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Per the California Labor Code Section 3600, in order for an injury to be compensable through workers’ compensation, the injury must have arisen out of and be within the scope of employment. Often times this is referred to as AME or QME, arising out of employment or caused by employment. Determining whether your injury happened on the job or within the scope of employment can be tricky in some situations.

There are several circumstances that may be unclear as to whether your injury is work related. Being injured on a lunch break, at a company event, or commuting/traveling, can sometimes fall into gray areas. As such, it is important to speak to an experienced attorney to avoid your claim being denied. The workers’ compensation attorneys at Allegiance Law have the knowledge and experience to determine if you have a valid workers’ compensation claim and to make sure your rights are protected.

Lunch Breaks:

Generally, injuries that occur while the employee is on a lunch break are not covered by workers’ compensation. However, there are some exceptions depending on the facts. Here are some common examples of when you may or may not be covered:

  • If you fell and injured yourself at a cafe, while picking up your lunch on your break, you likely cannot claim workers’ compensation for your injury.
  • If you fell and injured yourself at a café, while picking up your lunch and also your boss’s lunch, then you may be able to claim coverage under workers’ compensation.
  • If you hurt yourself on the company’s premises, such as in the cafeteria, during your lunchtime break, then your injury is likely covered by workers’ compensation, as your use of the cafeteria is beneficial to your employer.

Company Events:

Many companies sponsor special events like softball games, holiday parties, or picnics. Sometimes an employee can sustain an injury during such an event. Depending on certain circumstances, the employee may or may not be covered by workers’ compensation.

To determine whether the event was within the course of employment, which will determine if the employee’s injury sustained at the event is compensable through workers’ compensation, the courts will examine the following factors:

  • The extent to which the company expected or required employees to attend
  • The degree to which the company benefits from the activity
  • Degree of sponsorship or participation by the company
  • Whether the activity takes place on company property
  • When the activity occurs in relation to work
  • The frequency of the activity

Typically, where the attendance at the event is voluntary, the event is not during work hours, and the event is not on the company premises, the employee will not be considered to be within the scope of employment if injured.

Travel:

An employee injured while traveling may or may not be covered under workers’ compensation. Typically, an employee injured while traveling on a business trip or to a worksite is covered under workers’ compensation. However, an employee that is injured during his or her regular commute to and from work generally is not covered.

Claim Disputes:

Occasionally, there is a disagreement as to whether an injury that an employee suffered is covered under workers’ compensation benefits. An employee has a right to challenge the decision that the injury suffered is not covered under workers’ compensation.

If you were injured in a workplace accident and were denied compensation, it is important to speak to our knowledgeable and skilled workers’ compensation attorneys, as they will help you determine if you were injured within the scope of employment and which benefits are available to you.

Please contact us today for a FREE 30-minute consultation. Our workers’ compensation attorneys are available to meet with you during business hours, evenings, and weekends. Allegiance Law is located in San Francisco, but we will be happy to drive and meet you. You may contact Allegiance Law, at 415-404-6395. Or you may contact us by filling out the client inquiry form on this page.