Is Manager’s PTSD After Robbery Compensable?
A manager at a Mattress Firm store in a mall stowed her purse under the manager’s desk near the front of the store, as she typically did. The manager had keys to all of the Mattress Firm stores in the region in her purse. Two women entered the store, and one asked for assistance in shopping for a mattress. The manager accompanied the woman in walking through the store showroom. The second woman remained near the store entrance, close to the manager’s desk. When the manager was at the far end of the store, the second woman took her purse from under the desk.
The manager immediately realized that the second woman took her purse and quickly made her way to the store entrance. The manager also recognized the first woman as the thief in a prior incident in another store. The manager grabbed her purse as the second woman was leaving the store. The manager hung onto the purse as they entered the parking lot.
The women entered a waiting vehicle, and the manager lost contact with the purse. The manager reached through an open window of the vehicle to grab her purse. The second woman rolled up the widow onto the manager’s arm. The first woman drove the vehicle away while the manager’s arm was trapped. The manager was dragged through the parking lot and sustained injuries to her shoulders, legs, and arms. The manager was also diagnosed with post-traumatic stress disorder.
She sought workers’ compensation benefits for her injuries. Mattress Firm denied workers’ compensation benefits for the manager’s PTSD. The trial court held that the manager’s PTSD was compensable under the street risk doctrine, which states that the risks of the street are the risks of the employment, if the employment causes the worker’s use of the street. Mattress Firm appealed.
How the court ruled: The court explained that the manager’s injury occurred in the course of employment because the robbery occurred during normal business hours at a time when the manager was on duty and responsible for helping any customer who entered the store. Also, the parking lot outside the mall was considered part of Mattress Firm’s premises.
A is incorrect. The court found that the manager was indiscriminately exposed to the general public. The store was open to anyone who chose to walk through its doors. Also, the manager’s duties included greeting and assisting any person who came into the store.
C is incorrect. The court found that the manager acted immediately to retrieve her purse and remained on Mattress Firm’s premises throughout the entire episode. Also, she said her actions were motivated by her belief that her purse contained money and keys belonging to Mattress Firm.
B is correct. In Mattress Firm, Inc., et al. v. Mudruk, No. W2014-01017-SC-R3-WC (Tenn. 08/24/15), the Tennessee Supreme Court held that the manager’s PTSD after the robbery was compensable. The injury arose out of the manager’s employment under the street risk doctrine.
Editor’s note: This feature is not intended as instructional material or to replace legal advice.
Workers Comp Docket
Comp Recipient Can’t Sue Company for Refusal to Hire Her
Yardley v. Hospital Housekeeping Systems, LLC, No. M2014-01723-SC-R23-CV (Tenn. 08/21/15)
Ruling: In a case of first impression, the Tennessee Supreme Court held that a job applicant did not have a cause of action under the workers’ compensation law against a prospective employer for failure to hire her.
What it means: In Tennessee, a job applicant does not have a cause of action under the workers’ compensation law for failure to hire if the prospective employer declined to hire the applicant because she filed a workers’ compensation claim against a previous employer.
Summary: A housekeeping aide for a hospital was injured at work and received workers’ compensation benefits. She performed light-duty work for another hospital department. The hospital entered into a contract with Hospital Housekeeping Systems for the hospital’s housekeeping services. As part of its contract, the company agreed to interview the hospital’s housekeeping employees and at the company’s discretion hire the employees to continue in their positions. The company hired most of the hospital’s housekeeping staff. When the aide was released to full duty, she sought to return to her housekeeping job. The company’s division vice president allegedly told her that it would not hire anyone receiving workers’ compensation benefits. In an email, the vice president said that bringing the aide on board would be “a workers’ comp claim waiting to happen.” After she was not hired, the aide sued the company. The Tennessee Supreme Court held that the aide did not have a cause of action under the workers’ compensation law against the company.
The court explained that an employer cannot lawfully discharge a worker for filing a workers’ compensation claim. The court pointed out that the workers’ compensation law applied to employers and employees. Here, the aide was not an employee but a job applicant. Therefore, the company had no obligation to her under the workers’ compensation law.
The aide argued that if employers could lawfully refuse to hire applicants because they filed or were likely to file workers’ compensation claims the action would have a chilling effect on workers’ decisions to file claims. The court found the alleged harm was too speculative to justify an exception to the employment-at-will doctrine.
The aide also asserted that the second injury fund is intended to encourage the hiring of workers who suffered previous injuries by relieving employers of part of their workers’ compensation liability. The court could not find a legislative intent to allow applicants who had previous injuries to sue prospective employers for failure to hire.
Initial Injury Must Be Significant Contributing Cause of Subsequent Injury
Washington County School District v. Labor Commission, No. 20130847 (Utah 08/25/15)
Ruling: The Utah Supreme Court held that to recover workers’ compensation benefits for a subsequent non-workplace injury, a worker must establish that the initial workplace injury was a significant contributing cause of the subsequent non-workplace injury. The court sent the case back to the Labor Commission to determine whether a bus driver met the standard.
What it means: In Utah, to recover workers’ compensation benefits for a subsequent non-workplace injury, a worker must establish that the initial workplace injury was a significant contributing cause of the subsequent non-workplace injury.
Summary: A school bus driver for the Washington County School District suffered a back injury when he fell down the steps of his bus. He underwent surgery and received workers’ compensation benefits for the injury. Later, the driver was reinjured when a child jumped onto his back and knocked him to the ground at a local festival. He required additional surgery for the second injury. The driver sought workers’ compensation benefits. The administrative judge with the Labor Commission determined that his second injury was causally linked to his workplace injury and awarded benefits. The district appealed. The Utah Supreme Court held that to recover workers’ compensation benefits for a subsequent non-workplace injury, a worker must establish that the initial workplace injury was a significant contributing cause of the subsequent non-workplace injury. The court sent the case back to the commission to apply the appropriate standard.
The court explained there must be a meaningful causal link between the initial workplace injury and the subsequent non-workplace injury in order for the worker to recover workers’ compensation benefits for the second injury. The court said that the commission provided compensation for a subsequent injury if there was any causal connection between the two inquiries even a very minor connection. The court explained that it did not believe the legislature intended to include any and all subsequent injuries that were in any way causally connected to the workplace injury.
The court declined the district’s invitation to adopt a standard requiring a greater than 50 percent causal connection between the two injuries to provide compensation. The court explained that this standard was not supported by the plain language of the workers’ compensation law.
Employer Doesn’t Have Right to Request Change of Worker’s Physician
Clark Construction Group, Inc., et al. v. District of Columbia Department of Employment Services, et al., No. 14-AA-464 (D.C. 08/20/15)
Ruling: The District of Columbia Court of Appeals held that an employer did not have the right to request a change of an injured worker’s attending physician.
What it means: In the District of Columbia, an employer does not have the right to request a change of an injured worker’s attending physician.
Summary: A construction worker for Clark Construction sustained work-related injuries. He sought medical treatment for his physical injuries and also received psychiatric care. His doctor diagnosed him with major depression.
The worker was reevaluated by Clark’s physician, who diagnosed him with depressive disorder and “possible” bipolar disorder and believed that the worker’s depression and anger manifested as physical pain. Clark’s physician recommended additional treatment focused on anger control and new prescription drugs. Clark sought to change the worker’s treatment with his doctor.
The District of Columbia Court of Appeals held that Clark did not have the right to request a change of the worker’s physician.
The court rejected Clark’s argument that the Office of Workers’ Compensation had the authority to order a change of treating physician whenever it is in a worker’s best interests, regardless of which party brings the request. The court explained that the OWC has the authority to unilaterally order a change in a worker’s physician, but the law does not explicitly grant an employer or its insurer the right to request a change of the worker’s physician.
A worker has the right to choose his attending physician and can request a change of physician. The court found nothing in the law expressly giving employers the right to request a change of a worker’s physician.
A dissenting judge opined that the decision would “gag the employer” by prohibiting the employer from furnishing information that could be useful and compelling.
Driver’s Preexisting Hypertension Doesn’t Block Benefits
Marvel v. Roane Transportation Services, LLC, No. E2014-01252-SC-R3-WC (Tenn. 07/23/15)
Ruling: The Tennessee Supreme Court held that a driver was entitled to benefits for his heart attack.
What it means: In Tennessee, an extraordinary exertion or unusual physical strain is not required for a heart attack to be compensable. Furthermore, preexisting heart disease will not prevent a worker’s recovery for a heart attack.
Summary: A truck driver for Roane Transportation started to suffer chest pains while securing steel coils to the back of his truck. He tried to continue to the location for his scheduled delivery, but he had to pull over at a truck stop to seek help. Paramedics took him to a hospital for treatment where he was diagnosed with a heart attack. When he was discharged from the hospital, the driver learned that Roane terminated him because he was medically unable to drive a truck. The driver continued to experience chest, arm, and leg pain and had multiple fainting episodes.
The driver sought workers’ compensation benefits. The Tennessee Supreme Court held that his heart attack was compensable.
There was evidence from a physician that it was possible that the driver’s physical exertion could have contributed to his heart attack, but it was not the sole cause of the heart attack. The driver’s high cholesterol and hypertension were risk factors that also may have played a role. Another doctor noted that given the driver’s history of hypertension and high blood pressure, physical exertion was likely a “factor in creating the environment that provoked the heart attack.” The court found that the heart attack was causally related to the driver’s work activity.
The court also found that the driver’s fainting spells were causally related to his heart attack. Although there was a conflict of expert medical opinions, the court pointed out that there was no evidence that the driver had fainting spells before his heart attack.
The court concluded that the driver was permanently and totally disabled. The driver testified that he was only able to walk a quarter of a block before he had to rest. His medical restrictions prevented him from working any labor-intensive jobs similar to the ones he previously held.
Driver’s Employer-Paid Travel Is Within Course and Scope of Employment
American Casualty Co. of Reading, Pennsylvania v. Bushman, No. 04-14-00685-CV (Tex. Ct. App. 08/19/15)
Ruling: The Texas Court of Appeals found that a driver was acting in the course and scope of his employment when he was fatally injured in a car accident.
What it means: In Texas, a worker’s travel is not necessarily excluded by the coming and going rule if the worker’s transportation is paid for by the employer.
Summary: A truck driver for Salem Holding Co. was instructed to go to another city and spend a week training a new dispatcher. Salem was to reimburse him for his mileage and travel expenses, including lodging expenses. While driving his personal car on the way to the other city, he died in a car accident. The driver’s widow sought workers’ compensation benefits. Salem’s carrier, American Casualty, denied the claim.
The Texas Court of Appeals held that the driver was acting in the course and scope of his employment when the accident occurred.
American Casualty argued that the driver’s travel did not originate in Salem’s business and was not in furtherance of Salem’s affairs. The court found that the driver’s travel furthered Salem’s affairs because he was traveling for work at the time of the accident.
The court also found that the driver’s required work travel originated in Salem’s work, business, trade, or profession. The driver was not traveling by his own choice but was required to perform a job outside his ordinary job duties and away from his ordinary job site. The court rejected American Casualty’s argument that the driver was not on a special mission.
American Casualty argued that even if the driver’s travel originated in Salem’s business and furthered Salem’s affairs, the driver’s travel was excluded by the coming and going rule because he was traveling to work in his personal vehicle and reimbursement of his travel expenses was not a necessity from Salem’s perspective. The court explained that a worker’s travel is not necessarily excluded by the coming and going rule if the worker’s transportation is paid for by the employer. As Salem was to pay for the driver’s travel, his travel was not excluded from the course and scope of his employment.
Evidence Shows Causal Connection Between Comp Claim, Termination
Harris v. OHNH EMP, LLC d/b/a Wyant Woods Care Center, No. 27455 (Ohio Ct. App. 08/12/15)
Ruling: The Ohio Court of Appeals reversed a grant of summary judgment to an employer on a worker’s claim that he was terminated in retaliation for his workers’ compensation claim.
What it means: In Ohio, an increase in negative feedback a worker received after he filed a workers’ compensation claim can establish a causal connection between his claim and his termination.
Summary: A laundry/housekeeping supervisor for Wyant Woods Care Center had a positive 90-day performance evaluation. Less than two months later, he slipped and fell while assisting another employee with stripping the floor. He sustained injuries to his back, neck, and wrist and filed a workers’ compensation claim. He returned to work with restrictions. Two months after the injury, he was terminated. The supervisor alleged that Wyant Woods retaliated against him for pursuing a workers’ compensation claim. The Ohio Court of Appeals reversed a grant of summary judgment to Wyant Woods.
The court explained that the two months that passed between the filing of the supervisor’s workers’ compensation claim and his termination was not sufficiently close to establish causation. The supervisor presented additional evidence that Wyant Woods failed to follow its progressive discipline policy guidelines in terminating him and that he received negative reviews after his accident that he had not received before his accident. The supervisor also pointed out that Wyant Woods opposed his doctor’s request that he undergo an MRI. The day before he was terminated the supervisor was absent from work so that he could receive treatment for muscle spasms related to his injury. Also, he retained an attorney a week before his termination. The court found evidence to infer causation between his pursuit of workers’ compensation benefits and his termination.
Wyant Woods claimed that it terminated the supervisor because he had poor performance and failed to meet deadlines. The court found there remained an issue of fact regarding whether Wyant Woods actually terminated him for poor work performance. Wyant Woods said the supervisor had a history of unsatisfactory performance throughout his employment, but the spaces on his termination sheet to list prior discipline were left blank. Also, there was evidence that another supervisor who did not suffer a workplace injury failed to meet deadlines and was not terminated.
Work as Pizza Delivery Driver Doesn’t Cut Entitlement to TTD Benefits
The Harper Co. v. Zurborg, et al., No. 2014-CA-001844-WC (Ky. Ct. App. 08/14/15, unpublished)
Ruling: In an unpublished decision, the Kentucky Court of Appeals held that a laborer was entitled to temporary total disability benefits from the date of his injury until the date he reached maximum medical improvement.
What it means: In Kentucky, a worker is entitled to TTD until he reaches MMI and reaches a level that would permit a return to employment at the type of work he had been performing at the time of the injury.
Summary: A laborer for The Harper Company injured his back while unloading concrete forms. He immediately sought treatment in the emergency room and did not return to work after he was released from the hospital. Later, he was notified that he had been terminated by Harper. At the time, he also worked part time as a pizza delivery driver, although he said he was in pain and unable to work full time.
After an independent medical examination in which the examiner opined that the laborer’s herniated disk was causally related to the work incident, Harper began to pay temporary total disability benefits. Later, the Workers’ Compensation Board held that the laborer was entitled to TTD from the date of his injury until the date he reached MMI. The Kentucky Court of Appeals agreed with the board’s decision.
Harper argued that TTD benefits should not have been awarded before the date it began voluntarily paying benefits. The court explained that the laborer had the burden to prove that he was disabled from the time of his injury until he reached MMI. The court found that opinions by the laborer’s physician and the examiner established that he was unable to return to work after his injury despite the lack of restrictions included in earlier reports from other treating physicians.
Both the physician and the examiner opined that he could not return to the type of work he was performing at the time of the injury.
Harper also argued that the laborer should not receive TTD benefits because he was working as a pizza delivery driver during the time he was disabled. The court explained that the condition of TTD continues until the worker reaches MMI and reaches a level that would permit a return to employment. “Return to employment” was interpreted to mean a return to the type of work that was customary for the worker or that the worker had been performing before the injury. Here, the court found that pizza delivery was not the same type of work that was customary for the laborer before his injury. Therefore, his job as a delivery driver did not render him ineligible to receive TTD benefits.
Workers’ Comp Docket
Widow Entitled to Interest on Death Benefits Award
Stenz v. Industrial Commission of Arizona, No. CV-14-0298-PR (Ariz. 07/20/15)
Ruling: The Arizona Supreme Court held that a widow was entitled to interest on an award of death benefits from the time the carrier received notice of her claim.
What it means: In Arizona, death benefits are liquidated and interest on them accrues from the time a carrier receives notice that a survivor filed a claim with the Industrial Commission.
Summary: A worker suffered a work-related injury and filed a claim with his employer’s insurance carrier, Pinnacle Risk Management. Pinnacle accepted the claim and paid benefits. Four years later, the worker died. Alleging that his death resulted from the work injury, the worker’s widow filed a claim for death benefits. Pinnacle denied this claim. An administrative law judge upheld the denial, but the Court of Appeals set aside the denial. Nearly four years after the widow filed her claim, the ALJ entered a final order awarding benefits. Pinnacle paid the benefits dating back to the worker’s death but did not pay interest on the unpaid benefits. The widow alleged that she was owed interest on the unpaid benefits from the time the claim was originally filed. The Arizona Supreme Court held that the widow was entitled to interest.
The court explained that interest accrues when there is a legal indebtedness or other obligation to pay benefits and the carrier has notice of the obligation to pay. A claim for death benefits is subject to a fixed payment schedule. The amount to be paid did not depend on the ALJ’s later award. Because the obligation to pay was created by statute and was for a liquidated amount prescribed by the state’s schedule, Pinnacle had notice of the obligation when it received notice of the widow’s claim. The court found that interest began to accrue on that date.
Pinnacle argued that mechanisms already existed to prevent carriers from withholding benefits in bad faith. The court pointed out that allowing interest may induce insurance companies to act more quickly, but the primary purpose is to protect a worker’s right to be “made whole” after an injury. The court explained that the recovery of interest furthered the purpose of the workers’ compensation law. A contrary ruling would deprive a worker of the full value of the benefit owed while encouraging carriers to prolong litigation to delay paying benefits.
A concurring judge opined that interest should accrue from the date of death rather than the date the carrier received notice of the claim but noted that the parties did not make that argument and the monetary difference would be relatively small in this case.
Special Event Injury Compensable If Employer Benefits
Jacobitz v. Aurora Cooperative, No. S-14-903 (Neb. 07/10/15)
Ruling: Finding that the workers’ compensation court used an incorrect standard in determining that a laborer was acting in the course of employment when he was injured, the Nebraska Supreme Court reversed and sent the case back for a determination under the correct standard.
What it means: In Nebraska, recreational or social activities are within the course of employment when the employer derives a substantial direct benefit from the activity beyond the intangible value of improvement in employee health and morale that is common to all kinds of recreation and social life.
Summary: Aurora Cooperative held a customer appreciation supper. The manager said that he invited employees, including a general laborer, for morale but attendance was not required. The laborer delivered the invitations for the supper to the post office during his work hours. He also helped set up tables for the supper in the community building during work hours. He said he did not know what trouble he would get into for not attending and said he went to the function as part of his job. The laborer did not assist in preparing the food, serving the food, or cleaning up. The manager towed a smoker used to cook the meat for the supper to a shed on the co-op’s property. The laborer walked to the shed. When the manager was driving back to the community building, the laborer got into the bed of his truck. During the ride, the laborer fell out, sustaining head injuries. The workers’ compensation court awarded benefits, finding the laborer was injured in the course of employment because the co-op received a substantial benefit from his attendance at the event. The Nebraska Supreme Court found that the compensation court used an incorrect standard in its decision and sent the case back for a determination using the correct standard.
The court agreed with the co-op’s argument that the compensation court erred in finding that the co-op derived a “substantial benefit” because the correct legal standard for finding that the event arose in the course of employment is a “substantial direct benefit.” The court explained that using “direct” as a part of the analysis has importance and must be applied when determining whether a worker was injured in the course of employment. The compensation court erred in failing to consider whether the benefit to the co-op was both substantial and direct.
The compensation court found that the co-op received a “substantial benefit” from the laborer’s participation in the supper. The compensation court found that the laborer visited with customers at the supper. However, the compensation court did not consider whether that substantial benefit was direct, as required.
Helicopter Transport to Hospital Is Reasonable, Necessary Treatment
Chavez v. Stokes, No. 42589 (Idaho 07/07/15)
Ruling: The Idaho Supreme Court held that a worker’s medical transport on a helicopter after his injury was reasonable and necessary medical treatment.
What it means: In Idaho, there is no specific test for the reasonableness of medical treatment. The totality of the circumstances should be considered.
Summary: An irrigator on a farm suffered a partial amputation of his left pinky finger when his hand slipped into the chain of a motor on an irrigation line. Paramedics who responded observed that the irrigator appeared in considerable pain. The paramedics requested a helicopter transport to another hospital, noting that the finger may have been able to be surgically fixed. The irrigator was transported to the hospital on the medical helicopter, but his finger could not be reattached. A hand specialist amputated the finger. The irrigator sought workers’ compensation benefits. The farm owner conceded that all reasonable and necessary medical expenses were due to the irrigator but disputed whether the helicopter transport was reasonable and necessary. The Idaho Supreme Court held that the helicopter transport was reasonable and necessary medical treatment.
The court found that there should not be a specific test for the reasonableness of medical treatment. The totality of the circumstances should be considered. The court also explained that whether the worker’s condition gradually improved should not be determinative of whether treatment is reasonable.
Here, a paramedic made the determination that it was possible to reattach the irrigator’s finger and that taking him to another hospital was his best chance of success for the procedure. No evidence showed that the call for transport “was a mistake.” The court recognized that the transport could be seen as unnecessary in hindsight, but the evidence showed that the transport was reasonable medical treatment at the time of the injury.
Company President’s Stroke Compensable Despite Decision Not to Obtain Coverage
Harper v. Banks, Finley, White & Co. of Mississippi, P.C., No. 2012-CT-00811-SCT (Miss. 07/02/15)
Ruling: The Mississippi Supreme Court held that the president of an accounting firm’s fatal stroke was compensable. Even though the firm had not obtained workers’ compensation coverage, it was obligated to compensate the president’s dependents.
What it means: In Mississippi, an uninsured employer can be obligated to compensate a worker for his injuries even if the worker was the one who decided not to obtain coverage.
Summary: The president of the accounting firm Banks, Finley, White & Company of Mississippi was diagnosed with high blood pressure and he intermittently took medication. He suffered a stroke. Two weeks later, he returned to his usual work schedule of working approximately 11 hours per day. One year later, he had another stroke and died. His dependents sought workers’ compensation benefits. The firm had not obtained workers’ compensation coverage because the president had erroneously determined that it did not have the requisite number of employees to mandate coverage. The Mississippi Supreme Court held that the president’s strokes were compensable and that the firm was obligated to compensate his dependents.
The court explained that there was no policy providing coverage to any of the firm’s employees. It employed five people, so it fell within the law requiring coverage. Nothing showed that the firm provided any written notice that it was electing to exempt the president. Therefore, he was covered under the workers’ compensation laws at the time of his death.
The court also found that the medical testimony showed that the president had labile hypertension, a condition that causes a person’s blood pressure to rise due to stress. Also, other than high blood pressure, there were no medical causes for the president’s strokes. The evidence showed that the president was under a considerable amount of stress from work that was more than the usual and everyday work stress.
The court found that the stress was so much that it caused an increase in the president’s blood pressure, which in turn caused his stroke and his death.
A dissenting judge pointed out that the president’s dependents were seeking the very workers’ compensation benefits that the president failed to procure. Also, the president could have been held criminally and civilly liable for failure to procure coverage. Another dissenting judge opined that the medical testimony was speculative and did not show a causal link.
Employment Did Not Facilitate Assault Motivated by Worker’s Sex Offender Status
McDaniel v. Western Sugar Cooperative, No. A-14-793 (Neb. Ct. App. 07/14/15)
Ruling: The Nebraska Court of Appeals held that a worker’s injury resulting from an assault by a coworker was not compensable.
What it means: In Nebraska, assaults motivated by personal reasons are not compensable under workers’ compensation even if the assault occurred at work.
Summary: A worker for Western Sugar Cooperative was walking and talking with a coworker at work. Then the coworker began assaulting the worker with a brass hammer and calling him a child molester because the coworker had learned that the worker was a registered sex offender. The worker suffered injuries to his nose, clavicle, and left shoulder.
The worker did not know the coworker outside of work, but they lived near each other in the same small town. The worker sought workers’ compensation benefits. The Nebraska Court of Appeals held that the worker was not entitled to benefits.
The court concluded that the assault did not arise out of the worker’s employment. In order for an assault for personal reasons to arise out of the employment, the employment must have exacerbated the animosity or dispute or facilitated an assault that would not otherwise have been made.
The worker argued that but for his shared employment with the coworker, the two men never would have encountered each other and the coworker never would have known about his criminal history. The worker asserted that the employment facilitated the assault and that he should be entitled to compensation.
The court disagreed, explaining that no evidence showed any employment-related dispute between the worker and coworker or any animosity over work performance. Although the sole relationship between the two men was as coworkers, the motivation for the assault was the coworker’s personal feelings toward discovering that the worker was a sex offender.
The court explained that the cause of the assault was entirely disconnected from Western Sugar’s business and the employment of the two men. It was plausible that because the men lived near each other in a small town they would have encountered each other and the coworker would have had the ability and opportunity to carry out the assault elsewhere.
Shoe Program Improperly Required Workers to Contribute to Cost of Compensation
Lewings v. Chipotle Mexican Grill, Inc., No. B255443 (Cal. Ct. App. 07/01/15, unpublished)
Ruling: In an unpublished decision, the California Court of Appeal held that Chipotle violated the law by requiring workers to contribute to the cost of compensation.
What it means: In California, no employer can receive from any employee a contribution, either directly or indirectly, to cover the cost of workers’ compensation.
Summary: A company called Shoes for Crews marketed its nonslip shoes to employers by offering to reimburse them for workers’ compensation expenses if a worker is injured in a slip and fall while working. Chipotle Mexican Grill implemented a Shoes for Crews program in which workers were permitted to buy shoes directly from Shoes for Crews or through a payroll deduction. This was considered a safety program or good safety practice by workers’ compensation carriers. Based on its workers wearing the Shoes for Crews shoes, Chipotle obtained a reduction in its workers’ compensation premiums. On two occasions, Chipotle deducted money from a worker’s wages for the shoes. At one point, Shoes for Crews paid $25,000 to offset the cost of medical bills arising from injuries sustained by Chipotle workers. The worker sued on behalf of all nonexempt or hourly workers who worked for Chipotle in California, alleging that it violated the law by requiring workers to bear the cost of workers’ compensation expenses. The California Court of Appeal held that Chipotle violated the law when it required workers to contribute to the cost of compensation.
The court found that the warranties offered by Shoes for Crews covered a part of compensation. Any time Chipotle was self-insured, the warranties directly covered the cost of compensation by paying medical expenses. Any time Chipotle had workers’ compensation insurance, the warranties indirectly covered the cost of compensation by defraying increases in insurance premiums and replacing lost dividends.
The court also found that the Chipotle workers contributed to the cost of compensation. When the workers purchased shoes, they indirectly contributed to the cost of compensation because their purchases resulted in Chipotle receiving warranties from Shoes for Crews designed to offset their workers’ compensation medical expenses.
The court rejected Chipotle’s argument that it did not violate the law because the shoe purchases were voluntary. The court explained that a contribution can be received or deducted by Chipotle regardless of whether it is voluntary or involuntary. The court also rejected Chipotle’s argument that the worker did not have standing to sue because she did not allege that she suffered a slip and fall, filed a workers’ compensation claim, or that the $25,000 payment made by Shoes for Crews had anything to do with her. When the worker and coworkers purchased Shoes for Crews shoes, they secured at least part of the cost of compensation.
Teacher Establishes Causal Relationship Between Work, Allergies
Paradise Valley Unified School District v. Industrial Commission of Arizona, No. 1 CA-IC 14-0066 (Ariz. Ct. App. 06/30/15, unpublished)
Ruling: In an unpublished decision, the Arizona Court of Appeals held that the aggravation of a teacher’s allergies was compensable.
What it means: In Arizona, a symptomatic aggravation of a preexisting condition that requires additional medical treatment or results in additional disability can be compensable.
Summary: A kindergarten teacher for Paradise Valley Unified School District developed headaches, a burning throat, and a runny nose during her workdays, but her symptoms resolved at night after she got home. She also developed chest tightness, difficulty breathing, muscle aches, a fever, and chills. All of the teacher’s symptoms improved when she was away from her classroom. The school hired experts to perform an environmental assessment of the classroom. The assessment revealed cladosporium mold and elevated carbon dioxide levels. The teacher sought workers’ compensation benefits. The Arizona Court of Appeals held that she was entitled to benefits.
The teacher’s treating internist did not know specifically which toxins in the classroom caused the symptoms, but he opined that there was a direct connection between her symptoms and the time she spent in her classroom. An independent medical evaluator stated that the teacher was exposed to mold and carbon dioxide in her classroom, but there was no evidence that she developed a diagnosable condition based on that exposure. The evaluator opined that the exposure temporarily aggravated the teacher’s preexisting allergic rhinitis and required additional testing and treatment. The court found that the medical testimony was sufficient to find a causal relationship between the teacher’s work and the temporary aggravation of her allergies.