Worker deaths could trigger a workers’ compensation claim for surviving dependents

March 6, 2019 | 6:00 am


Armando Gallegos had been working as a correctional officer for 13 years when he was attacked by 12 inmates at Kern Valley State Prison in April 2018. He suffered a broken vertebrae, a broken nose and a concussion, and spent five months trying to recover from those injuries.

Tragically, Gallegos died in September 2018 at age 56. Just recently, the Kern County Coroner’s Office released his cause of death: “congestive heart failure due to hypertensive cardiovascular disease, with contributing of advanced conduction disease and history of assault by inmates.”

The Department of Corrections and Rehabilitation had recommended attempted homicide charges for inmates involved in the attack. The group said information on possible new charges was pending the results of the coroner’s autopsy.

The cause of death announcement brings to light legal issues that arise with the death of workers, and the compensation families can receive with a loved one’s passing.

Families do not often assume that a worker’s death could trigger a workers’ compensation claim on behalf of the surviving dependents. Death benefits may be due when death occurs through a single industrially-related event, or within 240 weeks of an industrial injury resulting in death. However, a new California Supreme Court case significantly broadened what can be determined an industrial death and lowers the standard of proof for such claims.

Learn more about workers’ compensation and work fatalities here:

 

The Standard of Proof 

South Coast Framing Inc. v. WCAB (Clark) completely changed burden of proof for families seeking survivor death benefits. In South Coast Framing, the Court rejected previous standards of proof, such as “significant factor” and “material factor.” Instead, the court determined that the correct standard is that “the employment be one of the contributing causes without which the injury would not have occurred.”

The court described the standard of contributing cause as little crumbs off the crust of a 12-inch pie. In other words, the contributing cause would be so miniscule that you would not notice it if were missing.

 

Mysterious Circumstances 

Oftentimes, even determining contributing cause can seem challenging to surviving dependents. Sometimes the circumstances involving the death are so inexplicable that courts have indicated that they will rely on the fundamental principal that all reasonable doubts as to whether an injury is compensable are to be resolved in favor of the employee. This standard is particularly beneficial in cases where no autopsy is performed.

 

Benefits

Death benefits are payments to a spouse, children or other dependents if an employee dies with employment being a contributing cause. This includes burial expenses of up to $10,000, and medical expenses incurred.

The amount of the death benefit depends on the number of dependents. In cases with a single adult dependent, the surviving dependent may be entitled to a benefit of $250,000. For three adult total dependents, that number goes up to $320,000. In the case of one or more totally dependent minors, payment of death benefits will continue at least until the youngest minor’s 18th birthday; disabled minors receive benefits for life. Death benefits are paid at the total temporary disability rate, which is two-thirds of the employee’s average weekly earnings.

The period within which to commence proceedings for the collection of death benefits is one year from death; or within 240 weeks of an industrial injury resulting in death.

 

Dependents

The law distinguishes between total and partial dependents of the decedent. Minor children and spouses who earn $30,000 or less are conclusively considered total dependents. The Labor Code allows for two more types of dependents; those who are good-faith members of the deceased employee’s family or household, and those with specified marital, blood or adopted relationships with the decedent. These include:

  • grandchild;.
  • father or mother;.
  • father-in-law or mother-in-law;.
  • grandfather or grandmother;.
  • brother or sister;.
  • uncle or aunt;.
  • brother-in-law or sister-in-law; and.
  • nephew or niece.

In these cases, the amount of dependency must still be proven.

 

Additional Benefits

Workers’ compensation laws allow for additional benefits to the defendants of specified employees. These employees include public safety officers, firefighters, public officials, and correctional officers. The benefits range from extending survivor benefits beyond the age of eighteen for a minor dependent to scholarships for surviving minors.

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If you or someone you know is injured in an accident at work, please call the attorneys at Chain | Cohn | Stiles at (661) 323-4000, or chat with us online at chainlaw.com.

Chain | Cohn | Stiles is home to two state certified workers’ compensation specialist attorneys, Beatriz Trejo and James Yoro. Mr. Yoro has also been recognized in the prestigious U.S. News & World Report’s “Best Lawyers” listings.

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*NOTICE: Making a false or fraudulent Workers’ Compensation claim is a felony subject to up to 5 years in a prison or a fine of up to $150,000 or double the value of the fraud, whichever is greater, or by both imprisonment and fine.

Failing workers’ compensation system ‘adding inequality to injury’

March 10, 2015 | 10:25 am


Note: The following article was written by Chain | Cohn | Stiles senior partner James A. Yoro, who manages the Bakersfield-based law firm’s Workers’ Compensation* Department, for publication into The Bakersfield Californian’s “Community Voices” section. You can the full article in the Kern County Journal here

By James A. Yoro

One of the most important protections that employees have is a workers’ compensation system that is supposed to provide them with minimum necessary benefits when they suffer an injury on the job.

This system was predicated on a “Grand Bargain” that was initiated during the Industrial Revolution to deal with the rising tide of work-related injuries and death. The injured worker gave up the right to sue the employer for civil damages. In exchange, the employee would receive medical treatment and a sufficient amount of monetary benefits to help them get by during their recovery period. If their injuries caused some permanent limitation or restriction on their ability to function, additional benefits were paid to reflect their level of disability. If they were unable to return to their usual and customary job, they would be provided retraining to help them adjust to other more suitable employment within their limitations.

Workers’ compensation was a progressive idea that came to fruition at a time when we as a society recognized that it was not fair to treat injured workers as if they were nothing more than a piece of broken machinery – something to be discarded and replaced. Human capital is a valuable commodity that contributes to the success of our economy. Therefore, when workers get injured, they should be helped and cared for and not marginalized. Originally, this was the goal of the Workers’ Compensation system. At the beginning of the 20th century, all 50 states adopted such a system in accordance with this philosophy.

But in the last 15 years, things have gone horribly awry for the injured worker.

Within the last week, two investigative reports and several news articles – including by OSHA and the U.S. Department of Labor, National Public Radio and The Washington Post – reveal how poorly injured workers are now being treated in the Workers’ Compensation system and the effect this cost shifting of the burden has affected our economy and our society.

The Department of Labor report titled, “Adding inequality to injury: The costs of failing to protect workers on the job,” summarized its findings as follows:

“The costs of workplace injuries are borne primarily by injured workers, their families, and taxpayer-supported components of the social safety net. Changes in state based workers’ compensation insurance programs have made it increasingly difficult for injured workers to receive the full benefits (including adequate wage replacement payments and coverage for medical expenses) to which they are entitled. Employers now provide only a small percentage (about 20 percent) of the overall financial cost of workplace injuries and illnesses through workers’ compensation. This cost-shift has forced injured workers, their families and taxpayers to subsidize the vast majority of the lost income and medical care costs generated by these conditions.”

The study concluded that the “failure of many employers to prevent millions of work injuries and illnesses each year, and the failure of the broken workers’ compensation system to ensure that workers do not bear the costs of their injuries and illnesses, are truly adding inequality to injury.”

I have represented injured workers for more than 25 years and I’ve seen firsthand this slow deterioration in the system and how it has affected those most vulnerable in our society – the injured, the handicapped and disabled – in their struggle to obtain the benefits they deserve and achieve some measure of dignity. At times, my level of frustration is overwhelming as I gaze into the eyes of my clients and see the look of quiet desperation in their eyes as they struggle to avoid near poverty, bankruptcy and sometimes divorce simply because they got injured on the job.

Franklin Roosevelt once said, “The test of our progress is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little.”

If this is the measure for progress then the workers’ compensation system is in a period of regression. The “Grand Bargain” is no longer a bargain.

– James A. Yoro is a certified workers’ compensation attorney with nearly 40 years of legal experience, and partner at the Bakersfield-based law firm Chain | Cohn | Stiles.

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Learn more about the recent reports on the workers’ compensation system:

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If you’ve been hurt while on the job, contact the Bakersfield workers’ compensation attorneys at 661-323-4000. Also, visit Chain | Cohn | Stiles’ specialized workers’ compensation website — for frequently asked questions and answers, and other information — by clicking here.

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*NOTICE: Making a false or fraudulent Workers’ Compensation claim is a felony subject to up to 5 years in a prison or a fine of up to $150,000 or double the values of the fraud, whichever is greater, or by both imprisonment and fine.