Tuesday, October 13, 2009

Esquivel v. WCAB (Cal. Ct. App. - Oct. 13, 2009)

With the Ninth Circuit taking several days off, the California Court of Appeal helpfully steps in today and cranks out some published opinions. Some of them -- like this one -- basically answer themselves, in my mind. Here are the facts:

"At the time this case arose, Tania Esquivel, a correctional officer receiving benefits under the Workers' Compensation Act (the Act), resided in the City of San Diego and was being treated for her industrial injuries by medical providers located within eight miles of her home. For reasons unrelated to her need for that treatment, Esquivel drove about 130 miles to her mother's home in Hesperia, in San Bernardino County. Esquivel suffered serious new injuries when she drove through a stop sign in Hesperia while en route from her mother's home to the San Diego offices of the medical providers. The workers' compensation judge (the WCJ) found that Esquivel's motor vehicle accident injuries were a compensable consequence of her existing industrial injuries and awarded her temporary disability indemnity and additional medical benefits. . . ."

To me, Justice Nares need say no more. No way. I'm surprised, quite frankly, that you get benefits in the first place pursuant to some sort of "coming-and-going" rule if you're normally injured on the way to your doctor. Sure, it's a but-for cause, but I'd have thought that the rule would be that this is your option since you could live right outside your doctor's door. That's a silly principle in practice, of course, but it's one that we routinely apply to, say, wage and hour rules and a variety of other accident situations.

But even if a coming and going rule applies, there's gotta be a limit to it. And if you drive 100+ miles for your own benefit/fun/whatever, that's on you. You're not covered by worker's comp whenever you're on a 3000 mile (or whatever) trip to the doctor 'cause you had a huge itch to see Arcadia National Park. That's on you, not your employer.

Justice Nares says it more doctrinally than I do, of course. His holding says: "The issue we must decide is whether there is a reasonable geographic limitation on an employer's risk of incurring compensability liability under the Act with respect to new injuries an employee suffers while en route to or from a medical appointment for examination or treatment of an existing industrial injury. We conclude there is and hold that the employer bears this risk while the employee is traveling a reasonable distance, within a reasonable geographic area, to or from the medical appointment. Under our holding, a new injury that an employee suffers while traveling a reasonable distance, within a reasonable geographic area, to or from a medical appointment for examination or treatment of his or her existing compensable injury is also compensable under the Act. In the absence of a specific statutory or regulatory test for determining both the boundaries of the applicable 'reasonable geographic area' limitation and what constitutes a 'reasonable distance,' we also hold that such determinations must be made on a case-by-case basis considering all relevant circumstances."

Which seems right. "Fairness" and "reasonability." Always good tests. And one that, here, means that the accident's on Esquivel, who drove through a stop sign, not her former employer. Which seems even more right to me.

(I say that even though Esquivel's attorney, Thomas Hampton, is a USD Law graduate, and presumably misses out on a fairly good payday as a result. Sorry, Tom. Good try. But you're in the wrong on this one.)