on workers’ comp with his March release on Amazon Kindle, “Workers’ Compensation Simplified for Employers.”

For an on-the-job injury by a remote worker to be compensable, Marable said it has to meet two criteria. First, the claim has to have arisen out of and in the course of the worker’s employment. Second, work must be a prevailing factor in the injury.

The first criterion is fairly simple to satisfy, according to Marable. If a worker goes to the same place to work regularly, whether that is at a home office or a company, this requirement is met.

“The second one becomes funky,” Marable said. “That can be very, very difficult to prove, and the reason why is that we would need to prove that the work created more of a risk to be injured than your everyday life.”

If someone is walking down the hallway at home and slips, falls and gets injured, that may not be enough for a claim to be compensable.

But if that worker falls while carrying a heavy piece of equipment – perhaps a computer sent by the workplace for use in a home office – there is more of a chance it will be covered, Marable said.

Ultimately, the determination will be made by a state administrative law judge, Marable said.

“Every case is unique in itself, and every claim is looked at individually with multiple factors,” he said.

Marable said a formal home office arrangement is not necessary for a workers’ comp claim.

“Whether you have a home office or you work on your laptop on the couch or table or desk, you’re still working from your house,” he said. “Regardless of where you’re at inside your house, you’re still at that location working remotely.”

And work does not have to happen within typical business hours for workers’ comp to apply, Marable said.

“Probably what a judge would do is they would look at the normal working hours of that salaried individual,” he said. “If working in evenings at home is part of your normal day-to-day work activities, I would think a judge would find that satisfactory.”

The good news is risk of injury appears to be lessened for remote workers.  The National Council on Compensation Insurance estimates the relative risk of injury for remote workers to be 20% reduced from their on-site counterparts, according to a 2022 study.

Hurt on the job at home
When a job-related injury happens at home, workers should follow the same procedures they would if they were hurt on company grounds, Marable said, adding that caring for the injury is the top priority.

For injuries that do not require an immediate visit to the emergency room, he broke the process down to a series of steps:

1. Unless the severity of the injury makes this impossible or impractical, the worker should immediately notify a supervisor of the injury.
2. The supervisor should supply the worker with a first report of injury form for the worker to fill out and sign. The FROI includes information on when the injury occurred, what caused it and what body parts are hurt.
3. If the employer has an occupational medicine supplier set up, the employee should go there for initial treatment. Otherwise, an employee might opt for a primary care provider or urgent care clinic.
4. After the first level of treatment is completed, a treatment plan will be provided. It may include follow-up visits or work-related restrictions.
5. The employee should report back to the supervisor.
6. Treatment will continue until the employee recovers.

Marable said he recommends employers offer light duty whenever possible. He noted employees may have restrictions, such as in what they can lift or how far they can walk, but transitional duty should be offered when possible.

“When your employee comes back to work, the chances of them continuing and staying as an employee is a lot greater than when they go home and do not work,” he said. “If they’re at home, they don’t have the opportunity to come back and be part of the culture and be with their team.”

This is true even for the home worker, he noted, since home workers do not typically work in isolation.

In Missouri, unlike most other states, workers’ comp claims may be paid directly by the employer if they are under a certain dollar amount – $3,500, according to the Missouri Department of Insurance.

Marable said when workers take no more than three days off of work for a claim, it can be treated as medical only, and this can reduce the claim amount by 70%.

Of course, sudden traumatic injuries, like a fall, are not the only type of injury a worker may experience. The NCCI notes that for clerical workers, claims frequently stem from strain-related injuries, such as carpal tunnel syndrome. NCCI notes office equipment, home office space and ergonomic challenges may contribute to work-related slips and falls and repetitive motion claims. As a result, some companies are choosing to enact telecommuting protocols to mitigate hazards. Risk management strategies may include reviewing remote workplaces, defining job parameters and setting specific business hours.

Updating codes
Business leaders who have not updated their policies since before the pandemic may need to scrutinize those documents to be sure they reflect their workplace’s new reality, according to Marable.

WFH Research has found the pandemic has permanently increased the work-from-home trend with 28.1% percent of respondents in its May 2023 survey reporting they had worked from home at least one full day in the previous week.

The cost of workers’ comp insurance for each employee is based on job codes located in a manual published by the NCCI. In general, the riskier the work, the higher the cost – so coverage is assessed at a higher cost for a worker employed as a commercial roofer than as a data entry clerk, for example.

Marable cautioned that codes for specific workers within a business may have changed since before the pandemic.

“Let’s say you had an insulation worker who got COVID and went to work from home on a customer service team,” he said. “Someone who is in full-time customer service and is no longer in the field has a rate that is much lower than for someone that’s going in and blowing insulation into homes.”

It’s important to make sure employees are properly classified, Marable said.

“Job duties can change,” he said. “In the last five years, a lot has probably changed in your operation since COVID and work-from-home. Make sure you’re not overpaying.”

The average cost of workers’ comp insurance in Missouri is $64 per month, according to digital business insurance agency Insureon.