Legal Corner

Workers Compensation
Family of fatally injured school volunteer limited to comp - California

In Kuo v. Dublin Unified School Dist., a Court of Appeal affirmed a trial court's ruling that a school volunteer killed while helping load food into vehicles during a food drive was an employee of the district, and workers comp was the exclusive remedy. The district submitted a 2012 resolution declaring that volunteers should be designated employees for work comp purposes and filed a memorandum of coverage from the Protected Insurance Program for Schools, showing that it had elected to provide comp coverage to volunteers.

Worker can pursue negligence claims under general maritime law - California

In Ranger v. Alamitos Bay Yacht Club, a maintenance worker was injured when he slipped and fell while boarding a vessel. He filed for work comp and then sued for lack of training and argued the vessel was unseaworthy and dangerous to employees. A Court of Appeals found the Longshore and Harbor Workers' Compensation Act (LHWCA) displaced general maritime law and made workers comp the exclusive remedy.

Upon appeal, the Supreme Court disagreed. Although amendments to the LHWCA adopted in 1984 exclude those employed by a "club" and subject to coverage under a state work comp system, it did not deprive them of the right to pursue tort remedies that are otherwise available under federal law.

Worker who lied about previous injury entitled to comp - Georgia

In McKay v. Inalfa, a worker who was injured, suffered multiple fractures, and received comp benefits in 2012, answered "no" on a job application when asked whether she had previously suffered broken bones or other injuries. In 2021, she injured her back and her doctor determined it was an aggravation of a previous injury. When she returned to work, she told her supervisor about the earlier injury and continued to work at the company. A few months later, she injured her back again.

The Court of Appeals acknowledged precedent set by a Supreme Court ruling in Elec. Co. v. Rycroft, which held that a worker who had made false representations about his or her physical condition when applying for a job was not eligible for comp benefits when there was a causal connection with the new injury. However, the court determined this did not apply because the company continued to employ her after managers became aware she had had a prior injury.

Prohibited act defense fails because of faulty equipment - Minnesota

In English v. Reliable Prop. Servs, a worker was hired to do snow removal and used employer's toolcat. On his first shift of the season, he reported the toolcat had no side or rearview mirrors. Without the mirrors, the employee needed to turn his body to look behind him and side to side to safely operate the toolcat and could not wear the shoulder harness portion of the seatbelt and only wore the lap belt portion. The employer told him that the machine would be repaired and he should continue using the toolcat.

A week later, he lost control of the toolcat and hit a permanent concrete planter on the sidewalk and suffered a serious spinal cord contusion. He underwent emergency surgery but continued to experience weakness, spasms, falls, unsteadiness, and a decline in mobility. The employer terminated him a month after surgery, indicating he had violated a "Life Saving Rule."

The employer and insurer denied primary liability for work comp benefits, arguing the employee's failure to wear a seatbelt was a prohibited act that barred his claim. A compensation judge and the Court of Appeals disagreed, finding the employee's testimony credible,and determined that the employee's injury arose out of and in the course of employment and was not barred by the prohibited act defense.

Company that denied medical care liable for bills but won't be sanctioned - Missouri

In Erwin v. Midway Arms, Inc., a worker injured his back and received comp benefits. However, after determining the employee had reached maximum medical improvement (MMI), the employer declined to authorize further medical care. His attorney made three attempts to obtain more payments for increased pain and suicidal tendencies, but none were authorized. Ultimately, he received a letter stating he was at MMI and no further treatment would be authorized.

The injured worker pursued additional treatment independently, including back surgery and filed a comp claim seeking reimbursement for $144,950. He also sought sanctions against the employer for unreasonably refusing further treatment. The Labor and Industrial Relations Commission denied both, finding the worker had not sufficiently notified the company of the need for additional treatment.

The Appeals Court overturned the denial of medical expenses, noting the three attempts made by the worker's attorney. The court emphasized that an employee's pursuit of independent medical care, following the employer's refusal, does not absolve the employer's responsibility for reasonable and necessary medical expenses. The court upheld the decision to vacate sanctions, finding that while the employer's reliance on the MMI assessment was ultimately incorrect, it did not reach the level of "unreasonable and outrageous" conduct.

Video of worker leads to denial of benefits but not disqualification from future benefits - New York

In DeBryne v. Pittsford Mercury, Inc., a worker was classified as permanently disabled in 2007 after a work-related shoulder and hip injury. In 2022, the employer sought to terminate his benefits based on video surveillance, which showed an investigator receiving a home improvement estimate from the worker. The company argued that the video documented the worker was engaging in work for profit while receiving benefits in violation of comp law.

A Workers' Compensation Law Judge (WCLJ) rescinded the paid comp benefits and imposed an additional six-month discretionary disqualification penalty but refused to permanently disqualify the worker from future benefits. Upon appeal, the Appellate Division agreed noting that imposition of such a penalty is reserved for situations where the underlying deception has been deemed egregious or severe. Since the video did not show any physical exertion or "actual work" it did not meet the standard.

Worker cannot pursue Labor Law for out-of-state injuries but negligence claim can proceed - New York

In Ramirez-Gomez v. Empire Today, LLC, a worker was allegedly injured while performing construction work at a property in New Jersey. He filed claims for violations of the Labor Law and negligence. The Appellate Division agreed with the employers that the Labor Law does not extend to accidents occurring outside the state, even where all parties are New York domiciliaries.However, it noted this does not preclude pursuing common-law negligence claims for out-of-state incidents.

Landmark decision: employer must cover CBD oil for work injury - 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" and ordered reimbursement in Mark R. Schmidt v. Schmidt, Kirifides, and Rassias, PC. The case involved a comp attorney who exacerbated a preexisting spinal injury while lifting work-related materials. As an alternative to opioids for his pain, a doctor prescribed over the counter CBD oil. The employer refused to reimburse the employer for his out-of-pocket costs because CBD oil is not a pharmaceutical drug and is not approved by the FDA.

The state Supreme Court recently heard the appeal and affirmed the lower court's ruling. It noted that the employer's arguments focused on the "shortcomings of CBD oil" and not on the plain and unambiguous language of the statute. It wrote that "any item that is part of a health care provider's treatment plan for a work-related injury falls within the purview of the broad-encompassing phrase 'medicines and supplies'" under the Workers' Compensation Act (WCA). Thus, employers must pay for any item that is part of a health care provider's treatment plan, including CBD oil and over-the-counter supplements, under the WCA.

Catalyst of workplace assault necessary to determine exclusive remedy applicability - Tennessee

In the case of Bernard v. Amazon.com Services LLC, an employee alleged that he was subjected to continuous harassment by his co-worker and repeatedly filed complaints with management. The harassment escalated, culminating in an assault and injury to the worker.

Subsequently, his employment was terminated, and he filed a lawsuit, asserting claims of negligent hiring, supervision, and retention, as well as vicarious liability for the assault.

Amazon moved to dismiss the case, invoking the exclusivity provision. For the exclusivity provision to apply, the injury must "arise out of" the employment; a private personal dispute does not arise out of work and thus is not subject to the exclusivity provision.

Following precedent set by the Supreme Court in Woods v. Harry B. Woods Plumbing Co., the court considered three categories of assault -- inherent connection to employment, inherently private, or a neutral force. It found the complaint lacked sufficient factual details to determine the origin of the harassment, and therefore, could not apply any of the Woods categories. "Without any factual allegations 'on what catalyst spurred' the assault, the motion to dismiss must be denied because, at this stage, the Court cannot conclude that Bernard's injuries arose from his employment."

Injury in company basketball game not compensable - Virginia

In Devonte Jones v. Frito Lay, Inc, a forklift driver injured his Achilles tendon playing in a tournament on a company team. The company paid entry fees to have two teams in the tournament and selected 16 employees from sign-up sheets based upon their basketball experience. The tournament was not on the company's premises and the company did not provide jerseys, equipment, or food. The players volunteered to play and provided their own transportation.The forklift driver used his paid vacation days to participate.

The state's statute specifically excludes "any injury, disease or condition resulting from an employee's voluntary participation in employer-sponsored off-duty recreational activities which are not part of the employee's duties." The Workers Compensation Commission (VWCC) found that the injury did not qualify as a work accident because the company was only a limited participant in the basketball tournament, and the employee's participation was entirely voluntary and not required or expected by the company.

Truck driver entitled to comp for road rage beating - Virginia

In Hot Rock Haulers, LLC v. Kegley, a tractor trailer driver was navigating construction while hauling a load that restricted visibility. When a car pulled ahead of him and forced him to stop, he exited the truck to file an incident report as required by the company. The men in the car accused him of hitting their car and severely beat him. A workers compensation commissioner denied the claim finding the injury did not arise out of his employment, but the commission reversed, and the employer appealed. Noting that the men were upset about the truck hitting their vehicle, not about the driver personally, the appeals court found the assault was "a circumstance born of employment" and, therefore, was compensable.

Video surveillance key to nixing permanent injury - Wisconsin

In Fields vs. Bridgeman Foods, an employee fell on a slippery floor at McDonalds and sought benefits for a permanent back injury. He was videotaped on five days, two of which were days when he had medical appointments. The judge described a "startling difference" between the videos related to his medical appointment and those on other days. He is walking extremely slowly, at some points as if he can barely move, and uses a cane and has on a back brace. In the others he does not use a cane, has no back brace, and demonstrates no difficulty entering or exiting his vehicle or driving a motorcycle.

An appeals court affirmed the judge's finding of a temporary back injury with no permanency.