Understanding the criteria for determining work-related injuries and knowing how to prove it can greatly impact the outcome of your workers’ compensation injury claim, and even whether you are entitled to workers’ compensation benefits.
Is My Injury Work Related? Factors Considered
When it comes to determining whether an injury is work-related, several factors come into play. While the specific criteria may vary depending on the jurisdiction and the type of compensation plan, there are common elements that are generally considered.
On the Payroll
One crucial factor in work-relatedness is being on the payroll. Generally, employees who are on the company’s payroll are eligible for workers’ compensation claims, while volunteers are typically excluded. However, the rise of independent contractors and the gig economy has introduced a number of complexities. In some cases, subcontractors may be covered under the employer’s policy if they lack their own insurance and work under the direct control of the employer.
For example, a restaurant hiring self-employed entertainers on a 1099 basis may need to provide coverage if the entertainer is injured while performing duties controlled by the restaurant.
On the Clock
Another significant aspect of work-relatedness is being on the clock at the time of the incident. Generally, injuries that occur during an employee’s working hours are considered work-related, while commuting from home to work is not. However, if an employee is driving from one work location to another during working hours, the injury may still be considered work-related.
It’s important to note that being off-the-clock does not automatically disqualify an injury from being work-related. If the injury happens on-site or on employer time, it may still be deemed work-related. The circumstances surrounding the incident and applicable laws will determine the work-relatedness of the injury.
On Employer Time
In some cases, injuries may occur when employees are not actively performing their job duties but are still on employer time. This can, under certain circumstances, include employer-sponsored activities or events as work-related such as team-building exercises, company gatherings, or other activities where attendance is expected by the employer. Following employer directions or running errands for work purposes may also be deemed work-related even if the employee has not officially started their shift.
Work-related injuries are not limited to the immediate work area or workstation. Injuries that occur on the employer’s premises, including parking lots, stairwells, break rooms, or canteens, may still be considered work-related. The key factor is whether the employer has control over these spaces and if the injury occurred within the scope of employment.
For example, if an employee slips and falls on ice in the parking lot while entering the building to clock in, the injury may be considered work-related.
Exceptions to Work-Relatedness
While most work-related injuries are covered by workers’ compensation, there are exceptions. Injuries that occur as a result of rule-breaking or serious violations may not be eligible for workers compensation in New York. Fighting, horseplay, and intentional self-inflicted injuries are often not covered under workers’ compensation.
However, not all employee misconduct automatically disqualifies an injury from being work-related. If an employee violates safety guidelines but still suffers an injury, it may still be deemed work-related. Employers have a responsibility to provide a safe working environment, and if an employee’s actions result from a violation of safety policies, the injury may still be considered work-related.
Is My Injury Work Related? Importance of Gathering Evidence
When faced with resistance from an employer or their insurance company, gathering and presenting evidence becomes crucial in proving the work-relatedness of an injury. While popular media often portrays evidence as a dramatic smoking gun, in reality, it is a collection of facts and information that helps establish the truth of a claim. This is why it is important to work with an experienced Workers’ Compensation Attorney who can help and guide you in gathering the necessary evidence to support your claim and help ensure a favorable outcome.
What Evidence Should I Gather?
If for no other reason, this is why you should work with an experienced New York Workers Compensation Attorney such as the Workers Comp legal team at McMahon Kublick PC in Syracuse. To bolster your case, it is critical to gather all the relevant facts and documentation that support the work-relatedness of your injury. This includes information about the incident itself, steps leading to the injury, the location of the incident, and the timing. Identifying witnesses who observed the incident or have information about events leading up to it can also strengthen your case.
In addition to collecting evidence that supports your claim, it is equally important to be aware of any potential evidence that may be used against you. For example, failing to disclose a pre-existing condition during the initial examination may be used to challenge the work-relatedness of your injury. Being fully aware of all the facts surrounding your injury allows you to address any credibility issues that may arise.
The Proof Process
The process of proving work-relatedness generally involves three phases, although not all cases progress through each phase. These phases help determine the validity of your claim and establish whether your injury is work-related.
After suffering an injury at work, the first step is to file a workers’ compensation claim.
While an employer may challenge the claim, they must present evidence to back up their challenge. At that point, the case will typically proceed to an adjudicating body, such as an administrative law judge.
It is therefore crucial to diligently present evidence supporting the work-relatedness of your injury. This is where the expertise of a workers’ compensation attorney can be invaluable.
Syracuse Workers Compensation Lawyers Work for You
Understanding the factors that determine work-related injuries and knowing how to prove their work-relatedness is key to a successful outcome of a workers’ compensation claim in New York. From being on the payroll to gathering evidence and navigating the proof process, each step plays a vital role in establishing the validity of your claim.
Remember, while this guide provides a comprehensive overview, it is essential to consult with experienced workers’ compensation attorneys who can provide tailored advice based on your specific circumstances and help ensure that your injury is recognized as work-related and receive the compensation you deserve. Call now to talk to an experienced, dedicated Workers’ Compensation lawyer at McMahon Kublick PC in Syracuse to ensure the best possible outcome for your NY Workers’ Compensation claim.