For a typical work injury to be compensable under the Workers’ Compensation Act, the claimant bears the burden of proving that “an injury by accident” arose “out of and in the course of [their] employment,” and both of these “independent and distinct criteria” must be satisfied. O.C.G.A. § 34-9-1(4); Mayor and Alderman of the City of Savannah v. Stevens, 278 Ga. 166 (1) (2004). “In the course of the employment” has been defined as relating to the “time, place, and circumstances under which the accident takes place, and an accident arises…
For a typical work injury to be compensable under the Workers’ Compensation Act, the claimant bears the burden of proving that “an injury by accident” arose “out of and in the course of [their] employment,” and both of these “independent and distinct criteria” must be satisfied. O.C.G.A. § 34-9-1(4); Mayor and Alderman of the City of Savannah v. Stevens, 278 Ga. 166 (1) (2004). “In the course of the employment” has been defined as relating to the “time, place, and circumstances under which the accident takes place, and an accident arises… when it occurs within the period of employment at a place where the employee may reasonably be in the performance of his duties and while he is fulfilling those duties or engaged in something incidental thereto.” Ray Bell Constr. Co. v. King, 281 Ga. 853, 854-855 (2007). An accident arises out of the employment when a causal connection between the employment and the injury is present. Id.
As claims became more sophisticated, the Georgia courts were faced with the task of having to expand this general definition of a compensable injury, and chose to do so through the creation of exceptions to deal with those cases requesting compensability that didn’t neatly fall into the established parameters. In 1935, the Georgia Supreme Court opined that when an employee is injured when on a scheduled lunch break while he remained at his place of employment, the injury is not compensable, as the “preparation for lunch and his eating lunch was his individual affair,” and as such, the injury arose out of an individual pursuit, not his employment. Ocean Acc. & Guar. Corp. v. Farr, 180 Ga. 266, 270-271 (1935). A later Court of Appeals opinion described the situation as “…founded on the proposition that during the lunch hour the employee turns aside from his employment for his own purposes, and the master-servant relationship is suspended.” American Hardware Mut. Ins. Co. v. Burt, 103 Ga. App. 811, 814 (1961). However, the Court did not extend this exception to injuries when an employee is on an unscheduled break, explaining that the time spent on an unscheduled break is not “released to [the employee] as free time during which he may do as he will.” Edwards v. Liberty Mut. Ins. Co., 130 Ga. App. 23, 24 (2) (1973). Injuries in this situation would be deemed compensable.
Ingress and Egress
In another line of cases that also fell outside the established general definition of a compensable work injury, the Georgia Court of Appeals grappled with the claims of employees who were injured in the process of coming to and leaving from work. The Court ultimately recognized that when an employee is “stepping aside from the employment” when they elect to go home or take a lunch break, that act is “…an act contemplated by the employment… which necessitates the return to the place of the employment…,” thus making injuries occurring in that scenario compensable. Travelers Ins. Co. v. Smith, 91 Ga. App. 305, 309 (1954). The theory was later formally applied to the situation when an employee is leaving the workplace on a scheduled lunch break and is injured while still on the employer’s property. The Court of Appeals held, “Where the employee is still on her employer’s premises in the act of egressing those premises, even if on a break, then the Workers’ Compensation Act does apply. Therefore, [the employer] may not deny [the employee] benefits based on the inapplicable ‘scheduled break’ exception.” Rockwell v. Lockheed Martin Corp., 248 Ga. App. 73, 73 (2001).
Dealing with the Tension
Due to these prior rulings, the prevailing theory in Georgia’s case law essentially held that employees who left their employer’s property for a scheduled lunch break (and were subsequently injured on either the exit or return) would have a compensable claim, but employees who remained on the employer’s grounds and were injured would not be nearly as lucky. The Georgia Court of Appeals was recently tasked with settling the dissonance between these previous decisions in Frett v. State Farm Employee Workers’ Compensation et al., A18A0820.
Each workday, Ms. Frett was provided with a mandatory, 45-minute lunch break, and the time of the lunch break would vary each day (Pg. 1). The Employer, State Farm, agreed that Ms. Frett was free to do as she pleased during her lunch break, including leaving the office (Pg. 2). She was also not expected or asked to do work during her lunch period. Id. During the warmer months, the claimant enjoyed eating her lunch outdoors on a bench outside the office building or in her car in the parking lot. Id. The State Farm location that Ms. Frett worked at was in a suite within a bigger shared office building, and they did not own the parking lot or any of the outdoor areas around the office. Id. On the day of the accident, as Ms. Frett was exiting the breakroom with her lunch to go outside, she slipped on a puddle of water and fell. Id.
The ALJ assigned to the claim deemed it compensable, awarding Ms. Frett both temporary total disability benefits and medical benefits that were related to her fall, based on the precedent set in the Rockwell case (Pg. 3). On appeal, the State Board reversed the ALJ, opining that the “scheduled break” exception would control, as the accident had occurred while the claimant was on a “regularly scheduled break” and attending to a “purely personal matter,” and the fact that she was still on State Farm’s premises did not have any effect on the outcome (essentially stating that the ingress/egress rule was not applicable). Id. The Superior Court of DeKalb County affirmed the findings of the State Board. Id. When her case reached the Court of Appeals, Ms. Frett argued that the Board erred in its ruling by incorrectly applying the “scheduled break” exception and opining that the ingress/egress rule did not apply to an employee leaving their place of work on a scheduled lunch break. Id.
The Court of Appeals took note of how the previous rulings on the ingress/egress rule and “scheduled break” exception interacted in a way that led to arbitrary results in claims and created muddied waters in case law. It ultimately opined that continuing to extend the ingress/egress rule into cases where a claimant was injured when leaving or returning to work on a regularly scheduled break was “an improper dilution of the Supreme Court’s decision in Farr.” (Pg. 12) Because of this ruling, the Court noted that the decision overturned previous holdings in the Smith, Rockwell, and Chandler v. Gen. Acc. Fire & Life Assur. Corp., 101 Ga. App. 597 (1960) (holding that an employee returning to work from dinner was entitled to a reasonable amount of time for ingress to work and that an accident occurring in that time period arose out of and in the course of her employment). Id. The Court of Appeals also noted that the Georgia Supreme Court should be the final decision-maker on whether the ingress/egress rule could be applied to the “scheduled break” exception (Pg. 12-13). With this ruling, the Court established a bright-line rule that it hoped would eliminate the guesswork in deciding whether a claim could be compensable (Pg. 13).
As a result of the ruling, Ms. Frett’s request for benefits (both medical and indemnity) was ultimately denied, as it was found that her injury arose out of an “individual pursuit” instead of her employment with State Farm. Id. With this ruling, employers and insurers can move forward with confidence in defending claims of this nature, knowing that a clear distinction has been created that helps to define when an employee truly is owed benefits.