Oakland - A new California Workers’ Compensation Institute (CWCI) study shows that almost half of all litigated claims in the LA Basin are cumulative trauma (CT) claims that involve physical or mental...
LexisNexis has selected some recently issued noteworthy IMR decisions that illustrate the criteria that must be met to obtain authorization for a variety of different medical treatment modalities. LexisNexis...
CALIFORNIA COMPENSATION CASES
Vol. 89, No. 2 February 2024
A Report of En Banc and Significant Panel Decisions of the WCAB and Selected Court Opinions of Related Interest, With a Digest of WCAB Decisions...
By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board
In the 1785 poem, To a Mouse , Robert Burns observed that the best...
By Hon. Colleen Casey, Former Commissioner, California Workers’ Compensation Appeals Board
The struggle is real. How and when should Workers’ Compensation Judges (WCJs) apply the statute...
An administrative assistant in 2012 was leaving work, stepped off of a ramp onto a sidewalk on the employer’s property on the way to her car and injured her ankle. The court of appeals affirmed an award of benefits and found that the accident arose out of her employment. Lincoln University v. Kathy Narens, 2016 Mo App. Lexis 345 WD 79003 (Lexis Advance), 2016 Mo App. Lexis 345 (lexis.com) (Mo. App. 2016).
The ALJ made a factual finding that the accident was caused by an unsafe hazard of uneven ground and a congested walkway. The employer argued her accident was not related to any identifiable hazard and she was injured merely when she was walking. The court deferred to the Commission on the finding whether a hazard exists.
The court further rejected the argument that an injury leaving work did not arise in the course of employment. The court found the legislature intended to cover accidents before or after the actual performance of job duties and did not abolish that rule when it retained the extended premises statute to include accidents on property owned and controlled by the employer.
The court noted the employer was "undaunted” in its appeal.
The case is important for several reasons. It demonstrates the appellate court defers to the commission on the finding of what factual circumstances of an accident represent a risk or unsafe condition. It also demonstrates that the worker has an obligation to show some identifiable risk or unsafe condition if the employer contests compensation that an accident did not arise out of employment.
The Supreme Court in Johme v. St. John’s Mercy Healthcare, 366 S.W.3d 504 (Lexis Advance), 366 S.W.3d 504 (lexis.com) (Mo. 2012) held that Section 287.020.3(2)(b) (Lexis Advance), Section 287.020.3(2)(b) (lexis.com) requires an employee to show “a causal connection between the injury at issue and the employee’s work activity” and that “it is shown to have resulted from a hazard or risk to which the employee would not be equally exposed in “normal non-employment life.” In Johme, claimant fell off her shoe and did not introduce evidence that there was any risk at work that would cause her to fall off her shoe.
Lincoln University reiterates the need to show a hazard or risk. The court concludes the statute requires something more than being injured while on property owned and control by the employer. The identification of an unsafe condition becomes an element of proof of the prima facie case and the failure to identify such a hazard precludes a recovery from benefits if the employer disputes the accident arose out of employment. The decision in Lincoln could be explained based on the limited standard of review of the court of appeals because the issue was not whether the worker failed to introduce some evidence to identify a risk but whether the Commission erred in finding the alleged facts represented a bonafide risk.
Missouri employers believed that statutory reform provided an equal exposure defense and if an employee was injured from the same type of general risk encountered away from work that the worker could not access worker’s compensation benefits. Hager v. Syberg’s Westport, 304 S.W.3d 771 (Lexis Advance), 304 S.W.2d 771 (lexis.com) (Mo. App. 2010) supported this conclusion and spawned a number of parking lot cases. The courts since Hager, including Lincoln, broadened the scope of worker’s compensation coverage by narrowing the application of the equal exposure defense to the point where the defense is illusory in most cases. Lincoln concludes strict construction means that risks had to be identical and unless the employer could someone show the employee was equally exposed to the exact risk away from work there was no defense. This produced a line of appeals that the court found the employee was not exposed to the same crack in the ground, the same slippery ice, the same clog of dirt, the same motorcycle helmet or the same weak chair when the employee was not working. This judicial interpretation moves Missouri closer to positional risk and away from reform that tried to limit liberal access to comp benefits.