Court Sets Geographical Limits on Compenable Consequence Claims

Tuesday, October 27, 2009 | 0

By Michael LeClerc

Last week, October 13, 2009, the 4th District Court of Appeal held that there are reasonable geographical limits to an
employer's liability for compensable consequence claims.

In Esquivel v. WCAB, the injured worker resided in San Diego. After suffering an industrial back injury, she was taken off work and placed on temporary disability, during which time she received medical treatment at a facility approximately
8 miles from her home.  During this period of treatment, she took a weekend trip to visit her mother in Hesperia,
136 miles away.  After her visit, she left her mother's intending to drive back to San Diego, straight to a scheduled
medical appointment for her industrial injury.  However, she drove through a stop sign just minutes after leaving her mother's house. She was seriously injured.  The injured worker claimed her injuries were industrial as a compensable consequence of  driving to her medical appointment.

The WCJ agreed that the accident was compensable because even though the accident occurred over 100 miles from both applicant's home and her doctor's office, she was nevertheless on her way to the doctor's office and, because she had not significantly deviated from her journey to the doctor's office (regardless of her starting point) the accident was compensable.  In the WCJ's reasoning, it is neither the starting nor the stopping point that matters but rather the intent of the injured worker.  Because she was driving to a medical appointment after her visit to her mother's house, there was sufficient industrial nexus.

The WCAB reversed the WCJ and found that the accident occurred too remotely from both applicant's home and her doctor's office to assign the risk of injury to the employer.  Applicant petitioned the Court of Appeal for Writ of Review, arguing that there is no geographical limit to the employer's liability for injuries arising out of travel for medical treatment.

The Court of Appeal disagreed with applicant's position.  The Court found that there is a geographical limit to employer
liability for medical travel:  Employer's are only liable for injuries arising out of travel to and from medical
appointments while traveling a "reasonable distance" within a "reasonable geographic area."  What exactly constitutes a
"reasonable distance" and a "reasonable geographic area" must be determined on a case by case basis.  Here, the 136 miles that Esquivel planned to drive from her mother's house to her medical appointment was unreasonable given the fact Esquivel lived just eight miles from the treatment facility.

THE BOTTOM LINE:

There are geographical limits to an employer's liability for compensable consequence claims arising out of injuries occurring from travel to and from medical treatment.  While the Court left open the definitions of "reasonable distance" and "reasonable geographical area" to be determined on a case by case basis, a 136-mile trip to a facility less than 10 miles from applicant's residence clearly meets these definitions.

Of course, the longstanding deviation principal still applies as well:  If the injured worker intends to travel to a medical
appointment and is injured following a deviation from the normal course (ie to go shopping) the accident is not compensable.

Given the defenses of reasonable geographical distinct and deviation, as well as the potential for subrogation against a third party defendant we recommend that all compensable consequence claims arising out of medical travel injuries be fully investigated.

To read the Esquivel decision, subscribers may click the case title in the sidebar.

Michael LeClerc is an attorney for the Hansen LeClerc law firm in Redding. This column was reprinted with his permission from the law firm's blog, http://www.rhinocomplawyer.com