The Going and Coming Rule in Workers’ Comp Cases

Workers’ Compensation in Massachusetts is a government-mandated insurance program designed to provide benefits to workers who suffer an injury or illness while working. These benefits are designed to replace wages injured employees can no longer earn as well as cover expenses for medical treatment.

However, there are situations where injured workers may or may not be covered by workers’ comp insurance such as when they are going to or coming from work.

If you were injured while traveling to your job or back home from it and your claim for workers’ comp insurance is being disputed, you need to talk to an attorney right away.

Injured Workers Entitled to Workers’ Compensation Benefits

With few exceptions, employers in Massachusetts are required to provide employees with workers’ comp insurance. This insurance program is a safety net that ensures injured workers will be able to pay their medical bills and provide basic necessities for their families if they suffer an unfortunate accident or illness at work.

The two basic requirements to be covered under workers’ compensation are:

• You must be an employee, not a contractor or other type of worker.
• The injury or illness must be work-related.

Most workers’ comp cases are straightforward. For example, if a warehouse worker is suddenly hit by an object which falls from a shelf and others witness the accident, there is no doubt that the accident happened and that it took place at work. In this case, if the worker is injured to an extent that he or she is unable to perform normal job duties, a workers’ comp claim will most likely be approved quickly.

However, there are many cases in which the insurance company will deny a claim and refuse to pay benefits. This often happens when the “Going and Coming” rule is a major factor in a workers’ compensation case.

What is the Going and Coming Rule?

A “workplace injury” seems easy enough to understand. If a construction worker falls off a ladder while at a worksite, the accident obviously happened at work. But what if an employee gets hurt while going to or coming from work? Do workers’ comp benefits extend to such a degree?

When filing a workers’ comp claim, serious issues come into play if the worker’s injury happened while traveling to or from work. In most related cases, the point of view has generally been that workers’ compensation benefits do not extend to employees who suffer injuries in an incident while going to or coming from work. This is known as the “Going and Coming” rule and insurance companies use it to great effect to deny claims.

This means that any medical bills and lost wages arising out of an accident while you are headed to work or going back home from it will most likely not be covered by workers’ comp. The argument here is that workers are not performing any job duties even though their commute is job-related.

However, there are exceptions to the coming and going rule. One such exception deals with workers who normally leave their workplace “base” to perform their job. This is often called the “traveling employee exception”.
For instance, if a health care provider is on her way to a patient’s residence to provide care and she gets injured in an accident, she will most likely be approved for workers’ comp benefits. This is due to the fact that she was “going” to a patient’s home in fulfillment of her normal job duties.

Another exception is when an employer orders a worker outside of the immediate work area on an errand. In this case, an employee who is sent to the store for office supplies and ends up seriously hurt in an unfortunate accident while doing so can claim workers’ comp benefits.

Also, it is important to note that even if a worker has signed off from work for the day if he is still on the employer’s property when injured, worker’s comp benefits can be claimed. Consider a worker who has punched out and is walking to his vehicle. He is hurt in the parking lot which belongs to the employer. This injured worker should not face any issues claiming benefits if his injuries keep him from being able to work.

Of course, insurance companies can still dispute such exceptions and they often do. An experienced workers’ comp lawyer knows how to deal with such cases effectively.

Does the Going and Coming Rule Apply in my Case?

If your work-related injury or illness is serious enough to keep you from working, leading to high medical bills and considerable loss of wages, it is imperative that you are approved for workers’ comp benefits as soon as possible.

But will the Going and Coming Rule keep you from getting the benefits you need?

Even though this rule is upheld in most cases where workers get hurt while traveling to and from work, there are exceptions that are both obvious, such as the examples mentioned above, and others not so immediately obvious.

The fact is that there is no telling whether this rule will lead to your claim being denied until all the facts and circumstances of your case have been thoroughly examined.

On the other hand, if your claim has already been denied because of the Going and Coming rule, whether you choose to appeal or not is a decision that should be made after careful consideration of the facts.

The wisest course of action is to contact an attorney who specializes in workers’ comp cases as soon as possible for advice.

Act Now and Get a Free Consultation

Workers’ comp cases must be filed and/or appealed in a timely manner, especially if your bills are piling up while you are being denied benefits due to the Coming and Going rule.

Act now and call us at the Law Office of Robert E Frawley at (617) 523-2929 for a free consultation!