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Foreman injures lower back at work, but was he really 'working'?

Foreman injures lower back at work, but was he really 'working'?

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Estimated read time: 7-8 minutes

Ouch! That hurt!

Matt was the caretaker of a large commercial property, and also the foreman for any building, remodeling, or repair work done on the property. One day, during his work hours, Matt was driving his own vehicle along the highway adjacent to his employer's property when he noticed a large semi-truck and trailer coming towards him in the opposite direction. Nothing unusual – until one of the wheels on the trailer came off, bounced several times on the road, and came to rest in front of him on the shoulder of the road.

The driver of the big rig, oblivious to what had just happened, simply kept on truckin'. Amused but astonished, Matt pulled over, let down the tailgate on the bed of his pick up truck, and rolled the heavy tire and rim over to his truck. He began to lift and slide the tire on to the tailgate with the intention of putting the tire into the bed of his truck. Just as he got the tire flat on the tailgate, Matt felt an electric shock in his low back, followed by an excruciating pain that radiated from his low back down and into his left leg.

Matt was able to drive back to his employer's property, where he got some subordinates to unload the tire. He then immediately reported the injury to his employer, asked for some time off, and went home, intending to get medical treatment at his earliest convenience. The next day, Matt was seen by an orthopedic physician and diagnosed with a ruptured disc. Soon thereafter, at his doctor's recommendation, Matt had surgery to repair the disc, which was paid for by his own medical insurance.

The workers compensation carrier denied his claim stating that Matt was outside the "course of his employment" while driving his own vehicle on the highway; and outside the "scope of his employment" by lifting a semi-trailer tire he had no business dealing with in the first place.

Matt came to see Davis & Sanchez for help.

An injury "outside the course and scope of employment" is a favorite legal doctrine used by workers compensation insurance carriers to deny a claim. The insurance carrier and its attorney had no interest in settling the case, which left Matt no alternative, but to have his attorney take the case to trial (more accurately, to a hearing in front of an administrative law judge at the Utah Labor Commission).

At the hearing, Matt testified that he was well within the "course of his employment" while driving his own truck on the highway. Why? First, because his employer did not offer a work vehicle but did reimburse Matt for mileage driven on company business, which often included errands to big box stores for lumber, hardware, and other materials. And second, because Matt was driving back to work from just such an errand when he noticed the wheel come off the big rig, and he sought a mileage reimbursement from his employer for that trip in his personal vehicle.

As for being within the "scope of his employment", Matt testified that a subcontractor working on his employer's property owned a semi-truck and trailer. At the time Matt saw the tire come off the big rig on the highway, Matt believed that the logo on the trailer identified the truck as belonging to his subcontractor. That is why he stopped at the side of the road to pick up the tire.

As it turned out, the subcontractor was not missing a tire on any of its semi-truck trailers. But being a conscientious person, and one who valued a good business relationship with this subcontractor, Matt thought it in the best interest of both parties to pick up and return the tire to its rightful owner. Matt's attorney argued that Matt's assumption, which turned out to be wrong, should not be held against him.

The judge was persuaded that Matt was in both the "course and scope of his employment" and ruled in Matt's favor. He ordered the workers compensation insurance carrier to pay Matt his lost wages, reimburse Matt's health insurer for medical expenses they paid, reimburse Matt for copays, deductibles, and co-insurance expenses he paid, pay Matt for mileage he traveled to and from medical appointments, pay Matt a lump sum for the permanent impairment to his low back, pay Matt 8% interest on the money he was owed but did not receive for over three years, and remain liable for any future medical treatment that might arise as a result of Matt's industrial injury. The insurance company attorney appealed the case and lost again on appeal.

One other thing should be noted. Matt was fortunate enough to have a working spouse and good health insurance at the time of his accident. He was able to quickly have the surgery his doctor recommended and begin healing. Many injured workers do not have a working spouse or health insurance, and when a claim is denied, they suffer considerably for months and often years without even the most basic medical treatment.

It isn't surprising that people in these situations might become dependent on opioids. Even Matt, however, with the advantages of a working spouse and health insurance, found his financial status, emotional health, and career path at risk because of his denied claim. His award by the Labor Commission after years of litigation, while a welcome outcome, did not begin to compensate him fairly for what he lost.

What benefits is an employee entitled to if injured at work?

Like other states, the state of Utah requires employers to carry workers compensation insurance. In the event of an accident at work, this insurance is designed to pay an injured worker's medical expenses, a modest wage until the employee can get back to work, and modest compensation for a permanent impairment--such as consequences of a serious orthopedic surgery or an amputated body part.

In extreme cases, workers compensation insurance pays death benefits to an employee's family if the employee is killed, or a modest income for life if the employee is never able to return to work again. Whose fault the accident is (the employer's or the employee's) does not matter.

Workers compensation benefits are not a gateway to easy wealth. These bare bones benefits are designed to keep an injured worker' family afloat financially until the employee can fully recuperate.

Most injured workers say they would trade their workers compensation benefits in a heartbeat for the accident never to have happened in the first place. Employees often lose good health, income, health insurance, ongoing retirement contributions, and future earning power following a serious accident at work--even with workers compensation insurance coverage.

Is it any wonder that the Workers Compensation Fund has adopted as its motto: "Be careful out there!" Another reason to "be careful out there" is that insurance companies do not like to pay. They will often use every means at their disposal to delay or avoid payment altogether.

Most workplace injuries aren't reported

What happened to Matt could easily happen to you or to those you love.

In 2021, the U.S. Bureau of Labor Statistics reported that an average of 2.3 per 100 full-time workers were injured on the job that year. The most common non-fatal injuries were sprains, strains, and tears. Construction, transportation, and warehouse industries accounted for the most work-related deaths.

When you're dealing with the lasting effects of a workplace injury or death, the last thing you want is a financial burden to carry as well. However, many workers are unaware of the benefits available to them through worker's compensation. The Occupational Safety and Health Administration estimates that half of workplace injuries go unreported.

Have you been injured at work? Get help!

If you suspect you aren't receiving the compensation you rightfully deserve for a workplace injury or illness, it's important to act quickly. Let the award-winning team of attorneys at Davis & Sanchez help; they have handled thousands of cases. As a law firm focused solely on workers' compensation, Davis & Sanchez offers free case evaluations to help you determine if hiring an attorney is your best option.

Contact them today to get the help you need.

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