Caring for the Caregiver: Reducing the Top Three Home Care Workers’ Comp Claims

Author, Raysan Benito, Account Executive, Rancho Mesa Insurance Services, Inc.

In California workers' compensation, Class Code 8827 applies to employees who provide in-home personal care services, including assistance with daily living activities, companionship, and, in some cases, nursing services. While these caregivers focus on the well-being of their clients, they often face significant injury exposures themselves.

A review of claim trends among leading workers' compensation carriers shows three injuries consistently account for the majority of losses in the home care industry: strains and sprains, slips and falls, and workplace violence.

Top Home Care Injuries

Strains and Sprains. Strains and sprains are among the most common and costly injuries in home care. Caregivers frequently lift, reposition, and transfer clients, creating significant physical demands that can lead to shoulder, back, and other musculoskeletal injuries. In addition, cumulative trauma claims have increased as repetitive motions and physical exertion take their toll over time.

While proper lifting techniques are important, training alone is not enough. Effective injury prevention requires safe patient-handling systems, including transfer assessments and the use of mechanical lifting devices such as Hoyer lifts when appropriate. Agencies should also identify high-risk situations, including bariatric care, before services begin and ensure caregivers have the equipment and support necessary to perform their duties safely.

Slips, Trips, and Falls. Unlike employees who work in a controlled environment, home care caregivers enter a different workplace every day. Client homes may contain hazards such as poor lighting, loose rugs, cluttered walkways, stairs, pets, and wet surfaces.

Because these environments were not designed as workplaces, risks can be difficult to predict. Agencies should implement pre-service home assessments to identify hazards and establish procedures to address unsafe conditions before caregivers begin providing care. Understanding where slip and fall injuries occur most frequently can also help management target corrective actions and reduce future losses.

Workplace Violence and Combative Behavior. Caregivers occasionally encounter patients, family members, or visitors who become verbally or physically aggressive. Cognitive impairments such as dementia, behavioral health issues, and emotionally charged family situations can all contribute to workplace violence exposures.

These incidents can be particularly serious because caregivers often work alone without immediate access to supervisors or coworkers. To reduce risk, agencies should maintain a workplace violence prevention program, conduct client risk assessments, provide de-escalation training, and establish clear reporting procedures for employee concerns.

Three Ways to Reduce Claims

While these exposures cannot be eliminated entirely, agencies can significantly reduce losses by focusing on three key areas:

Conduct Pre-Service Assessments. Inspect client homes before care begins to identify physical, environmental, and behavioral hazards. Some organizations also allow caregivers to decline assignments they believe pose an unreasonable safety risk.

Rancho Mesa’s proprietary SafetyOne™ mobile app allows users to perform pre-service safety observations to identify, document and mitigate areas of concern.

Invest in Ongoing Training. Provide continuous education on patient handling, transfer procedures, lift equipment, and workplace violence prevention. Regular competency evaluations and coaching help reinforce safe work practices.

Rancho Mesa clients utilize the SafetyOne platform to administer and track on-going safety training for their employees.

Build a Supportive Safety Culture. Employees should feel comfortable reporting concerns, requesting assistance, and refusing unsafe assignments without fear of repercussions. Organizations that actively support their caregivers are more likely to identify risks before injuries occur.

For Class Code 8827, the primary drivers of workers' compensation losses are strains and sprains, slips and falls, and workplace violence. The most effective response is straightforward: assess client environments, train employees consistently, and create a culture where caregivers feel supported and empowered to speak up. When agencies prioritize the safety of their caregivers, they are better positioned to provide safe, high-quality care to their clients.

To learn more about how to control these claim exposures, reach out to me at rbenito@ranchomesa.com or (619) 798-2823.