There are generally two requirements for an employee who is injured at work, to qualify for Workers’ Compensation: (1) the employee must suffer by accident; and (2) the injury must arise out of and in the course of employment.
As a general rule, employees must suffer an injury by accident in order to give rise to a claim under the Workers’ Compensation laws. The term “accident” has been interpreted as an “unlooked for and untoward event which is not expected or designed by the injured employee.” For example, injuries by accident often arise in the construction context. An employee that falls from a ladder or trips into a hole would likely be able to claim any injuries resulting from that accident under the Workers’ Compensation statute. Likewise, a welder who is injured due to an equipment malfunction or a supermarket worker who slips on a wet floor could also claim. Satisfying the injury by accident standard does not automatically result in a claim being valid. However it is an essential element. On the other hand, an employee who claims a workplace injury but cannot reproduce any details regarding when, where, and how the accident occurred will have an uphill battle in bringing the claim.
Furthermore, this claim cannot arise based on something that occurs in the normal course of an employee’s work. For instance, if an employee normally lifts boxes and places them on a truck, an unforeseen knee injury resulting from that lifting likely will not qualify as an injury by accident.
As an exception to the injury by accident standard, back injuries-only require a “specific traumatic incident.” The principal distinction between both are that the specific traumatic incident can occur within the employee’s normal job duties. Here, the unforeseen, unusual aspect of the injury is not required, but it does have to be specific. Returning to the hypothetical above, if an employee lifts boxes onto a truck bed everyday as a part of their normal routine and injures his back while lifting one day, that claim could likely be brought as a specific traumatic incident. The employee’s injury occurred during a specific instance at work.
It is often frustrating for claimants that the types of injuries covered under the specific traumatic injury standard are so limited. Every case is very fact specific. If you feel like you have been injured at work, you should consult a workers compensation attorney in your area for an objective evaluation of your case.