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Are Injuries at a Work Event (Bonding Activity, Holiday Party, Happy Hour) Compensable?

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Archive: Jun 2018

Are Injuries at a Work Event (Bonding Activity, Holiday Party, Happy Hour) Compensable?

Work events that happen outside the workplace can be a fun time to relax with your coworkers. However, accidents can happen anywhere and, if you suffer an injury at a workplace event, you need answers regarding compensation for your injuries. When accidents occur at employer-sponsored events, workers’ compensation laws become more complex. Discuss your injury with an attorney to understand your next steps after a work event injury.

As fun as employer-sponsored events are, they also bring the risks of being in an uncontrolled situation. While participating in an employee sports game, someone may become injured. Following happy hour, drunk driving may result in a crash. Though these accidents may not happen on the job, they still occurred at or because of a work event. In some cases, employers may be responsible for these kinds of injuries.

Real World Scenario for Work-Event Injury

Consider a scenario where employees have gathered at a company picnic. Beyond food and company, management is encouraging employees to play some games. While participating, an employee overexerts herself and is unable to work due to the injury. She also needs to deal with the bills from her treatments. Though she suffered harm during a work-sanctioned event, whether the company is liable for her injury depends on a few issues.

Workers’ compensation exists to protect from illnesses and injuries that arise from work, regardless of who was at fault for the accident. In some cases, performing a task for the sake of one’s job, even if it occurs outside of the workplace, can still be eligible. Work events require closer examination, but they can qualify for compensation under certain conditions.

Factors to Consider

When it’s a question of whether a work event qualifies as something an employee does during the course of employment, courts consider these factors in their decisions:

  • Whether the employer expected or required employees to participate.
  • Company’s level of sponsorship.
  • If the accident occurred on company property.
  • How much the company benefits from the activity.
  • When the activity occurred in relation to work hours.

The employee’s expected attendance is one of the most critical components whether a work event qualifies. By California law, injuries from voluntary recreational activities are not eligible for workers’ compensation. This eliminates most work events from falling under the company’s range of responsibility.

However, an exception to this law comes if the employer required employee participation. This requirement can be either direct or indirect. As such, a work event would be within the course of employment if attendance was mandatory, even if the employee was not receiving pay for their time.

The level of company involvement and sponsorship also affects eligibility for workers’ compensation. If the employer covered all rental, games, and food costs at a park or if an executive member distributed awards can imply the company/workplace sponsored the event.

If the company mostly sponsored an event, then the employer’s amount of responsibility may increase. As the employer is partially or fully responsible for supervising the event, a workers’ compensation case can become more valid.

Think back to the employee who suffered an injury at the company picnic. If her employer said that everyone needed to come or if the company paid for the food, activities, and even rented out the area for the picnic, she may be able to receive workers’ compensation. Likewise, if the picnic occurred on company ground, she may receive workers’ comp. These factors would not guarantee that her situation would qualify, but she would still have grounds to look into the matter further.

Determining if an accident at a work event counts as workers’ compensation can be difficult. California law has guidelines, but they are not always clear, especially if the injury happened in a non-traditional situation. Discuss your incident with one of our attorneys to determine if your case qualifies for workers’ compensation.

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Do You Need Workers’ Compensation Insurance in California?

A workers’ compensation insurance policy is a type of liability insurance where employers assume liability for potential worker injuries on or caused by the job, which their insurer pays. Workers’ compensation can help cover costs of work-related injuries and illnesses. California state law requires employers to have a workers’ compensation policy, and failure to do so is punishable by law.

California employers must provide employees with workers’ compensation benefits, regardless of the size of the employer or number of employees. California Labor Code Section 3700 specifies the requirements that businesses must follow.

To learn more about California laws, speak to an Orange County workers compensation lawyer today.

Workers’ Compensation Requirements for Employers

In the case of a business owner’s desire to purchase workers’ compensation insurance for only herself/himself, the sole proprietor inclusion is necessary for the workers’ compensation policy. Health, life, and/or disability income insurance are options for sole proprietor workers’ compensation.

A workers’ compensation policy must include all employees, including executive officers and directors of corporations. This only changes when the directors and officers fully own the corporation. In this case, they may elect to not receive workers’ compensation benefits.

California Labor Code Section 3351 lays the groundwork for who is actually an employee. It also determines all that a workers’ compensation policy covers. Different company types may have different liability concerns.

Employers must post a “notice to employees” poster in an obvious place at the work site for employees to access information about workers’ compensation coverage. Failure to post a notice is a misdemeanor, punishable by a fine up to $7,000.

Employers must purchase their workers’ compensation insurance from licensed insurance companies or through the State Compensation Insurance Fund. Self-insurance for workers’ compensation is also an option. In the case of self-insurance, the state must give approval for it to count as a valid form of workers’ compensation.

Penalties for Failure to Comply with Workers’ Compensation Laws

California Labor Code makes failure to have workers’ compensation a misdemeanor under Section 3700.5. As a criminal offense, the failure to have workers’ compensation is punishable by a fine of at least $10,000, county jail time up to a year, or both. The state also issues penalties up to $100,000 against illegally uninsured employers.

Beyond the legal ramifications, employers who do not have workers’ compensation insurance will be responsible for paying all bills related to the injury or illness of employees who suffer any harms at work. The injured or sick employee can also file a civil action lawsuit against the employer for being illegally uninsured, in addition to their workers’ compensation claim.

In cases of employers operating without workers’ compensation coverage, the Division of Labor Standards Enforcement will issue a stop order. With this order, the employer must stop all use of employee labor until they obtain coverage. Failure to comply with the stop order is a misdemeanor and punishable by up to 60 days in county jail, a fine up to $10,000, or both.

Financial Penalties for Lack of Workers’ Compensation Insurance

Labor Code Section 3722(b) allows for additional fines based on the premium the uninsured employer would have paid during the uninsured period, or the sum of $1,500 per employee during the uninsured period. The administered fine is whichever amount is greater.

Labor Code Sections 3722(d) and (f) cover cases where the employee filed for workers’ compensation and the judge finds that the employer did not secure insurance. After the dispute the employer may face a penalty of a maximum of $100,000, dependent on the number of employees and if the employee’s claim that brought the issue to light was compensable.

These fines are in addition to the consequences of simply not possessing workers’ compensation insurance that fall under Labor Code Section 3700.5. Anyone may report an uninsured employer to the Division of Labor Standards Enforcement.

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Will Getting Elective Surgery Affect Your Workers’ Compensation Case?

Workers’ compensation insurance provides a way for employees to receive monetary support for on-the-job injuries and illnesses. California, like most states, requires employers to have workers’ compensation insurance, even if they only have one employee. Workers’ comp insurance pays for the costs of any work-related accidents. Sometimes, it can be tricky to determine when an injury or even a treatment is eligible for compensation. In certain situations, elective surgery can affect your workers’ comp case. Discuss the specifics with one of our Orange County workers compensation attorneys.

Are Surgeries Covered in Workers’ Compensation?

Not all work-related injuries or illnesses require surgery, but some of them do. Dependent on your employer’s compensation policy, you may need to see an approved doctor to file a compensation claim. That doctor will make a diagnosis and determine what treatment is necessary, such as surgery.

Section 4600 of California labor code requires workers’ comp to cover any treatment that would reasonably cure or relieve injured workers from the effects of their injury, including surgeries. If a physician determines the surgery is necessary, then it is eligible for a claim. However, insurers may not cover elective surgeries; the surgery must be a way to repair your injury.

What is an Elective Surgery?

Many people consider elective surgeries as unnecessary procedures. However, most people schedule elective surgeries well in advance, as opposed to emergency or urgent surgeries, which occur because of pressing medical conditions. Often, emergency and urgent surgeries occur in life-threatening situations where no other option is available for the patient’s survival.

As such, an elective surgery can still be medically necessary, just not needed immediately. These surgeries can help ease recovery from your injuries or help alleviate conditions of work-related illness. Depending on your condition, your workers’ compensation doctor may recommend an elective surgery as part of your recovery.

How Does Elective Surgery Affect Workers’ Compensation?

If your workers’ compensation doctor has stated that an elective surgery as medically necessary for your condition, it can then be part of your workers’ compensation claim. On the other hand, if you could have an elective surgery, but the doctor does not deem it part of your reasonable recovery, then it would not be eligible for compensation.

Matters of cosmetic surgery are also up for debate when it comes to workers’ compensation. While it may not seem necessary for recovery, some cases of serious injuries, such as burns, lacerations, and crushing require plastic surgery for proper recovery. As such, workers’ compensation may pay for cosmetic surgery in these situations or even when the accident compromised previous plastic surgery.

Doctors may not always deem a plastic surgery procedure medically necessary, though. It is up to the judgment of your workers’ compensation doctor whether you require plastic surgery to resolve your problem. Some cases where stitches have the potential to turn into scars may not seem as pressing to a doctor as they do to you.

If you have a disagreement with your doctor over their diagnosis, speak with one of our attorneys. Second opinions may not be an option in workers’ comp cases, but it may be an option for a personal injury case.

Elective vs. Unnecessary Surgery

As with any workers’ compensation claim, the policy may deem your elective surgery ineligible for benefits. If this occurs, you have the right to appeal your case. If you complete the settlement conference, go through a trial, and are still not satisfied with the decision, you can file a Petition for Reconsideration.

While elective surgery may seem medically unnecessary, the specific case can determine otherwise. Receiving an elective surgery will affect your workers’ compensation case will vary depending on the purpose of the surgery if it is medically necessary for reasonable recovery and your consulting doctor’s opinion.

For specific help on your case, talk with an attorney to guide you through the process, help submit required workers’ compensation forms on time, and represent you in court if necessary.

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