Workers Compensation Newsletters

Adult Consultative Examination Reports

When an adult Social Security Disability Insurance claimant fails to provide, or provides inadequate, medical information to make a "disability" determination, the Social Security Administration (SSA) will request that a consultative examination (CE) be performed. The claimant's treating physician or an independent medical source may perform the CE. When the CE has been completed, a report must be provided to the SSA that meets the minimum requirements specified by the SSA.

Dual-Purpose Travel by Employee

"Dual-purpose" travel by an employee occurs when the employee embarks on a trip on behalf of the employer that coincides with travel for the employee's benefit. In other words, the journey serves both the business purpose of the employer and the personal purpose of the employee. Characterization of the trip as business, personal, or both does not have to be made at the outset of the trip. A trip can start out as purely personal but then transform into a business endeavor.

Fault of Employee

A core principle within the area of workers' compensation is that the question of "fault" is largely irrelevant. It is only when the employee's "fault" in connection with the injury is occasioned by him leaving the course of employment or is a statutory defense in a jurisdiction will the inquiry come into play. The test for workers' compensation is generally not personal such that an employee's misconduct, whether negligent or intentional, will affect the receipt of benefits. Rather, the test is merely whether the injury arose out of and in the course of employment.

Violation of Law or Commission of Crime

As a general rule, an employee is not necessarily withdrawn from workers' compensation eligibility if he is injured while violating a law or committing a crime in furtherance of his job duties. Most often, the violation of a law or commission of a crime will affect an employee's receipt of benefits if, in the applicable state, it constitutes "wilful misconduct" or is the subject of its very own statutory provision giving a defense to the employer. The violation of a statute does not ipso facto equal "wilful misconduct." Rather, flagrancy and knowledge on the part of the employee are generally required for an act to rise to the level of "wilful."

Workers' Compensation Exemption re Number of Employees

In some states, an employer is exempt from maintaining workers' compensation insurance if it regularly employs only a certain number of employees. For example, with certain exceptions, employers in Alabama, Arkansas, Georgia, Virginia, New Mexico, and North Carolina are exempt if they have less than three employees. Employers in Rhode Island and South Carolina are exempt if employing less than four employees while employers in Mississippi, Missouri, and Tennessee are exempt if employing less than five employees. If the employee is injured and the state has altered its exemption statute, the operative version of the statute on the date of the employee's injury will control.