Workers’ compensation is a state-run insurance system designed to provide “no-fault” benefits to employees injured on the job. No-fault means that a worker may receive medical and income replacement benefits without having to establish the employer was negligent or somehow responsible for the injury. However, the injury must occur in the course of employment and not some “individual pursuit.”
Frett v. State Farm Employee Workers’ Compensation
Georgia courts have long held that an employee who is on a scheduled lunch or rest break during the workday is engaged in an “individual pursuit,” and therefore not entitled to workers’ compensation benefits if they are injured during that time. Recently, the Georgia Court of Appeals reaffirmed that principle in a case addressing an employee was injured while preparing to leave work for lunch.
The plaintiff in this case worked as a claims adjuster for an insurance company. As part of her job, the company required the plaintiff to take an unpaid 45-minute lunch break each day. The company staggered lunch times throughout the day using an automated system, which required each individual employee to “log out” before taking the break.
The plaintiff said that although she was free to leave the company’s offices for lunch, she normally ate in an employee break room or on a bench outside the building. On the day in question, the plaintiff logged out at her assigned lunch time and went to the break room to prepare some food. The plaintiff said she intended to take her meal outside to eat on the bench. But as she exited the break room, she slipped and fell on a puddle of water.
The plaintiff later filed a claim for workers’ compensation benefits. An administrative law judge for the State Board of Workers’ Compensation awarded the plaintiff temporary total disability benefits and medical expenses. But the State Board itself reversed the ALJ, holding that the injury occurred while the employee was on a “regularly scheduled break,” and therefore not subject to workers’ compensation.
The plaintiff appealed the Board’s ruling to the courts. The Georgia Court of Appeals, agreeing with a lower court and the Board, agreed the plaintiff was not entitled to workers’ compensation under these circumstances. As the Court noted, the so-called lunch break exception applies “even if the injury occurs within working hours and on the employer’s premises.”
But there was an additional complicating factor. There is another long-recognized rule applicable to Georgia workers’ compensation cases that holds an employer is liable for workers’ compensation benefits during periods of “ingress and egress” from the employer’s premises. This leads to a conflict in the law, the Court explained, because an employee who was injured while leaving for lunch off-premises would receive workers’ compensation benefits, but an employee who is injured while having lunch on the premises would not.
The Court of Appeals resolved this conflict by stating that going forward, it would no longer “apply the ingress and egress rule to the scheduled break exception,” unless the Supreme Court of Georgia directs otherwise. As for the present case, the Court said it was “undisputed” the plaintiff was on her scheduled lunch break when she was injured, so she was simply not entitled to workers’ compensation benefits.
It should be noted the Court’s decision means the plaintiff could choose to pursue a separate personal injury claim against her employer, as workers’ compensation no longer provides the “exclusive remedy” for her situation.