Upload
others
View
2
Download
0
Embed Size (px)
Citation preview
Presents
Affirmative Defenses
By:
Ofer Holzman Jack D. Hoskins
Gerald C. MacRae and
Matthew J. Fernstrom
TableofContents• LC5705 2-3• Ini8alPhysicalAggressor 4-6 • Horseplay 7-8• Intoxica8on 9-11• SelfInflictedInjury 12-13• Suicide 14-15• StatuteofLimita8ons 16-21
• IndependentContractor 22-26
1
Affirmative Defenses Inallcasestheburdenofproofrestsuponthepartyholdingtheaffirma8veontheissueCALaborCode5705
LaborCode5705outlinesthedefensestoaclaimwheretheburdenshiOsfromtheapplicanttotheEmployer
2
Affirma8veDefenses• 5705
– IndependentContractorStatus– Intoxica8on– StatuteofLimita8ons
• OtherAffirma8veDefenses– SelfInflictedInjury– Suicide– Ini8alAggressor– Horseplay– Coverage
3
Ini8alPhysicalAggressorNocompensa8onispayableforInjuriesarisingoutofanalterca8oninwhichtheinjuredemployeeistheini8alphysicalaggressorLCSec8on3600(a)(7)
Cons8tu8onaldespiteananalysisofwhoisatfaultMathewsv.WCAB37CCC124(1974)
Whatisaphysicalaggressor?Thefirstpersontoengageinconductthatareasonablepersonwouldperceivetobeareal,presentandapparentthreattobodilyharmMar8nezv.WCAB41CCC51(1976)
4
Ini8alPhysicalAggressorCon8nued
• VerbalAggressionvs.PhysicalAggression– Requirementofanovertact– intentandabilitytocausebodilyharm– Noneedforactualphysicalcontact
5
Ini8alPhysicalAggressorCon8nuedDoesnotapplywhennointentforbodilyharm(horseplay,prank)ac8onposesnorealdangeractedtorestrainanothertoavoidviolencedispropor8onateretalia8on
Subjectmaberofdispute–AOEAninjurysustainedinanalterca8onduetoanimosityunrelatedtotheemploymentdoesnotariseoutoftheemployment
6
Horseplay Aninjurysufferedbyanemployeewhoini8atedorisawillingpar8cipantinhorseplayisnoncompensable
Horseplay–nonworkrelatedac-vi-eswhichhaveaninherentpoten-alforinjuryHorseplayisdis8nguishedfroman“alterca8on”byanabsenceofanimosityorawillingnesstoinflictbodilyharmMabhewsv.WCAB37CCC124
7
HorseplayCon8nuedAninnocentbystanderemployeeinjuredduringhorseplayisnotbarredfromrecovery
ThehorseplaydefensedoesnotapplywhentheemployercondonesthehorseplayHodgesv.WCAB43CCC879(1978)
8
Intoxica8onAninjurycausedbyintoxica8onbyalcoholortheunlawfuluseofacontrolledsubstanceisnon-compensableLC3600(a)(4)
“Controlledsubstance”shallhavethesamemeaningasdescribedinsec8on11007ofHealthandSafetyCode
9
Intoxica8onCon8nuedMustshowactualintoxica8on,notmerelyatraceorsimplepresenceofalcoholorcontrolledsubstanceintheemployeessystemat8meofinjuryFactualanalysistodeterminewhethersomeonewasintoxicated: -whatwastaken -howmuch -sizeofperson -person’sac8ons
10
Intoxica8onCon8nuedDefenseRequiresShowingofProximateCause
i.e.didtheintoxica8oncausetheinjuryAfindingthattheintoxica8onwasa“substan8alfactor”incausingtheinjurywasfoundtobesufficientSmithv.EdSmithWelding(1981)46CCC1053
11
SelfInflictedInjury• SelfinflictedinjuriesarenotcompensableLC3600(a)(5)• “SelfInflicted”
– Ac8onwasintendedbytheemployee– Employeeintendedtoinjureselfwhenac8ngNobenefitsdueeveniftheinjuryisgreaterthantheyoriginallyintended
12
SelfInflictedInjuryCon8nued
• Mustshowintentwastoinjureoneselfandnotsimplyanimpulsiveact– “Employeeswhomerelyactrashlyorimpulsivelyneitherexpectnorintendtonecessarilyhurtthemselvesnoraretheirresul8ngworkrelatedinjuriesautoma8callynon-compensable.”Smithv.WCAB65CCC277
13
Suicide• WillfullyanddeliberatelycausingonesowndeathisnoncompensableLC3600(a)(6)
• Mustshowthatthesuicidewasavoluntaryact– DidthedeceasedemployeehavetheabilitytoresisttheimpulsetocommittheactBeauchampv.WCAB(1968)33CCC112
– Abilitytoresistimpulseisamedicalques8on,painandextremejobstresshavebothbeenfoundtobeindustrialfactorsleadingtoanirresis8bleimpulse
14
SuicideCon8nued• SuicideDefenseDoesNotApplyWhenCompensableConsequenceSuicideisFound– Suicidethatresultsfromanunderlyingcompensableinjury
– Underlyingcompensableinjurycreatesirresis8bleimpulse
• WithouttheunderlyinginjurytherewouldhavebeennosuicideBallardv.WCAB(1979)36CCC34(enbanc)
15
StatuteofLimita8ons
• LC5400etseq.• StatutesofLimita8onsareliberallyconstruedinfavorofemployeesGraniteConstruc8onCo.v.WCAB(2003)112Cal.App.4th1453
16
StatuteofLimita8onsCon8nued
Establishingproperno-ceofrightstoworkers’compensa8on– Signage/WallPos8ngLC3550
• EmployeeHandbookwithsignature– Employersdutytogiveclaimformandno8ceofworkers’compensa8onrightsLC5401
Employerno8cefulfilledwhenapplicantknowsinjurywasworkrelatedandofrighttofileKaiserv.WCAB(1985)39Cal.3d57,64-65.
17
StatuteofLimita8onsCon8nued
• OneyearSOLforclaimsLC5405• Laterof:
– DateofInjury• SpecificInjuryLC5411
– DateofIncident• CTLC5412
– Kneworshouldhaveknownitwasworkrelated– Dateoflastindemnitypayment– Dateoflastfurnishingmedicalbenefits
18
StatuteofLimita8onsCon8nued
• ClaimsBarred:– Employeeknowsinjurycausedbyworkandawareofrights
• Doctorinformingemployeethatinjurywork-related• KnowledgeofWCproceduresfrompriorclaims• Acknowledgmentbyapplicant
19
StatuteofLimita8onsCon8nued
• ClaimsNotBarred:– Laybeliefofindustrialcausa8onbecauseinjuryhappenedatwork
– Generalawarenessofworkcompsystem– Reten8onofAborney,Aborneyknowledgenotimputed
– ExistenceofDoctor’sreportre:injuryifemployeeunawareofreport
– Treatmentwithnonindustrialtreater
20
StatuteofLimita8onsCon8nued• StatuteofLimita8onsforvariousclaims
– S&WLC54071yearfromDOI• Notextendedbypaymentofbenefits/filingofapplica8on
– LC132a1yearfromdateofdiscrimina8on/termina8on
– NewandFurtherDisabilityLC54105yearsfromDOI– DeathBenefitsLC54061yearfromdateofdeathorlastbenefit
– Liens3yearsfromlastDOSiflastDOSPRE7/1/13,18monthsforlastDOSAFTER7/1/13LC4903.5
21
IndependentContractor• Anypersonwhorendersserviceforaspecifiedamountfor
aspecifiedresult,underthecontrolofhisprincipalastotheresultofhisworkonlyandnotastothemeansbywhichtheresultisaccomplishedLC3353
• IndependentContractorstatusisliberallyconstruedinfavoroffindingtheinjuredindividualtobeanemployeeLC3202
• Anypersonrenderingserviceforanother,otherthananindependentcontractor,ispresumedtobeanemployeeLC3357
22
IndependentContractorCon8nued
“Therighttocontrolthemeansbywhichtheworkisaccomplishedisthemostsignificanttestoftheemploymentrela8onship”Tiebergv.UnemploymentIns.App.Bd.(1970)2Cal3d493
23
IndependentContractorCon8nued• Ques8onstoAskWhenDeterminingStatus:
– Isthepersoninques8onengagedinadis8nctoccupa8onorbusiness?
– Isthekindofworkbeingperformedusuallydonebyaspecialistwithoutsupervision?
– Whatistheskilllevelrequiredinthepar8cularoccupa8on?– Whatisthelengthof8metheservicesarebeingperformed?– Whatisthemethodofpayment,isitby8meorbyjob?– Istheworkpartoftheregularbusinessoftheemployer?– Whoprovidesthetools/instrumentali8es?S.G.Borello&Sons,Inc.v.DepartmentofIndustrialRela8ons(1989)48Cal.3d341
24
IndependentContractorCon8nuedDeemedanEmployee:CleaningPerson-workedforapartmentmanager,dura8on,payment
TaxPreparer-noindependentclients
GolfCaddie-clubsupervised,dress,behavior,typesofservice
Sharefarmers-inspiteofcontractasindependentcontractor,control
25
IndependentContractorCon8nuedDeemedanIndependentContractor:Gardener-workedformanyclients,noonetoldhimhowtodothejob
UniversityStudent-injuryassis8ngprofessorinfield,not“renderingservices”
TruckDriver-equipment,lumpsumpayment,paidwith1099,notaxeswithheld
26
Recommenda8ons• Affirma8veDefensesRequireFactSpecificInves8ga8on– Witnessstatements(Aborneyv.Inves8gator)– Deposi8onofApplicant
• RaisetheDefenseintheDenialNo8ce/Answer• SetforAOE/COETrialASAP
27