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The Takeaway

Two keys to effectively managing workers’ compensation claims include:

1. Preparing before any incidents occur, including writing detailed job descriptions for every position and incorporating workplace safety tips and injury reporting procedures into employee handbooks.
2. Promptly capturing the details immediately following an incident, including obtaining witness interviews and statements and conducting site inspections.

Just Because It Happened at Work Doesn’t Mean It’s a Work Comp Case

Workplace injuries happen, and, in some industries, they happen frequently.

However, simply because an injury occurred at work doesn’t mean it qualifies for workers’ compensation benefits. For employers in Missouri and Illinois, taking prompt action immediately after such incidents is critical as key details often fade, are forgotten, or become lost over time.

An employer is uniquely positioned to know its work and workplace, and the details it secures can greatly assist claims professionals and defense counsel in protecting the employer’s interests.

Often, the relationship between injury and employment seems clear (e.g., a security guard directing traffic is struck by a vehicle, or a nurse sustains a back injury while preventing a patient from falling). In other instances, however, the relationship is less apparent.

One fundamental element of a compensable workers’ compensation matter in Missouri and Illinois is that the injury arose out of and in the course of employment. RSMo. 287.020.3(1); 820 ILCS 305/1(d). In determining whether this requirement is met, a prompt investigation of a claimed workers’ compensation incident is often critical.

In recent years, both Missouri and Illinois have placed greater importance on analyzing what activities are associated with or incidental to an injured worker’s employment. Many details that ultimately determine liability in workers’ compensation claims lie at the employer’s fingertips. Quickly securing that information (in coordination with the employer's claims team) can alter the outcome of a claim.

Key Steps for Safeguarding Employer Liability

Employers should be prepared to consult with their claims team and actively secure any immediately available details of a workplace injury. Every aspect of the investigation should be documented, preserved, and promptly shared with the employer’s claims team.

The following is by no means an exhaustive list as different industries have different resources available. Also, different injuries may require investigating different aspects of an employee’s job. Nevertheless, basic investigatory factors include:

Statements

• Get written and/or audio statements from those involved in or who have knowledge of the incident.
  • Have written statements signed by the individual providing the statement.
  • Preserve the statements in their original form.
• Be sure the statements include fundamental information.
  • Who was involved?
  • What happened?
  • Where did the incident happen?
  • When did the incident occur?
  • Why/how did it occur?
• As much as possible, have the statements include details about the incident.
  • These details can vary by injury, but even what seems like minutiae can prove valuable. Sample details could include:
    • What kind of shoes was the employee wearing?
    • What physical act was the employee performing (e.g., bending, kneeling, walking, etc.)?
    • What safety precautions were being observed?
    • What was the condition of any surface, structure, or machinery before, during, and after the incident?

Site Inspection

• Inspect any site where an employee was injured.
• Record the time when the site was inspected. (Conditions can change rapidly.)
• Photographs can be exceptionally helpful.
  • Slips, trips, and falls are clear candidates for immediate site inspection. An employee may state that an injury was caused by a foreign substance, a misplaced object, or an uneven break in the floor surface. Photographs can document the presence—or lack of presence—of these circumstances.

Witnesses

• Be sure to secure statements from the injured employee’s immediate supervisor(s) and co-workers.
• Don’t limit witnesses to co-workers.
  • Include customers, vendors, and even individuals who didn’t see the event but spoke with the employee about the injury and/or physical state at the time of or shortly after the injury occurred.

Surveillance Videos

• Check for the availability of on-site video.
  • These are increasingly common as many employers maintain security cameras for the safety of both patrons and employees. Review video capturing the moments before, during, and after an injury.
• Consider the availability of video from non-employer-based sources.
  • Many workplaces share space with other businesses (e.g., in office parks or shopping plazas).
  • Injuries on city streets may have been captured on outdoor cameras.
  • Injuries occurring at a residence (such as one sustained by a home health worker or delivery driver) may be recorded on a video doorbell.

Job Descriptions

• Document job descriptions before any injuries happen.
  • Be specific and precise in describing all the duties each employee is expected to perform.
  • Include a description of any physical demands associated with each job, perhaps including what they should not do.

Handbooks

• Employee handbooks should include procedures for maintaining workplace safety and reporting injuries.
• Include an acknowledgment form that will be signed by an employee before it’s submitted.

Conclusion

What qualifies as a compensable work injury has changed in recent years. Answers to liability questions that were true 10 years ago may no longer be valid. Even when an employer has protocols in place, consultation with claims professionals and defense counsel remains crucial, and the importance of details cannot be overstated.