Tuesday, May 20, 2014

Sometimes the right thing does happen in workers' compensation though it may take a while for that right thing to transpire.

The Florida First District Court of Appeals, which has original jurisdiction over all appeals from Florida Workers' Compensation Courts, did the right thing when it ruled Monday that a grocery store worker who was run over by the jealous boyfriend of one of his coworkers as he was gathering shopping carts in the store parking lot arose out of his employment.

Melvin Pivaral-Ramirez a father of two, had been the front-end manager for the King's Food and Meat Bazaar store. One of his normal job duties was to collect shopping carts from the store parking lot.

On the evening of June 5, 2011, Christopher Polanco, who believed Pivaral-Ramirez had been sexually harassing his girlfriend (a cashier at the store), executed on a plan he had been brewing for weeks by using a borrowed car to run over Pivaral-Ramirez.

Pivaral-Ramirez suffered severe brain injuries leaving him in a vegetative state, and he died two weeks later. His family filed a claim for death benefits.

By the way, there was no evidence that Pivaral-Ramirez had ever harassed the cashier/girlfriend of Polanco.

Polanco confessed that he had been planning the attack for several weeks and had knowledge that Pivaral-Ramirez collected shopping carts from the parking lot of the King's Food in West Palm Beach each night.

The Judge of Compensation Claims found that Pivaral-Ramirez was in the course and scope of his employment but that the injuries he sustained did not arise out of employment because there was nothing about Pivaral-Ramirez's employment that put him at risk of being murdered.

The 1st DCA reversed because the JCC analyzed the facts incorrectly.

The court explained that generally, "when a work-related risk brings about injury, the injury is compensable," but injuries that "are brought about by risks personal in nature," are not compensable.

Some jobs, the court acknowledged, are "more prone to workplace assaults than are others," depending on the nature of the duties of the job, and the nature of the environment of the job.

In this case, the court reasoned that the environment was what had put Pivaral-Ramirez in harm's way by placing him in a dark parking lot to collect shopping cars.

In other words, whether it was Polanco doing the driving, or someone else who was just negligent, Pivaral-Ramirez was at risk collecting shopping carts in a parking lot.

In a footnote the court explained that the error in analysis is common:

"This case presents a classic example of how courts can hyper focus on motive of a third party causing injury to an employee, ignoring a dangerous environment that also facilitated the injury. As Larson’s points out, “[t]he error here is a simple one: The court assumes that the claimant must prove both that the environment increased the risk of the attack and that it was motivated by something related to the employment. The correct rule is that either one or the other is sufficient to establish the causal link.” [Citing 1 Lex K. Larson, Larson’s Workers’ Compensation § 8.01[1][b] (rev. ed. 2013).]

That Pivaral-Ramirez had 2 children probably didn't help the defense on this case - dependency claims are always going to be more difficult to deny when there actually are dependents.

Those interviewed for the WorkCompCentral story this morning generally opined that the case didn't make any new law, and that such cases are highly fact dependent.

Though the family of Pivaral-Ramirez had to go through litigation to obtain benefits, the right result, albeit 3 years later, was obtained. The system sort of worked.

I say sort of because, in my mind, this is a case that should not have had to go to litigation to get what should be administratively delivered. But I also realize that this is the system that was devised to govern Florida's workers' compensation structure.

The opinion does not indicate whether the store was self insured or whether it had insurance - that the claim was denied in the first place tells me that a carrier or third party administrator, i.e. an entity that was not necessarily looking out for the best interests of the employer (and obviously not the best interests of the employee's dependents), was making the compensability decision.

The denial of benefits could have exposed the employer to civil damages for failing to provide a safe working environment for employees - i.e. a dark parking lot.

At the end of the day, though, the dependent/beneficiaries were vindicated. Hopefully there was still plenty left of the $150,000 death benefit to put to good use.

Polanco, who was 23 at the time of the killing, was convicted of second-degree murder in February 2013. He is now serving a 26-year sentence at the Desoto Annex prison in Arcadia, Florida.

No comments:

Post a Comment