The Oregon Workers’ Compensation system provides benefits for injuries that occur on the job. Many times, whether the injury occurred on the job is not an issue. However, there are often disputes about whether a worker was actually “on the job” when injured. These are commonly called “course and scope” denial cases.
To explain how Judges decide the relationship of the injury and whether it happened on the job requires a bit more specificity. Under the statute, a claim is compensable when the injury occurs while the worker was “in the course and scope of employment,” and the injury “arose out of the employment.” Because there are countless variations on the way people do their job, and the relationship employee has with her employer, the Workers' Compensation Board takes a flexible approach in determining whether not somebody was doing a work-related activity while at work in deciding this issue.
The formal name for the legal test to determine this question is called the “unitary work connection test.” Without getting into the finer details, the Judge or Board Member will look at the facts of each case in a hearing to answer two questions:
1. Was the worker “in the course and scope” of employment when the injury occurred?
2. Did the injury "arise" from work activity?
There may be a lot of evidence supporting the fact that somebody was in the course and scope of their employment, but not a lot of evidence that the injury arose out of employment activity. The facts may go the other way as well. The legal test allows the fact finder (the judge) to be flexible in applying this test. Basically, the Judge is looking at both factors, and then weighing all the evidence together to make a decision.
There are also a lot of nuances with this rule, and exceptions as well. For example, if somebody is going to or coming from work, then an injury suffered during this time is usually not within the course and scope of employment. However, there is a special rule for traveling salespeople. There is also an exception to this rule, known as the “parking lot” rule. Some cases say that if the worker is on the employer's property, even after their shift ends, like walking to their car, an injury may be covered.
There are also rules that can determine whether not somebody on a “personal errand” was actually doing a work-related activity. There are also a whole set of rules that deal with whether someone injured while engaged in “horseplay” should be covered under the Workers’ Compensation system. The list goes on and on, so that in the end, there are a lot of cases out there, each with its own unique story.
We have met with many injured workers to discuss the issue of a “course and scope” denial. in our experience, these cases are very fact specific, meaning each cases is unique. This often requires a lot of research, and a lot of investigation.
If you are looking at a “course and scope” denial, call us at 503-325-8600. We can review your claims file, and let you know where you stand.