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What happens when a workers’ comp claim involves a family member?
Many restaurant owners hire family members as employees. Just as spouses, siblings, children and other relations can be as productive, talented and loyal as non-family employees, they can also become injured on the job. To that end, employees who are family members are entitled to workers’ comp benefits.
When an injury results in a workers’ compensation claim, any distinction between family and non-family disappears. Both types of workers are treated the same, says Tameria Stukes, claims lead at Pinnacol Assurance in Denver.
“If an employee is a family member working for the business owner, they are a covered employee the same as any other,” Stukes explains. “Restaurant owners might think they don’t need to list a family member as an employee, but they should have all of their employees covered under workers’ compensation if they are performing the jobs as any other hired worker.”
Restaurant owners file workers’ comp claims due to on-the-job injuries
Workers’ compensation, or “workers’ comp,” is a type of insurance that limits employers’ liability and protects workers from certain medical costs and lost wages due to on-the-job injuries or illnesses.
With few exceptions, Colorado businesses that hire employees must purchase coverage. There’s no exemption for businesses that hire only family members or a mix of family members and non-family members.
Restaurants can be hazardous for workers. Injuries can include:
• Burns or scalds from hot stoves, pans, fryers, plates, cooking oils, grease, food or beverages.
• Cuts, punctures or scrapes from knives, slicers, cutters, or other kitchen tools or utensils.
• Sprains from slip or trip-and-fall accidents, repetitive motions, lifting or moving heavy boxes or furniture, or standing still for long periods of time.
• Vehicle accidents during food deliveries or catering jobs.
“In the restaurant business,” Stukes says, “you could have repetitive-type injuries, lacerations, slip-and-falls and other types of injuries that can cause an employee to be taken off work and/or have a long recovery.”
These risks are no different if the employee happens to be a family member.
However, on-the-job injuries of family members can result in owners working additional hours and putting themselves at greater risk of fatigue and injury, Stukes says. Conflict among family members over how to handle such situations can become stressful and lead to even more injuries on the job.
On-the-job injuries can trigger family concerns, conflicts and interference
Family members may also become unduly concerned or inappropriately involved in the details of another family members’ injury or workers’ comp insurance claim.
“Though the claim doesn’t differ for family members,” Stukes says, “there may be privacy issues that need to be addressed, such as the owner not having access to some of the claims issues or investigations.”
In some cases, family members’ emotional connections may prompt them to try to interfere in the claims process. This behavior “is understandable,” Stukes says, but it can make the claims process more difficult for the claims processor to follow through and doesn’t change the process in any way.
“The process is no different,” Stukes says. “The rules and regulations don’t change. Nor is the process compromised because the injured worker is a family member.”
If a conflict develops, the insurer may notify the restaurant owner that access to the claim has been “locked down,” or blocked, so that the process can proceed.
Family members’ workers’ comp benefits don’t differ from other workers’ benefits
Restaurant owners should know that workers’ comp claims involving family members can be just as costly as claims that involve non-family members.
“Due to the relationship, a family member who can’t return to work or has a life-changing injury may feel entitled to additional benefits,” Stukes says, “but again, this worker is entitled to the same benefits as any other injured employee. There are no shortcuts or benefit shortages because the worker is a family member.”
Advice for restaurant owners: play it safe
Workers’ comp claims can be costly. To avoid them, be mindful of safety hazards in the workplace, and be sure that all workers, family and non-family alike, are educated about restaurant safety.
Find out how Pinnacol’s workers’ comp coverage can put care to work for your restaurant.
