The One Mistake NOT to Make After a Workplace Injury!
As a trial lawyer, one of the first steps in analyzing a worker’s compensation claim is determining whether the employee’s injury “arose out of” and “in the course of” his or her employment. These terms are outlined in the Act under Ala. Code § 25-5-1 (8).
When relevant case law is examined, each of these phrases are defined independently.
“Arising out of” requires some sort of causal connection between the injury and the type of employment, and “in the course of” is more circumstantial (time, place, method of accident).
These terms are distinct, and both terms must be satisfied to proceed under the Worker’s Compensation Act.
Insurance companies and self-insured funds know the Workers’ Compensation Act, and have an immediate advantage over an employee who has suffered an injury but is unfamiliar with the law. How do the insurance companies use this to their advantage?
In many cases, they immediately request a recorded statement from the employee, under the guise of gaining a better understanding of how the incident occurred. In reality, the adjuster’s motive may be to deny the claim by disproving one of the above-mentioned phrases.
For example, an adjuster may ask questions that sound as follows:
Q: So, you were walking down the hall, and you slipped and fell?
A: Yes, but I slipped in something.
Q: Well, you can’t say for sure that you slipped, right? All you know is that you fell?
A: I guess that’s true. All I really know is that I was at work and I took a bad fall. I’m not sure what caused it.
The foregoing example is all an adjuster with ulterior motives needs to deny the claim. It is not enough to merely be at work when an injury occurs. There must be a causal connection. In our example, the adjuster has now obtained a recording from the employee that implies his injury did not “arise out of” his employment.
The majority of adjusters are good people, just doing a job. There are bad ones with ulterior motives, just like in every profession (including mine) has its share of bad actors. If you’ve suffered an on-the-job injury and are asked to give a statement, please consider your words carefully and consult a professional prior to doing so.