You Be the Judge

Is Accident After Holiday Lunch Compensable?

For an accident related to a social event to be compensable, courts say the event must benefit the employer in some way.
By: | September 10, 2014 • 3 min read

A supervisor for the Department of Public Safety sent emails inviting employees to attend a holiday lunch at a public restaurant “to celebrate the department’s hard work.” Attendance was voluntary, and attendees were required to pay for their own meals, though they benefitted from a group discount offered by the restaurant. Two technical support analysts decided to attend the holiday lunch and rode to the restaurant in a state-owned vehicle, which had been signed out by a coworker.

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Less than half of the employees who were invited attended the lunch. Attendance was not taken at the lunch, and no awards were presented. No formal speeches were given at the lunch, but three supervisors made brief remarks welcoming the attendees and thanking them for their service.

After the lunch, while the analysts were traveling on a public street toward their workplace, the coworker who was driving encountered a patch of ice and lost control of the vehicle. The vehicle crashed into a tree. One analyst was paralyzed from the chest down. The other analyst sustained a concussion and some cuts and bruises.

The analysts sought workers’ compensation benefits. The Industrial Commission concluded that their injuries did not arise out of or occur within the course and scope of their employment. The analysts appealed.

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The analysts argued that in selecting the location and date of the lunch, the department increased their risk of having a motor vehicle accident. The court explained that the increased risk analysis did not apply where a worker voluntarily attends a social event which itself does not arise out of the employment and is injured due to a risk that is common to the public while traveling on a public road to the event.

A is incorrect. For a social event to be considered a benefit to the employer, the benefit must not be “merely in a vague way through better morale and good will but through such tangible advantages as having an opportunity to make speeches and awards.”

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C is incorrect.The court found the fact that the analysts were riding in a vehicle provided by the department did not bring the accident within the “contractual duty” exception to the coming and going rule. The transportation to the lunch was not “an incident of the contract of” their employment but was provided as an accommodation.

How the court ruled: B.The North Carolina Court of Appeals held that the analysts were not entitled to benefits. Graven v. North Carolina Department of Public Safety, No. COA14-6 (N.C. Ct. App. 07/29/14).

The court found that any benefit to the employer was de minimis. The court pointed out that no awards were handed out at the lunch, the supervisors’ remarks did not rise to the level of a speech, and employees paid for their own meals. The court concluded that the lunch was for the benefit of employees.

Editor’s note: This feature is not intended as instructional material or to replace legal advice.

Christina Lumbreras is a Legal Editor for Workers' Compensation Report, a publication of our parent company, LRP Publications. She can be reached at [email protected]

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]