AOE-COE Investigations in the Remote Work Era

In Workers’ Compensation, every claim comes down to one core question: did the injury really happen on the job? That’s where AOE-COE investigations come into play.

Traditionally, if an employee was injured at the workplace during normal duties, the answer was clear. But the rise of remote and hybrid work has blurred the line between “on the job” and “at home.” Today, an accident might happen in a kitchen, on a staircase, or during a midday dog walk, and investigators have to determine if it’s truly compensable.

When your office is your kitchen table, is every accident still “on the job”?

What are AOE-COE Investigations?

AOE-COE investigations aim to establish whether an employee’s alleged injury is work related. These tests are the foundation of Workers’ Compensation coverage.

At its core, AOE-COE comes down to two tests every claim must meet:

• Arising Out of Employment (AOE): To pass this test, the injury must stem directly from the work itself. Consider a warehouse employee straining their back while lifting heavy boxes.
• Course of Employment (COE): To pass this test, the injury must occur within the time, place, and circumstances of employment. In other words, during approved work hours, in an authorized location, while performing assigned duties.

These two tests are critical because they determine coverage, liability, and potential litigation outcomes. AOE-COE is the gatekeeper between legitimate claims and those that fall outside Workers’ Compensation protection.

In AOE-COE investigations, investigators typically:

• Review assignment documents and Workers’ Compensation claim files
• Conduct interviews with the injured worker, supervisors, coworkers, and witnesses
• Analyze the accident scene and gather physical evidence
• Obtain recorded statements and provide detailed reports to the claims examiner

Remote Work Grey Areas

According to the Bureau of Labor Statistics, about 27% of U.S. workers are telecommuting at least part of the week. With remote work here to stay, AOE-COE Investigations are more complicated than ever.

Some scenarios that can lead to uncertainty include:

• Home office hazards: An employee trips over a power cord or injures their wrist using a home keyboard setup.
• Breaks and personal errands: Grabbing coffee from the kitchen may be incidental to work, but running to the store mid-day may not be.
• Movement within the home: Falling down the stairs between floors while carrying a laptop raises tricky questions.
• Dual-purpose activities: Consider taking a work call while walking the dog — is that work-related or personal?

Also, state laws differ on how remote-work injuries are treated. Some states take a stricter approach, while others are more employee friendly. For example:

• California takes a broad view, meaning that remote employees can be covered for injuries at home as long as the injury arises out of and in the course of employment. The state even recognizes its personal comfort doctrine, meaning small actions like grabbing coffee or stretching may still be compensable.
• Texas is much narrower. Under the Texas Labor Code, employees generally must be working at a designated place of employment unless prior authorization is given to work from home. Courts have denied claims when workers lacked prior authorization, even if the injury occurred while performing job tasks.

Why AOE-COE Investigations are Essential in Remote Work Claims

Remote work has blurred the line between personal and professional activity, making it harder to determine if an injury truly arose out of and occurred in the course of employment. That’s where AOE-COE investigations are critical: they provide the fact-based clarity needed to confirm or rule out compensability.

Key evidence types include:

• Timeline reconstruction: Was the worker logged in, attending meetings, or sending emails at the time?
• Workspace evaluation: Did the injury happen in a designated home office or in a casual space like a kitchen or backyard?
• Witnesses: Roommates, spouses, or even co-workers on Zoom calls can provide useful context.
• Digital footprints: VPN activity, call logs, and email timestamps can objectively show whether the employee was engaged in work.

This is important because catching a non-compensable claim early prevents unnecessary payouts, directly impacting ROI. The Coalition Against Insurance Fraud estimates Workers’ Compensation fraud costs insurers and employers billions annually, making strong AOE-COE investigations a financial necessity.

How Investigators Adapt Their Approach for Remote Work Claims

Investigators are reshaping their methods to fit the realities of remote and hybrid work. That means:

• Interviewing for context: Asking about daily routines, exact work schedules, and the physical setup of the home workspace.
• Exploring prior history: Documenting prior injuries or pre-existing conditions that could complicate the claim.
• Using virtual tools: Conducting site visits by video, requesting photos, or walking through the setup remotely.
• Working with employers: Reviewing remote work policies, job duty expectations, and approved equipment.

These steps give claims teams the documentation they need to defend decisions, whether approving or denying a claim.

Example:

Let’s say an employee reported slipping on the kitchen floor while grabbing coffee between Zoom calls. Investigators pieced together the facts using several tactics. Log-in records confirmed the worker was actively participating in a mandatory meeting at the time of the incident. Virtual photos of the home setup showed the kitchen was part of the employee’s regular workspace flow. Medical documentation aligned with the timing of the injury, reinforcing credibility. Finally, HR confirmed that company remote work policies allowed for short breaks during the workday, just as in an office setting. With these findings, the injury was determined to have occurred “in the course of employment” and was deemed compensable.

Remote work has blurred the boundaries between personal and professional life, making AOE-COE investigations more important and more challenging than ever. But with the right approach, investigators can separate fact from assumption, determine what truly arises out of employment, and protect claims outcomes. In an era where the home doubles as the office, clarity is everything. A thorough investigation protects fairness, prevents unnecessary costs, and helps keep the Workers’ Compensation system sustainable.

Want to learn more about AOE-COE investigations? Connect with our team today.

Check out our sources:

Bureau of Labor Statistics, U.S. Department of Labor. Job Flexibilities and Work Schedules—2022 Data from the American Time Use Survey. Sept. 2023, www.bls.gov/news.release/flex2.nr0.htm.

California Department of Industrial Relations. Workers’ Compensation Overview. www.dir.ca.gov/dwc/WorkersCompensationOverview.htm.

Coalition Against Insurance Fraud. Fraud Stats. insurancefraud.org/fraud-stats/.

Texas Labor Code. Title 5, Subtitle A, Chapter 401. Texas Statutes, statutes.capitol.texas.gov/Docs/LA/htm/LA.401.htm.