Interpretations of occupational accidents in appellate instances in 2016–2020
15.9.2021 | News
The first five years of the Workers’ Compensation Act
Having entered into force in 2016, the Workers’ Compensation Act has now been subject to interpretation for five and a half years. The recent years have been interesting because the new Workers’ Compensation Act introduced a new definition of what is to be regarded as an occupational accident. Insurance institutions started applying the new condition-related clauses to accidents that occurred on 1 January 2016 and later. The Employment Accidents Compensation Board, which ensures the uniformity of insurance institutions’ compensation practice, also started issuing soft law statements to insurance institutions regarding the interpretation of the new clauses.
Consequently, rulings from the appellate instances, i.e. the Employment Accidents Appeal Board and the Insurance Court, took longer to appear. The Appeal Board issued its first condition-related rulings regarding the Workers’ Compensation Act in the autumn of 2016, and the Insurance Court gave its first rulings regarding the conditions in 2017. This delay is natural, as the ruling in question would have had to have concerned an accident occurring on 1 January 2016 or later. First, the insurance institution makes a decision. This may then be appealed against by means of a complaint to the Appeal Board. The Appeal Board will take a certain amount of time to process its ruling. Once ready, the ruling of the first appellate instance has been obtained. Either an employee, an employer or an insurance institution may submit an appeal on the Board’s decision to the Insurance Court.
Appellate rulings regarding the circumstances of occupational accidents
Between 2016 and 2020, the Employment Accidents Appeal Board issued 251 rulings on the interpretation of clauses that concern the circumstances of occupational accidents under the Workers’ Compensation Act. The Insurance Court issued 23 rulings during the same period. The Supreme Court has not yet issued any interpretations regarding the concept of an occupational accident under the new Act.
The figures are surprisingly small considering that over half a million indemnified occupational accidents have occurred within the same period. Over 100 000 occupational accidents occur every year, and the new Act has been in force since 2016.
In order for a decision by an insurance institution to be evaluated by the Appeal Board, an employee must first submit an appeal against the decision. If the financial incentive is insignificant, for example because the accident has not caused inability to work, the employee will not necessarily submit an appeal against an insurance institution’s negative decision. From the perspective of legal interpretation and establishing the occupational accident concept, it is nevertheless beneficial to obtain interpretations on the new condition-related clauses from the appellate instances.
The majority of appellate rulings relate to interpreting the provision on travel between home and workplace
Section 23 of the Workers’ Compensation Act determines how accidents that happen during journeys between the home and workplace are compensated as occupational accidents. The provision contains many details that are open to interpretation, such as what is meant by ‘normal commuting’ and ‘the employee’s home’, what is a permissible minor deviation from the itinerary, what is deemed to be activity during a deviation, and did the journey even constitute travel between the home and workplace?
The Employment Accidents Appeal Board had issued 133 rulings on travel conditions by the end of 2020. The Insurance Court had issued 13 rulings within this time.
The Insurance Court issued statements regarding deviations and activity taking place during deviations, for example. Permitted deviations include visits to the daycare centre, school, grocery store, service station, and car repair shop. The accident cover is not suspended if an employee makes a deviation for these reasons. During a deviation, the accident cover remains active when an employee walks from the car to the front door of the daycare centre, for instance. The cover is suspended for the time that the employee spends inside the daycare centre or grocery store, for example.
In its rulings, the Insurance Court has also interpreted the concept of the employee’s home. In the cases that were processed, the homes of significant others were not deemed to be the employee’s home, as referred to in the Act.
Every year, around 20 000–25 000 occupational accidents usually occur during journeys between the home and workplace. These often involve serious injuries, causing inability to work and absence as a result of people breaking their arm, having fallen over because of a slippery pavement or yard, for instance. While most of these accidents take place on foot, over 3,000 of the occupational accidents that occur during journeys every year are traffic accidents.
Accidents at work or while working remotely
An accident is deemed to occur at work if it occurs during the course of work, while performing a work-related task assigned by the employer, or while traveling in relation to a work assignment. The Employment Accidents Appeal Board had issued 50 rulings regarding section 21 of the Act by the end of 2020. Of these, 11 concerned accidents that occurred while working remotely, and five of these cases were ruled in favour of compensation. The Insurance Court has issued five rulings regarding the conditions of being at work, and only one was related to a remote working situation.
The subjects of the interpretations were the meaning of ‘during the course of work’, what the employee’s work assignments consisted of, and when the question is one of the performance of a task assigned by the employer or traveling in relation to a work assignment.
In the Appeal Board’s rulings, situations in which the employee moved around at home, with the intention of retrieving tools related to their work (phone, work materials, work papers), were deemed occupational accidents that occurred while working remotely. The Insurance Court’s only ruling regarding remote work concerned going to the mailbox. The accident that occurred was not deemed an occupational accident because fetching the mail was not primarily connected with work assignments and, therefore, did not occur during the course of work. Among the accidents that occur while working remotely, only those that occur during the course of work are subject to compensation under the Act. In contrast, accidents that occur during breaks, for example, are not compensated as occupational accidents (restrictive provision in section 25 of the Workers’ Compensation Act).
The majority of indemnified occupational accidents occur at work, with around 100 000 of such accidents occurring every year.
Other circumstances in which occupational accidents occur
Occupational accidents can also occur in the location of the working area, outside the location of the working area during a meal or recreational break, or under the special circumstances defined in section 24 of the Act.
Occupational accidents in the location of the working area
Every year, around 3 000 accidents occur in the location of the working area. The Employment Accidents Appeal Board had issued a total of 13 rulings regarding this circumstance by the end of 2020. The Insurance Court did not issue any.
An accident that occurred at a coffee occasion held by the workplace and falling over in the lobby of the workplace were deemed compensable in legal practice, for example. Accidents that occurred while at the workplace gym or in the staff car park during the workday were not deemed compensable.
Typical accidents in the location of the working area that are subject to compensation are falling over and slipping at the workplace, in the staircase or in the yard, accidents during food breaks and injury while heating up food, for example, and accidents during breaks when moving around in the working area. Specifically, several occupational accidents had occurred because an employee had walked into a glass door at the location of their working area.
Occupational accidents related to meal and recreational breaks outside the location of the working area
Every year, around 1 000 accidents occur during meal and recreational breaks outside the location of the working area. The Appeal Board had issued a total of five rulings regarding these breaks by the end of 2020. The Insurance Court has not issued any rulings on these conditions for the time being.
The conditions that have been excluded from occupational accident cover include going to the gym or to the pharmacy during the workday, or spending a break at home and carrying out domestic duties while there.
Occupational accidents in special circumstances such as training and recreational events
Pursuant to section 24 of the Act, the special circumstances in which occupational accidents can occur include training and recreational events, health care appointments, and journeys related to these. Every year, a total of around 1 500 occupational accidents occur in connection with these circumstances. The Employment Accidents Appeal Board issued a total of 69 rulings regarding these circumstances between 2016 and 2020. The Insurance Court issued four rulings during the same period.
Accidents that occurred within the programme of training and recreation events, an accident while dancing within the programme, and an accident during the return journey from a recreation day were deemed compensable. However, any activity performed during the programme that increases the risk of an accident and is not an activity normally included in the event in question was not deemed compensable. These have included sitting on a high fence and taking a piggyback ride on the back of a friend, and accidents that occur in such situations.
Information on appellate rulings
The rulings published by the Employment Accidents Appeal Board are available on the Board’s website at www.tapaturmalautakunta.fi.
The Insurance Court’s published rulings are available at www.oikeus.fi.
Kirsi Pohjolainen työskentelee TVK:ssa laki- ja lainsäädäntöasioista vastaavana juristina. Työtapaturmavakuutuksen lakiasioiden parissa hän on tehnyt työtä vuodesta 1997. Blogeja syntyy erilaisista työtapaturma- ja ammattitautivakuutuksen ajankohtaisista teemoista.