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​At some point, nearly every employer will have an employee report an injury and seek treatment under a workers compensation policy. Every US State has "industrial insurance" or workers compensation laws that define the benefits payable to the injured worker (NRS 616 in Nevada). The benefits afforded to an injured worker can vary from state to state. However, there is one critical concept to which every state agrees: to be covered by workers compensation insurance (or self-insurance) the employee injury or illness must arise out of and in the course and scope of employment.
To understand this concept further, let's examine the meaning of "arise out of and in the course and scope of employment". In simplistic terms this concept dictates that:

1. The injured employee was engaged in an activity that benefits the employer,
2. The injury occurred at the employer's location or a location mandated or reasonably expected by the employer,
3. The proximate cause of the injury was related to the occupation of the employee.

A few claim scenarios are helpful to understand when an employee injury becomes compensable under workers compensation coverage.  These are actual injury and claim scenarios that clients of Safeguard Insurance have reported over the years:
Claim Scenarios

1. An employee of an electrical contractor is dispatched to install ceiling fans at a customer's home.  The employee must stand on a ladder to install the fans. The ladder becomes unstable, tips over, and the employee suffers a broken arm in the fall.
2. An outside sales employee visits a local restaurant for his lunch break.  While in the restaurant, he slips on a wet floor and suffers a severe back injury.
3. A truck driver for a distribution company takes a break from his normal delivery route to do a little scenic site-seeing. While on this site-seeing excursion, the driver is involved in an auto accident and suffers injuries.
4. An outside sales employee meets clients at a local restaurant for a business meeting and lunch.   During the lunch meeting, he uses the restroom and slips and falls on the wet floor. He suffers a severe head and neck injury as a result of the fall.
5. Two employees that work in the same retail store become involved in a verbal argument over their favorite sports team. The employees decide to "settle the argument like men" and step outside to engage in a voluntary physical altercation. Both employees suffer severe bruising, sprains, and dental injuries.

Coverage Analysis
Using the "course and scope" rule we can examine each claim and determine if workers compensation coverage might apply:

1. This situation seems fairly uncomplicated. The employee was assigned a task for the benefit of his employer.  He was working at an expected location. How and why the ladder became unstable is probably not relevant to the employee receiving compensation benefits. In this case, workers compensation coverage should apply.
2. Generally speaking,  employees are not covered for injuries that occur while on a lunch break. This injury would likely not be covered by workers compensation.
3. The driver was injured in an auto accident, which is certainly within the scope of his occupation. However, his unauthorized site seeing excursion means he was no longer working for the benefit of his employer or at an expected location. It is very likely this claim would be denied coverage under a workers compensation policy.
4. This scenario also occurred during the employee's lunch break. That that employee was meeting with a customer and presumably discussing business opportunities changes the dynamic.  His lunch meeting was for the benefit of his employer. A sales meeting is certainly within the scope of his employment. This scenario would very likely be afforded coverage under a workers compensation policy.
5. Two employees that voluntarily engage in a physical altercation would be hard-pressed to claim their injuries arose from and are related to the course and scope of employment. This scenario would almost certainly warrant a denial of workers compensation benefits to both employees.

Keep in mind that not every employee injury and subsequent workers compensation claim is the same. Two scenarios that seem very similar on the surface may, in fact, have hidden details that change the outcome of the claim. For example, if an employee is under the influence of drugs or alcohol at the time of an injury, coverage may be reduced or denied completely even if the scenario would otherwise warrant coverage. As a disclaimer, the above claim scenarios and analysis are meant to serve as a general overview of possible employee injuries and possible coverage decisions. They are not a conclusive narrative of coverage applicability for every situation.
Remember too that employers are protected by exclusive remedy laws. However, exclusive remedy does not preclude the injured employee from pursuing a claim against a third-party. For example, the electrical employee that fell from the ladder may pursue a defective product case against the ladder manufacturer. The employee that was injured by a slip and fall accident in a restaurant may pursue a premises liability claim. The errant driver on the site seeing excursion may have a valid auto liability claim against another driver. Lastly, the two employees that punched-out their differences may file lawsuits against each other for personal injury.

For more information contact Ryan Dye at: ryan@safeguardme.com 

Congratulations to DC Building Group for receiving NAIOP Spotlight’s General Contracting Firm of the Year Award for 2017. The 20th Annual NAIOP Southern Nevada Chapter Spotlight Awards were held on the evening of Saturday, March 4th, 2017 at the Red Rock Casino, Resort & Spa. The guests attire for the evening was based on the Roaring 20s to celebrate the 20th Annual NAIOP Spotlight Awards.

The attendees waited in anticipation until nearly the end of the evening to hear who would be named the General Contracting Firm of the Year. Once the NAIOP Southern Nevada Chapter Spotlight Industry Award Nominees for General Contracting category were listed, the audience waited in suspense with only this prelude hint as the host read: “This firm continues to grow and impress due to their quality of work and level of professionalism.” Before hearing “and the General Contracting Firm of the Year goes to DC Building Group!” Team representatives who accepted the award on behalf of the entire DCBG team were: Shawn Danoski, Gary Siroky, Dave Teator, Charlie Stewart and Jennifer Hall.

Shawn Danoski, CEO of DC Building Group, said, “Winning the NAIOP Spotlight Award for General Contracting Firm of the Year really means a lot because of the timing. Receiving this accolade now from such a high-caliber peer group is a testament to our firm’s successful growth and direction. This award reflects our aim to increase our capacities and recognizes our team for their dedication and solidarity.”
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DC Building Group also received multiple Spotlight Merit Awards from NAIOP for these projects: Goodwill Retail Store and Donation Center, Cracker Barrel – North Las Vegas, Guy Fieri’s El Burro Borracho in Rio Hotel and Casino, JS Products Corporate Offices and Distribution Center, M&Ms World Las Vegas Renovation at Showcase Mall, Southern Hills Baptist Church.