Situations That May Not be Thought of as Workers Comp, but Should be Reported

The New Hampshire Workers’ Compensation Statute, RSA 281-A:2,XI defines injury as an, “accidental injury or death arising out of and in the course of employment”. Both criteria must be met in order for a claim to be compensable.

In this article:

• Four Categories of Risk
• Injuries that occur before or after employees “punch in/out” of work
• Injuries that occur due to motor vehicle accidents
• All Injuries that the employee wants to claim as work-related

Not all injuries that occur in the course of employment are compensable. There has to be a risk or hazard created by the employment that is the cause of the injury.

The risk of employment has been the subject of several NH Supreme Court cases. The most recent of which, the Appeal of James Margeson 162 N.H. 273 (2011), more clearly defined what risks are employment-related.

The Supreme Court broke these types of risk into four categories:

1. Employment-related risks which they described as “all of the obvious kinds of injuries that one thinks of at once as industrial injuries.” The Court went on to say that “Typically a slip and fall is only attributable to an employment-related risk if it results from tripping on a defect or falling on an uneven or slippery surface on an employer’s premises.”
   
2. Personal Risks are those risks, “so clearly personal that even if they take effect while the employee is on the job, they could not possibly be attributed to the employment.” Such risks would include a fall while walking, caused by a seizure or a bad knee.
3. Mixed Risks that “involve a personal risk and an employment risk combining to produce injury.” …The Court stated that “while not all injuries resulting from mixed risks are compensable, the concurrence of a personal risk does not necessarily defeat compensability if the employee’s employment was also a substantial contributing factor to the injury.”
4. Neutral Risks are, “of neither distinctly employment nor distinctly personal character.” These are the claims that are the most controversial of modern Workers’ Compensation law according to the NH Supreme Court and these cases must be decided based on the facts of the individual case.

While many accidental injuries are either clearly work-related or obviously not work-related there are situations that arise that are not as definitive.

Injuries that occur before or after employees “punch in/out” of work

The NH Supreme Court has decided that commuting to and from work is not considered to be in the course of employment. However, they have also decided that injuries sustained when an employee is either walking to or from their car in the designated parking area, whether punched in or not, are considered in the course of their employment. Whether the injury was caused by a risk or hazard created by the employment has to be determined by the facts of the case.

Injuries that occur due to motor vehicle accidents

When an employee is injured in a motor vehicle accident in the course of their employment, there is frequently confusion as to whether a workers’ compensation claim should be filed. Some employers believe that it should be handled through auto insurance. However, the employee’s injuries must be handled like any other employee injury in the workplace, an Employers’ First Report of Injury must be promptly filed with NHADA WCT and the injured employee should seek treatment with a provider within Windham’s Work Injury Network. If the injury was the responsibility of the other driver, the NHADA WCT claims staff will work to recoup any payments made on the claim from the responsible driver.

All Injuries that the employee wants to claim as work-related

If an employee wants to file a workers’ compensation claim, the employer must complete a First Report of Injury, regardless of the circumstances, as soon as it is reported to them. NHADA WCT will conduct a thorough investigation to determine if it meets the criteria outlined by The NH Workers’ Compensation Statute for a compensable injury.

In summary, we encourage members to promptly file an Employers' First Report of Injury whenever they have knowledge of an injury. If you are unsure, please call 603-224-2369 and ask for Peter Sheffer, WCT Director psheffer@nhada.com, or Deborah Handrahan, Member Services Coordinator dhandrahan@nhada.com for assistance.

It is our pleasure to provide assistance to our members because our collective efforts to reduce claims costs by prompt reporting and effective claims management makes the Workers Compensation Trust strong.