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Can this person make a claim? Louisiana

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  • Can this person make a claim? Louisiana

    Yesterday, our receptionist was on her lunch break sitting on the floor of a co workers office clipping coupons. When she got to her feet, she heard a "pop" and her knee started to "hurt". There were no witnesses. I am the HR Person, I find all this out today when she arrives with a full leg brace...I immediately fill out an accident report from her above mentioned description of events. My bosses are asking if shes asked about filing for workman's comp (no she hasn't), my question is, does she have a valid claim if she decided to file?

  • #2
    Your workers comp carrier will decide whether the claim is valid or not.
    I am not able to respond to private messages. Thanks!

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    • #3
      Originally posted by Marketeer View Post
      Your workers comp carrier will decide whether the claim is valid or not.
      Yes, I do understand that, I was just wondering if an injury under those general circumstances would be considered as "file worthy".

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      • #4
        If there is ever a question as to whether something qualifies as workers comp or not, report it to your carrier. If it is, you're home free, and if it isn't, better that your carrier be the bad guy to make that decision.
        The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

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        • #5
          File it but expect a denial. Clipping coupons off the clock does not arise out of or occur in the course of work.
          I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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          • #6
            Agree with the others re file the claim with your comp carrier.
            However there is a fine line here as to AOE/COE... many judges have found in the EE/IW favor as if not for the employment, the EE would not have been in the position to suffer the injury in the first place.
            Let your comp carrier litigate the issue, the law requires you the employer to file with your carrier, and that is what you pay the premiums for.

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            • #7
              In many states an injury by accident occurring during lunch break or bathroom break is considered to be within the course and scope of employment and therefore covered. But this lady may not be covered due to lack of an "injury by accident." However, I am not familiar with Lousiana work comp law, so I don't know. I agree with the advice to report it to the insurance carrier and let the adjuster sort it out.
              Bob Bollinger, Attorney
              Board Certified Specialist in NC Workers' Compensation Law
              Charlotte, NC

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              • #8
                No Basis for a WC

                To be covered by workers’ compensation, an injury need not be caused by an accident (such as a fall or equipment malfunction). Equally common claims are for injuries due to repeated physical motions (back strain from lifting heavy boxes). Physical conditions that are aggravated by workplace conditions—such as emphysema made worse by airborne chemicals -- may also be covered. And, workers can sometimes be compensated for the effects of psychological stress caused by the job. In your case I don’t see any. Good luck for her if she plans on filing for WC.

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