Articles Posted in Workers’ Compensation

When an employee is injured in a California workplace accident, they will likely miss a substantial amount of work and may have significant medical expenses related to their injury. When it comes to recovering financially for injuries sustained in a California on-the-job accident, injured workers generally have two avenues of recovery:  a workers’ compensation claim or a third-party personal injury lawsuit.

A workers’ compensation claim is designed to be a quick and efficient way to get an injured employee compensation for their injuries. The workers’ compensation program is a no-fault program, meaning that an employee does not need to establish that their injury was caused by the negligence of their employer or a fellow employee. However, workers’ compensation claims do not permit the recovery of damages related to an employee’s pain and suffering, which can be considerable.

An injured employee’s other option is to file a third-party personal injury claim against the party responsible for causing their injuries. Injured employees who file third-party injury claims will need to establish that the named defendant was somehow negligent and that the defendant’s negligence was the cause of their injuries. If successful, an injured employee who files a third-party personal injury claim may be entitled to compensation for past and future medical expenses, lost wages, and any pain and suffering that was caused by the accident. In some cases involving “oppression, fraud, or malice,” the injured employee may also be eligible for punitive damages.

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In California workplace injury cases, the general rule is that a workers’ compensation claim is the injured employee’s sole remedy against their employer. The idea is that the no-fault workers’ compensation program is a more efficient method of getting an injured employee the compensation they need while they recover from their injuries. However, damages are limited in California workers’ compensation cases to actual medical expenses and lost wages.

California law also permits workplace injury cases to be filed against third parties that are responsible for an employee’s injuries. For example, if a truck driver is injured while unloading his cargo due to some hazard on the loading dock, the company receiving the delivery may be named as a third-party defendant in a personal injury lawsuit. However, special care must be taken in the preparation of these cases to avoid unintended consequences.

A recent case discusses the difficulties one plaintiff encountered after successfully obtaining a judgment against a third-party defendant. In that case, the plaintiff was injured in a Wal-Mart store while on the clock for another company. Immediately after her injury, the plaintiff sought and obtained workers’ compensation benefits through her employer for both medical expenses and lost wages.

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Earlier this month, an appellate court issued a written opinion in a California workers’ compensation case requiring the court to determine if an employee’s misdemeanor conviction for workers’ compensation fraud per se precluded him from recovering benefits for his injury. The court concluded that the employee may still be eligible for workers’ compensation benefits, notwithstanding the fraudulent conduct, if there is independent evidence of a compensable injury.

The Facts of the Case

The claimant was an employee at a car dealership. One day, while on the job, the employee slammed his hand in the trunk of a vehicle. No bones were broken, but the employee was unable to continue work due to the pain in his hand and shoulder. The employee filed a workers’ compensation claim.

For four years, the employee received workers’ compensation benefits and also was provided with medical care. However, the evidence suggested that the employee was not entirely receptive to the medical treatment provided and would at times refuse to allow the doctors to examine him or perform certain exercises on his hand. Notwithstanding his lack of cooperation, the employee was treated with opioid painkillers.

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Anyone injured while on the job in California may be entitled to receive compensation while they are recovering from their injuries under the California Workers’ Compensation Act (CWCA). Under the CWCA, when an employee suffers a qualifying injury, their employer must cover the employee’s medical expenses as well as provide the employee with ongoing workers’ compensation benefits for the duration of their recovery.

The Requirements of a Workers’ Compensation Claim

After suffering a California workplace injury, an employee should obtain the necessary medical care. In some cases, an employee will need to visit a specific doctor. However, in emergency cases, the employee can seek medical attention at the nearest hospital or medical facility.

The employee should then notify the employer immediately, or within 30 days at the very most, in order to preserve their right to obtain workers’ compensation benefits. In cases in which an employee’s injury has developed over time, the employee should notify the employer as early as practicable. Often, this would be the first time that the injury required the employee to miss a day of work. If an employee does not report the injury in a timely manner, the employer may have grounds to contest the employee’s workers’ compensation application.

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The California Court of Appeal issued an unpublished opinion recently in a lawsuit involving a car accident that occurred when a driver crashed his vehicle through a restaurant and injured a restaurant employee. The employee received workers’ compensation benefits and medical expenses.  She then pursued a civil claim against the driver.  The issue in the case was whether the workers’ compensation insurer for the employer had a right to recover compensation from a third party that had been released from liability by the insured individual.  The lower court had held that since the injured employee had not recovered damages from the defendant in a personal injury lawsuit, the workers’ compensation insurer had no right to reimbursement for benefits paid to the employee.

The restaurant’s workers’ compensation insurance company paid her $18,388.15 in workers’ compensation benefits and medical expenses. The employee then sued the driver for damages. The insurer filed a complaint in intervention, seeking to recover benefits paid to the employee.

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In a recent unpublished opinion, the California Court of Appeal addressed whether a contractor could be held liable for injuries to an individual after the completion of their work.  The lower court had granted the defendant contractor’s summary judgment motion, based on the affirmative defense of the “completed and accepted” doctrine, dismissing the plaintiff’s negligence and fraud action. This doctrine holds that once an owner has accepted the sufficiency of work performed by a contractor, that contractor can no longer be held liable to third parties for resulting injuries.

The plaintiff worked for Keogh Electric Corp. (“KEC”) as a foreman on a project to erect a distribution panel that sat atop an elevated concrete pad and would serve as a new metal shredder at Kramar’s Iron & Metal, Inc. (“Kramar’s”). In August 2012, the panel and pad were installed at Kramar’s. The plaintiff texted Douglas Keogh that “Kramar is done” on August 25, 2012, and later testified that this meant that KEC’s work on that project had been completed.

The plaintiff then accepted a job at Kramar’s.  He did not see anyone from KEC performing more work at Kramar’s, nor did he see anyone request that more work be performed on the electrical distribution panel. Kramar paid KEC in full for the work.

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The California Court of Appeal recently addressed whether the Workers’ Compensation Appeals Board could impose penalties for unreasonably delaying or denying advance disability pension payments to local peace officers disabled on the job.  The jurisdictional question posed in this case was whether the Workers’ Compensation Appeals Board could impose penalties according to the Labor Code for an unreasonable delay in payment.

The plaintiff in this case worked as a deputy sheriff in Sacramento and suffered a job-related injury. She applied for industrial disability retirement and requested advance disability pension payments, available under Labor Code section 4850.4, during the period that her retirement application was processed. She did eventually receive these payments, but she sought penalties for an unreasonable delay, under Labor Code section 5814.

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In an unpublished opinion, a California Court of Appeal addressed whether workers’ compensation served as the exclusive remedy for an employee psychologically harmed by her participation in a staged mock robbery. She was not aware it had been a training exercise.  On appeal, the issue was whether the jury had properly been given instructions about the workers’ compensation exclusivity rule.

The plaintiff employee of West Kern Water District worked as a cashier at the district’s office. While employees received some training on how to respond to a robbery, supervisors decided to test the response of employees to a staged robbery.  As part of the mock robbery, one of the district managers entered the office in a mask and demanded money from the employee, saying he had a gun. The employee victim had not been notified of the mock robbery, and she handed over money. She underwent treatment for psychiatric harm. She brought a claim for assault and intentional infliction of emotional distress.  A jury awarded her $360,000.

The trial court denied defendant West Kern Water District’s motion for judgment notwithstanding the verdict, but it granted their motion for a new trial on the ground that the jury had received an inappropriate instruction on the workers’ compensation exclusivity rule. The employee and the defendants appealed.

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In an appeal involving procedural issues central to the claims of injured workers, a California Court of Appeal addressed whether there had been a final order and whether an employer could seek review of a denial of a petition to remove and reconsider. The court reiterated that writs of review may only be sought from final orders or decisions of the appeals board.

The injured employee in this case alleged that he suffered an industrial injury and filed a workers’ compensation claim. After a medical report was circulated, his employer, Capital Builders Hardware, Inc., argued the report was inadmissible and requested that it be stricken. The workers’ compensation judge denied Capital’s motions, and Capital appealed the decision to the Workers’ Compensation Appeals Board. The board dismissed and denied the petition for removal and the petition for reconsideration.

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The California Court of Appeal, Second District, recently addressed the issue of whether an exception applied to the general rule that an independent contractor cannot recover tort damages for work-related injuries from their hirer. In this case, the court found that the employee had not presented evidence that his hirer contributed to his injuries. The court found there were no triable issues of material fact regarding his theory that the retained control exception or nondelegable duty exception applied.

Al Khosh worked for Myers Power Products, Inc., a subcontractor for an electrical project at California State University Channel Islands. Mr. Khosh was injured during the course of his employment and sued the general contractor, Staples Construction, for negligence.

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