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At what times am I covered by workers’ compensation?

You are covered by workers compensation if you are injured while performing your work duties provided work is a significant contributor to your injury. For example, if you suffer a heart attack on hearing news of the tragedy affecting your family while you happen to be at work and work is not causing you any substantial stress then you are not covered.Extensions of coverage include:

  • Recesses (lunch breaks);
  • Journeys to and from home without substantial deviation or interruption;
  • Some work functions.

Exclusions of coverage include:

  • A purely psychological injury caused by reason management action (possibly, but not necessarily, related to disciplinary action) conducted in a reasonable manner;
  • Injury sustained through engaging in serious and wilful misconduct.

For journey claims, the coverage starts/stops at your front gate. If you stop on the way home to get milk you are still covered. If you divert half a kilometre on a 15 km trip to pick the kids up from school you are still covered. If you meet friends for drinks for three hours and then continue home, you are not covered.The “reasonable management action” exception protects employers and their insurers where the employer conducts management action reasonably and the employee still suffers psychologically.Boundaries as to what constitutes “management action” are not entirely clear. It does not include psychological injury sustained because a poorly maintained gantry crane drops material on a factory floor, narrowly missing you. The behaviour must be reasonable and must be done in a reasonable way. Swearing at an employee while undertaking a performance review is not acting in a reasonable way.

If there is significant contribution to the psychological injury from something other than the protected behaviour then the psychological injury is still covered by workers’ compensation. For example if there is an accident at work (not leading to physical injury to yourself and not involving serious misconduct) and the employer conducts a review as to whether you are partly responsible for the accident, and both the accident and the review each contribute significantly to your developing a psychological injury, then you are entitled to compensation for the psychological injury, even if it was reasonable for the employer to conduct a review and even though they conducted it reasonably.Unless the worker is killed or extremely seriously injured, there is no right to a statutory claim if the injury arises from misconduct which is both serious and wilful.

The exclusion only applies if the worker engaged in the conduct knowing it was wrong to do so. If the behaviour falls within a category of things you know you should not do (starting a fight at work, driving while intoxicated) and there is time to consider your action, the exception is more likely to apply. An action done without any real forethought, even though extremely ill-advised (flicking on a cigarette lighter to investigate fumes coming from a shipping container) is less likely to come within the exception.