You Might Be Surprised By What Is Covered By Workers’ Comp!

A recent ruling by an Australian court found that a woman had a compensable injury when a hotel room light fixture somehow hit her during a sexual encounter. Can this really be true? You might be asking, “What are the factual details of the injury? Could this really be covered by workers’ comp in the United States?”

Well, I don’t think there was any video surveillance evidence and I’m not going to draw any pictures. Suffice it to say, the female employee was on an out-of-town business trip where she had dinner with a personal friend followed by a more intimate activity in her hotel room provided for by her employer. Neither the dinner nor the follow-up activity was required by her job as a representative of a health insurance company. The available evidence did suggest, however, that the offending light fixture did not come loose by any intentional act of the employee.

How ridiculous is that? Those Australians must be crazy! There is no way this would be covered by workers’ comp here. Not so fast! It could and probably has happened in the US, too. Questions regarding compensability of a workplace injury are highly dependent on application of state law, which varies greatly from state-to-state.

So…What Is Covered by Workers’ Comp?

Generally speaking, in order to be covered by workers’ comp, an injury must occur “in the course and scope of employment” which is also true under Australian law. In some states the injury in this case would not be compensable because the activity in the hotel room was not specifically related to the workplace, but in other states that have a “portal-to-portal” rule this injury could easily be covered.

Don’t Be So Quick to Deny a Claim

So, how did the Australian court come to the conclusion that the hotel room injury should be covered by workers’ comp? The court analogized that under Australian law there would be no justification for denying compensation had she been playing a card game in her room so the result should be no different just because the injury occurred during a sexual encounter. It makes you wonder what kind of card game the court had in mind. I’m not sure that I’m familiar with any card game that might result in a light fixture falling from the ceiling, but then again – I’m not Australian.

In any case, if one of your employees sustains an injury under similar circumstances, don’t be so quick to deny the claim. Like the result of this story, you might be surprise by what is covered by workers’ comp. As always, exercise caution and seek advice from your attorney first.