Legal Corner

Workers Compensation
Worker receives benefits despite breaking rules - California

In 3 Stonedeggs Inc. v. WCAB, a worker was injured in a car accident after leaving a fire camp without his employer's knowledge and in violation of its rules, and used marijuana. Employees were not supposed to leave the camp without approval from a supervisor as the camp was very remote, there was no cell service, and fire activity and equipment were moving about. While traveling, he collided head-on with a van, and suffered a broken leg and a head injury, which left him comatose. At the hospital, his urine tested positive for THC.

An administrative law judge denied the claim finding that he had materially deviated from the course and scope of his employment by leaving the camp in violation of the employer's policy. Upon appeal, the Workers' Compensation Appeals Board reversed, citing the "commercial traveler" rule. It noted the worker had traveled to the camp with his car and the employer did not instruct him not to use it during his off hours or for personal reasons. Further, since he spent a significant period away from home, traveling should have been expected. When the Court of Appeals concurred, the company filed a petition for review with the Supreme Court.

Duty of due care for ride-share drivers does not include background checks - California

In Shikha v. Lyft, an Appeals Court ruled the general duty of due care does not extend to a duty by ride-share platforms to perform background checks on all passengers. The case involved a Lyft driver who was brutally attacked and stabbed by a passenger, who had a lengthy criminal record.

Award for attendant care by husband overturned - Florida

In Girardin v. AN Fort Myers Imports LLC, a sales associate fractured her left foot while walking through her employer's parking lot and sought payment to her husband for attendant care services, 12 hours a day. A Judge of Compensation Claims awarded payment for attendant care services for 30 hours per week for a specified time. The company appealed and the Court of Appeals overturned.

It noted the award was based on a generalized finding that what the husband was doing qualified as attendant care services under Florida law. However, testimony indicated that much of what the husband was doing related to household duties, such as childcare, cleaning, and cooking. However, some tasks may be compensable as nonprofessional attendant care. The award was vacated in part.

Court overturns denial of death benefits to son 18 years after death of father - Illinois

In Cronk v. IWCC (Kimball Hill Homes), an Appellate Court overturned a denial of benefits for the son of a construction manager who died of a heart attack while shoveling snow at work in 2006. While the company had settled a death claim with the worker's wife in 2009, it maintained the worker's death was not related to his employment. A coroner had concluded that cardiovascular disease was a significant contributing factor.

When the son filed for benefits, an arbitrator found, even if the death was work-related, the son was not entitled to survivor benefits because he was not enrolled full-time in school and was over the age of 18 when his father died. In overturning the denial, the Appellate Court found the heart attack occurred in the course of employment and the son had just turned 18 and would enroll in college in a year, meeting the comp law that says a dependent who is under 25 and a student qualifies for death benefits. The brief interruption in the son's education did not preclude benefits.

Employer can direct care even though it failed to provide treatment - Missouri

In Helmig v. Springfield R-12 School District, an Appeals Court ruled that the school district could continue to direct care, although it refused to pay for an injured worker's treatment for over 12 years. In its ruling, the court noted that it was bound by the state's statute, which says nothing about waiving the employer's right to direct future treatment.

Precedent-setting ruling regarding mental injuries with no physical injuries - Nebraska

For the first time in Timothy J. Gosch vs. City of Papillion, the workers compensation court interpreted a 2010 amendment to the workers compensation statute that allowed first responders to obtain benefits for mental injuries without a triggering physical injury. The city denied a claim for PTSD, alleging it was untimely. The Appeals Court determined that the firefighter/paramedic had experienced a particularly gruesome incident when responding to a shotgun suicide attempt.

Since he was unable to return to his job, the court awarded a 25 percent permanent loss of earning power based on opinions from vocational rehabilitation experts and ordered the city to pay for all outstanding and future medical payments.

Injuries from hospital shooting should have been compensated - New York

In Justin Timperio v. Bronx-Lebanon Hospital et al, Workers' Compensation Board, a resident sued the hospital and the store that sold the rifle used in a mass shooting at the hospital, alleging negligence. The federal court stayed the action pending resolution of the workers' comp claim filed by the hospital. While the Workers' Compensation Board found the injuries compensable, the Appellate Division overturned noting the lack of evidence establishing any employment-related connection between the injured worker and the shooter. The shooter was a disgruntled former employee whom the resident did not know.

Upon appeal, the Court of Appeals overturned the ruling of the Appellate Division. The ruling notes the absence of evidence regarding the motive in workplace assault cases does not counteract the presumption that when an injury occurs at work, it arose from the injured worker's employment and is compensable under the workers compensation law. This ruling places the injured doctor's federal civil complaint against the hospital in serious jeopardy.

Exclusive remedy does not apply to sexual assault case - North Carolina

In Alderete v. Sunbelt Furniture Xpress Inc., a warehouse worker was sexually assaulted by a work-release prison inmate and sued his employer for negligent supervision. A trial judge denied a motion to dismiss and upon appeal, the employer argued that the case was subject to exclusive remedy. The Appeals Court disagreed finding that while there was no argument that the assault occurred in the workplace, it did not "arise" from his employment.

The court noted that the sexual assault constituted an accident under state law since the assault was unexpected and without design on the part of the employee. The assault was not related to the duties of the employee but was for a personal motive and, therefore, cannot be considered an act of his employer.

Employer may have to pay penalties for failing to reimburse an injured worker for medical marijuana - Pennsylvania

In Malak v. Maxim Healthcare Services, the Commonwealth Court ruled that the employer violated the state's workers compensation law when it refused to reimburse a nurse for medical marijuana out-of-pocket costs. The employer did not challenge whether the use of medical marijuana was reasonable and necessary to treat the work injury, but argued reimbursement exposed them to criminal liability under federal law.

Because the Medical Marijuana Act does not prohibit reimbursement for medical marijuana used to treat a work injury, the employer violated the Workers Compensation Act. The court remanded the case to the workers comp judge to determine what, if any, penalty should be imposed on the employer.

High court cases to watch: Comp coverage of CBD oil and dietary supplements; statutory employer issues - Pennsylvania

In November 2023, the Commonwealth Court ruled that CBD oil qualifies under the state's workers' compensation law as a "medicine" and a "supply" for reimbursement in Mark R. Schmidt v. Schmidt, Kirifides, and Rassias, PC. The state Supreme Court has agreed to hear the appeal and will examine whether the terms "medical services" and "medicines and supplies" in the Workers' Compensation Act include CBD oil, specifically, as well as dietary supplements, generally, and products that may be purchased without a prescription from a healthcare provider; whether cost containment regulations apply to CBD oil; whether the law requires employers/insurers to reimburse claimants, directly, for out-of-pocket expenses for "medical services" and "medicines and supplies," and if so, if claimants are obligated to submit supporting documentation.

In Jason Yoder v McCarthy Construction, Inc.; Castelli Mechanical Design and Catania Engineering Associates, Inc. v. Air Control Technology, Inc.; and RRR Contractors, the Supreme Court will address whether amendments to the Workers' Compensation Act that made it mandatory for all employers to obtain workers' compensation coverage necessitate denying statutory employer status to general contractors unless they have paid workers compensation benefits to the injured employee of a subcontractor; whether the statutory employer defense is waivable; and the factors that must be strictly established for a general contractor to qualify as a statutory employer.

Retailer considered statutory employer of sales rep from hardware company - Tennessee

In Coblentz v. Tractor Supply Co., a sales rep for a hardware company was visiting a retailer when a 12-foot steel barn door track fell out of a display and struck him on the head. He received workers comp from his employer and sued the retailer claiming the store had negligently installed or maintained the display and failed to warn him of the danger.

A Trial Court found and an Appeals Court agreed that the retailer was protected by exclusive remedy. The court noted that a company is considered a contractor if the work "being performed by a subcontractor's employees is part of the regular business of the company or is the same type of work usually performed by the company's employees." The work performed by the representative was typical of work performed by store employees - taking inventory, inspecting displays, stocking, and organizing.