Domestic Service: Is a Caretaker for a Woman with Dementia Entitled to Workers’ Compensation Benefits?

After a job-related injury occurs, workers typically ask one critical question: Am I entitled to workers’ compensation benefits? Fortunately, in Pennsylvania most workers are covered under the state’s Workers’ Compensation Act, and the answer, generally, is “yes.”

However, some types of workers are not covered by the Act and thus cannot collect benefits. Today, we discuss one such exception to the Act ― workers who are engaged in domestic service.

Caring for a Woman with Dementia

In the recent case of Van Leer v. Workers’ Compensation Appeal Board (Hudson), a caretaker for a woman suffering from mild dementia filed for workers’ compensation benefits, claiming she sustained multiple injuries in the course and scope of her employment. The court’s opinion does not say how the caretaker injured herself, but the injuries she claimed were extensive, including a broken nose; damaged teeth; lacerations on her face, hands, and legs; aggravation of pre-existing arthritis; a concussion; and possible scarring on her face.

Following a hearing, the workers’ compensation judge found that the caretaker’s main responsibility was to get the woman in her charge ready for bed and to make sure she stayed in bed throughout the evening. As the caretaker described it, her job consisted mostly of “sitting there and making sure.” The caretaker specifically denied providing any other type of service, such as medical care.

Based on these facts, the judge concluded that the caretaker was employed in “domestic service,” which is not covered by Pennsylvania’s Workers’ Compensation Act. Accordingly, the judge ruled that the caretaker was not entitled to benefits.

The caretaker appealed to the Workers’ Compensation Appeal Board, which affirmed the judge’s decision. The caretaker next appealed to the Commonwealth Court.

Domestic Service

In ruling against the caretaker, the Commonwealth Court first noted the legal criteria that governs the determination of whether an employee is a domestic servant:

Precedent holds that someone who is engaged in domestic service: (1) works in or around the employer’s home; (2) for the comfort and benefit of the employer’s household; but (3) does not further the employer’s business interests; and (4) does not provide professional or skilled services.

Relying on this criteria, the court applied the domestic service exception to the caretaker’s case, reasoning that the caretaker was serving a household member rather than providing skilled medical care.


The decision is unfortunate for the caretaker, who will not receive workers’ compensation benefits. For the rest of us, it’s a reminder that gainful employment, in some cases, is no guarantee of entitlement to benefits. If you have been injured in a work-related accident, we strongly advise that you contact a workers’ compensation attorney immediately to ensure that your legal rights are protected.