The good news is the pandemic is over. The better news is that a large number of the working population, particularly those in the non-retail, non-manufacturing areas, have enjoyed an expanding role in terms of working from home (WFH). Working from home has been established as a significant equalizer in the work/life balance parameters among today’s service sector employees.
It is a frequent news story noting that many larger employers are requesting their employees to return to the workspace, either on a full-time basis or a modified timeframe. However, this brings up an interesting conundrum of what are compensable injuries and what is not a compensable injury when the injury occurs at home and is not a function of the occupational situation.
The most common type of injury relative to working from home is musculoskeletal disorders involving muscles, bones and joints[1]. These can be secondary to the workstation, the work posture, awkward positioning, or repetitive strain. The most common injuries involve the neck, lower back, and shoulders. Sorting these injuries out of ordinary disease of life clinical scenario can be a challenge in adjudicating these complaints.
As with any clinical situation, and more so with the unwitnessed WFH injury, it is crucially important to establish the exact mechanism of injury. Does the clinical scenario offered by the injured employee match up with the pathology identified? Is the neck pain secondary to how the injured employee is positioned with respect to the laptop computer being used? Did the injured employee position himself correctly in line with the specific requirements of the employer?[2] Or perhaps was the injured individual sitting on a couch or bed when completing the work-related tasks? Other frequent issues, such as shoulder strain or carpal tunnel syndrome, are thought to be related to extended keyboard or computer use, and that is not supported in the literature.[3] As you can see, obtaining a detailed history of the mechanism of injury, a detailed history of the noted symptomology, and understanding the exact location of the symptomology reported by the injured employee is vital into ascertaining the correlation between the pathology noted, and the WFH scenario.
Other factors such as loneliness, burnout, anxiety, ability to compete for promotion, all have been noted to contribute to these types of injuries. Added considerations include those injuries such as eyestrain, establishing that the compensable event is causative as opposed to watching television. Lastly, given the date of reported onset of symptomology. When did the injured individual seek medical attention? Each of these data points are significant in establishing what occurred, what is the current, and is it a function of the furtherance of the employer’s interests?[4]
An additional consideration is the personal comfort doctrine. As you know, this is a legal principle that applies when individual employees sustained a compensable injury while attending to their personal needs during work hours. Did the injured employee trip over a laundry basket on their way to the restroom or trip over the family pet?
The personal comfort doctrine is not absolute, and there are some factors that courts will consider when deciding whether an injury is compensable. These factors include:
- The nature of the activity that the employee was engaged in.
- The location of the activity.
- The time of day the activity occurred.
- Whether the activity was reasonably necessary to the employee’s comfort or welfare.
- Whether the employer had any control over the activity.
It is important to note that not all injuries that occur while an employee is attending to their personal needs will be covered under the personal comfort doctrine. For example, an injury that occurs while an employee is engaging in horseplay or other reckless activity is not likely to be covered.
It is a new age, and a new workplace paradigm. With respect to people working from home, this raises significant challenges to the individual attempting to appropriately decide the file. As with everything, the devil is in the details, and it would behoove all parties to obtain as much of the history as possible so that the most proper decision,one that is consistent with the objective clinical data obtained, will enable the injured individual to receive all appropriate care.
[1] Oha K., Animägi L., Pääsuke M., Coggon D., Merisalu E. Individual and work-related risk factors for musculoskeletal pain: A cross-sectional study among Estonian computer users. BMC Musculoskelet. Disord.
[2] Chim J.M.Y., Chen T. Implementation of an Office Ergonomics Program to Promote Musculoskeletal Health: A Case Study in Hong Kong. IISE Trans. Occup. Ergon. Hum. Factors. 2021;9:96–105.
[3] Genova A, Dix O, Saefan A, Thakur M, Hassan A. Carpal Tunnel Syndrome: A Review of Literature. Cureus. 2020 Mar 19;12(3):e7333. doi: 10.7759/cureus.7333. PMID: 32313774; PMCID: PMC7164699.
[4] Debono M., Garzia C. Trade Union Members’ Experiences and Attitudes towards Working from Home during the Pandemic. Sustainability. 2023;15:1953.
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