XCI When Rules Need to Change

By: Publius

The tragic March 2006 death of Taneka Talley, victim of a racially motivated murder while working at a Dollar Tree store in Fairfield, California, has caused the Legislature to reexamine the issue of when a claim for workers’ comp benefits arises out of and in the course of employment.

The cause of this reexamination was Dollar Tree’s initial rejection of the claim for death benefits. Expressions of outrage notwithstanding, Dollar Tree had a plausible basis for denial, set forth in a long line of cases, including some with disturbingly similar facts, which hold that a fatal injury may occur in the course of employment but not potentially arise out of employment. When the causal connection between employment and the injury or death is breached, such claims are not compensable. (See State  Compensation Ins. Fund v. Workers’ Comp. Appeals Bd. (1982) 133 Cal.App.3d 643, 184 Cal.Rptr. 111.)

But it is also true that the Legislature is invested with plenary authority over the workers’ comp system by virtue of Article XIV, Section 4 of the Constitution. If the Legislature is to reexamine this issue, it has undisputed authority to do so. Workers’ comp benefits are not life insurance policies. We have seen the limitations of this benefit system in the recent past, when the Legislature sought to allow death benefits to be paid to the estate of the deceased worker – a law the courts overturned. Thus, if the Legislature is indeed going to embark on legislation that further refines what constitutes “arising” out of employment, it should do so by not reacting viscerally to the facts of the Talley case and instead, mindful of well-established case law, craft a rule that makes it clear to employers that tragedies such as these do indeed arise out of and in the course of employment.

Such careful drafting usually eludes the Legislature, and current legislative efforts certainly fall into that category. Case law states that if the injury was caused by a third party for a “personal” reason, then the claim may not arise out of employment. In this case, a “personal” reason doesn’t mean that the third party knew the employee but rather that the motivation behind the assault had nothing to do with the status of the victim as an employee.

The current legislative language in SB 145 (DeSaulnier) attempts to address this problem but instead opens the door to a host of new challenges. In his bill, “(n)o workers’ compensation claim shall be denied because the employee’s injury or death was related to the employee’s race, religious creed, color, national origin, age, gender, marital status, sex, sexual orientation, or genetic predisposition.”

What exactly does that mean? On the face of it, these protections already exist. But in context, the whole question of motive, key to existing case law in determining whether an injury arises out of employment, is replaced by a determination of whether a trait or status “was related to” the injury. This is a broader standard than current law and addresses one of the more frequent scenarios in which these injuries occur – when one spouse commits an assault on the other at the workplace. But apparently, if the two people are simply in an abusive relationship, the claim still can be denied.

It is also interesting that this legislation seeks to address the issue of apportionment to these same characteristics, although one is left to wonder how someone’s injury can be apportioned to marital status. Essentially, the bill says you cannot apportion to a trait or status, you can apportion only to a documented medical condition.

But when added to the language intended to address the Dollar Tree case, more questions are raised than answered. Is knee pain a result of repetitive bending in the workplace or because of arthritis in a worker over age 55? Does “arising out of employment” now lend itself to a disproportionate impact analysis to prove that the denial “related to” a trait or status that affects the old more than the young, women more than men?

Once again, the Legislature is attempting to legislate prophylactically rather than setting forth a clear policy. A clearer definition of what constitutes arising out of employment would address the tragedy that befell Taneka Talley. The goal is to make certain that when similar tragedies occur, benefits can be paid promptly. But the current debate will lead only to more litigation – something that no one should find acceptable.

PUBLISHERS' NOTE: Publius is written by a consortium of writers, sometimes internal, most frequently external. Workers' Comp Executive believes that it has the responsibility to air most viewpoints and welcomes the comments of its community on any subject. Publius does not necessarily represent the views of this publication.