In order to obtain workers’ compensation benefits in Georgia, the employee must have fallen ill or gotten injured while acting in the course and scope of employment. There are also allowances when some aspect of work exacerbated an existing condition.
Usually, if an employee who is injured in an auto accident commuting to or from work isn’t eligible for benefits (this is called the “coming-and-going rule), but there are exceptions to this too.
The recent case of Kelly v. Blue Ribbon Linen Supply, recently considered by the Idaho Supreme Court, is an interesting one that involves all these elements. Justices were asked to consider whether a commute from an independent medical exam, requested by the employer as part of an earlier work injury claim, may be considered an action that is in the course and scope of employment.
According to court records, employee suffered a compensable, work-related injury in September 2013 when a car rolled over her foot while she was working. The workers’ compensation insurance company paid both medical and time loss benefits to claimant.
But the following month, an insurance agent notified plaintiff that it had been arranged for her to undergo an independent medical evaluation. She was ordered to make arrangements to keep the appointment and bring all copies of MRI films and x-rays. Failure to do so, the letter indicated, would result in termination of workers’ compensation benefits for failure to comply. further, the letter indicated she would be reimbursed for all travel, destination and round-trip mileage expenses. The site of the independent medical exam was 125 miles from claimant’s place of employment.
She kept the appointment, underwent the exam and got in her vehicle to return home. She did not make any detours and headed straight home. The road was covered with snow. As she traveled southbound in her sport utility vehicle, a truck traveling northbound lost traction, crossed the center line and collided with her head-on. Nothing claimant did contributed to the accident.
As a result of the accident, claimant suffered severe physical injuries to her lower extremities. She was forced to reside in a skilled nursing facility for several months before she was well enough to move back home.
She later filed a claim for workers’ compensation for this collision. The state workers’ compensation commission rejected her claim because, justices reasoned, the injuries the result of an intervening cause, rather than plaintiff’s employment or the original injury.
On appeal, the sole issue before the Idaho Supreme Court was whether plaintiff’s injuries arose out of and in the course of her employment with the company.
To refute claimant’s position, defense cited an earlier case where a plaintiff was injured in a crash while traveling to receive treatment for an earlier work injury. But that case was not controlling here, the state supreme court ruled, because that treatment did not occur at the express request of the employer, as was the case here. In fact, plaintiff’s failure to show up to this appointment would have meant she would have lost her workers’ compensation benefits.
In this case, the court ruled, this scenario presented an exception to the coming-and-going rule. She was running a “special errand” for the employer. The court ruled the fact that it was the insurer who technically made the request was not functionally any different than if the employer had made it. The court found a significant causal connection between worker’s employment and her injuries, given that her employer – by way of the insurer – directed worker to take the actions for its own benefit. The time, the place, the doctor – all of it was chosen by the employer and was solely for the benefit of the employer. It was also noted that rather than arrange for an exam that was closer and more convenient to plaintiff, the insurance company set an appointment far away, at a time of year when the road conditions are often poor and exposed her to a dangerous condition during travel.
Thus, her injuries are compensable.
It should be noted plaintiff also has remedy through a third-party action against the other driver.
For information on Atlanta work injury compensation, contact J. Franklin Burns, P.C., at 1-404-303-7770.