AI Generated Opinion Summaries

This summary was computer-generated without any editorial revision. It is not official, has not been checked for accuracy, and is NOT citable.

Facts

• A personal care attendant, employed to care for her mentally disabled adult son under a Medicaid-funded program, was injured by her son during a family outing after her scheduled work hours. The outing involved errands and activities not specifically required by her employment but included tasks she sometimes performed as part of her job, such as laundry for her son. The injury occurred while driving home after these activities (paras 2-3).

Procedural History

• Workers’ Compensation Administration, Reginald C. Woodward, Workers’ Compensation Judge: The claim for workers' compensation benefits was denied on the basis that the injury did not occur in the course and scope of employment, nor did it arise out of employment (para 1).

Parties' Submissions

• Worker-Appellant: Argued that the injury should be covered under workers' compensation as it occurred while performing duties related to her employment, despite happening outside of scheduled work hours (para 4).
• Employer/Insurer-Appellee: Contended that the injury did not occur within the course and scope of employment as the activities during which the injury occurred were not part of the worker's employment duties but were personal or family activities (para 5).

Legal Issues

• Whether the worker's injury, sustained during a family outing after scheduled work hours, occurred in the course and scope of her employment and arose out of her employment (paras 4-5).

Disposition

• The court affirmed the Workers’ Compensation Judge's decision to deny the claim, concluding that the injury did not occur in the course and scope of employment, nor did it arise out of employment (para 1).

Reasons

• Per M. MONICA ZAMORA, J. (JAMES J. WECHSLER, J., J. MILES HANISEE, J., concurring):
  The court reviewed the factual findings under a whole record standard, giving deference to the Workers’ Compensation Judge's findings supported by substantial evidence and not reweighing evidence or substituting its judgment (para 6).
  The analysis involved interpreting administrative regulations related to the worker's employment, reviewed de novo. The worker's employment was defined and regulated by the Human Services Department’s administrative regulations, which outlined the scope of services and work schedule under the Personal Care Option (paras 7-11).
  Under the Workers’ Compensation Act, for an injury to be compensable, it must occur while the employee is performing service arising out of and in the course of employment. The court found that the worker's activities at the time of injury did not meet these criteria, as they were not specific to her son's needs or to benefit her employer but were part of a family outing (paras 12-15).
  The court considered and rejected the worker's claim that she was working outside her scheduled hours, based on testimony and documentation indicating she was to follow the schedule set forth in the Individual Plan of Care. The court concluded that the evidence supported the finding that the injury did not arise from or occur in the course of employment (paras 16-18).
  The court also found that the traveling employee and special errand exceptions did not apply to the worker's situation, as her trip did not require travel beyond a typical commute or at the direction of the employer for employment purposes (paras 19-24).