In California workers’ compensation law, most injuries that occur in the workplace or arise out of an employee’s job duties are considered compensable under the “arising out of and occurring in the course of employment” (AOE/COE) standard. However, certain circumstances can remove an injury from coverage—even if it happened during work hours or on the employer’s premises. One such circumstance is “horseplay.” In this blog post, we explore how the horseplay affirmative defense functions in California, key legal considerations, and best practices for employers and insurance carriers who may face these claims.
What Is Horseplay in the Context of Workers’ Compensation?
“Horseplay” generally refers to fooling around, pranks, or other forms of playful misconduct that deviate from an employee’s work duties. Examples might include:
- Engaging in wrestling or other physical antics with coworkers.
- Throwing objects at colleagues in a playful manner.
- Using workplace tools or equipment for non-work-related fun or mischief.
Under California law, if an employee is injured as a direct result of horseplay that substantially departs from the scope of employment, the injury may not be compensable.
Arising Out of and Occurring in the Course of Employment (AOE/COE)
California’s workers’ compensation system hinges on whether an injury meets two essential criteria:
- Arising Out of Employment (AOE): There must be a causal connection between the injury and the employment.
- Occurring in the Course of Employment (COE): The injury must occur during the time, place, and circumstances of employment.
When an employee is injured during horseplay, employers and insurance carriers may assert that the employee’s activity was not part of their job duties and fell outside these parameters. If successful, this argument can defeat the employee’s claim for benefits.
Key Considerations for the Horseplay Defense
- Nature and Extent of Deviation
Courts and the Workers’ Compensation Appeals Board (WCAB) look at how significant the deviation was from the employee’s regular work duties. A small, momentary prank might be treated differently than an extended, intentional episode of misconduct. - Employer Knowledge or Tolerance
If the employer was aware of or tolerated a certain level of “playful” behavior among employees, the WCAB might still find the activity arose out of employment. Consistent, tolerated workplace banter or joking is sometimes considered part of the work environment, potentially keeping the injury within AOE/COE. - Benefit to the Employer
If, despite the “horseplay” label, the activity somehow conferred a benefit to the employer (for example, a team-building exercise or an officially sanctioned event), the claim might still be found compensable. - Involvement of Other Employees
Whether the injured employee was the instigator, an active participant, or merely a passive victim of horseplay can impact compensability. For instance, if a bystander employee was injured during another person’s horseplay and was not actively participating, that bystander’s injury is more likely to be compensable.
Practical Steps for Employers and Carriers
- Conduct a Thorough Investigation
- Interview witnesses promptly.
- Gather any available security footage or electronic records.
- Document the nature and extent of the deviation from normal work activities.
- Review Workplace Policies
- Ensure you have clear anti-horseplay or conduct policies in place.
- Regularly train employees on safe workplace practices and the ramifications of engaging in horseplay.
- Obtain Written Statements
- Gather written statements from the injured worker and any coworkers.
- Clarity on who initiated or encouraged the behavior can be crucial to the defense.
- Consult with Legal Counsel
- Since every workplace injury has unique facts, working with a knowledgeable workers’ compensation defense attorney can help determine the strength of the horseplay defense.
- An attorney can advise on preserving evidence, conducting interviews, and effectively arguing the case before the WCAB.
Takeaways
The horseplay affirmative defense can be an effective strategy in California workers’ compensation claims, but its success depends on a fact-intensive inquiry. Proving that the employee’s injury did not arise out of or occur in the course of employment is no small task, especially given the broad protections afforded to employees under California law. Employers and carriers should act quickly to investigate, preserve evidence, and consult with experienced counsel when building a horseplay-based defense.
Why Choose Yrulegui & Roberts?
At Yrulegui & Roberts, our team of dedicated workers’ compensation defense attorneys has a wealth of experience reigning in questionable claims, including those involving alleged workplace horseplay. We pride ourselves on thorough investigations, strong legal advocacy, and delivering tailored solutions to meet the needs of California employers and insurance carriers. Contact us today for a consultation, and let our firm help you navigate the complexities of the workers’ compensation system—without all the horsing around.
Legal Disclaimer
This blog post is for general informational purposes only and does not constitute legal advice. Reading or using this information does not create an attorney-client relationship with Yrulegui & Roberts. Every situation is unique, and the outcome of any legal matter depends on specific circumstances. For legal advice tailored to your case, please consult a qualified attorney licensed to practice in your jurisdiction.
