'Tis the Season for Holiday Workplace Issues. Day 5 - What If Santa Was The One That Got Run Over By a Reindeer?

It is important not to require employee attendance at holiday parties and that pressure to attend is properly managed. Mandatory attendance at company-sponsored functions, like holiday parties, can result in workers' compensation claims if an attending employee is injured. It can also mean that the employee is entitled to be compensated for his or her time spent at the event pursuant to the Fair Labor Standards Act ("FLSA").

For workers' compensation liability, if the employee is required to attend a company-sponsored event, or there is significant business that takes place at the event that essentially makes attendance mandatory, then the employee will be considered to have been acting in the course of his or her employment and the same rules that apply to typical workers' compensation claims apply to injuries the employee suffers while at the holiday party.

The timing of the event is important for determining if and when workers' compensation laws may come into play. For example, if the event is held during normal working hours, then employee’s attendance will likely be considered as “in the course and scope of their employment” though courts will also typically look at:

  • The extent to which the employer expects/ requires employees to attend; 
  • The extent to which the employer benefits from the event, e.g., will clients be present and/or will work be done;
  • The degree of participation by the employer; 
  • Whether the activity takes place on the employer's premises or off-site; and
  • When the event takes place in relation to the employee's normal work hours. 

Several courts have recognized that an employee's voluntary attendance at a social event sponsored by his employer off the employer's premises and outside normal working hours cannot reasonably be viewed as conduct within the scope of his employment.

To help make your company holiday event festive while reducing your liability, keep the following tips in mind:

  • Make Attendance Optional: Make it clear to employees that attendance at a company-sponsored events is purely optional, not mandatory. This also means keep the event social, not work related. Keep work-related events, like handing out of bonuses or awards, for another day.
  • Pony Up the Pay: If attendance is required or the event is during work-time, compensate your employees, including overtime pay if their hours for the week exceed 40.

Thank you for sharing with us the fun with our week-long holiday blog series.  Stay tuned for a special "stocking stuffer" on Monday, December 17 as we wrap this up!  (Hint ... you didn’t think we could talk about holiday headaches without mentioning the FMLA, did you?)

You're Fired! Wait, Didn't Anyone Tell You? Ohio Supreme Court Addresses the Workers' Compensation Statutory Notice Requirement

The Ohio Supreme Court issued a decision yesterday in Lawrence v. City of Youngstown, 2012-Ohio-4247 (Sept. 20, 2012), which reminds employers that they have a duty to notify employees within a reasonably prompt time of their discharge.

Keith Lawrence, a former City of Youngstown employee, was suspended on January 7, 2007, without pay, pending an investigation. Two days later, the City discharged him. Lawrence claimed he did not become aware of his discharge until February 19th—nearly six weeks later. The City stated it sent Lawrence a letter because he was not working at the time he was discharged. Unfortunately for the City, the letter was not sent certified, so there was no proof that Lawrence received timely notice of his discharge. Lawrence's attorney sent the City a letter on April 17, 2007, stating Lawrence intended to bring an action alleging unlawful workers' compensation retaliation. Lawrence filed his complaint on July 6, 2007. One small problem—the notice letter was not sent to the City within the 90-day period required by Ohio's workers' compensation retaliation statute, R.C. 4123.90.

The statute states that any employee who believes he has been retaliated against for having filed a workers' compensation claim, "shall be forever barred unless [the action is] filed within one hundred eighty days immediately following the discharge... and no action may be instituted or maintained unless the employer has received written notice of a claimed violation of this paragraph within the ninety days immediately following the discharge."

The trial court and the Seventh District Court of Appeals ruled in the City's favor, finding they lacked jurisdiction because Lawrence's 90-day letter was not timely. The Seventh District further clarified, the "90-day notice period begins on the date of actual discharge, not notice of discharge." Neither the appellate court nor the trial court had jurisdiction over the retaliation claim, because Lawrence's notice to his employer was received more than ninety days immediately following his discharge.

Lawrence did not dispute that failure to comply with the 90-day notice requirement would mandate dismissal of his complaint. He argued, however, that R.C. 4123.95 requires a liberal construction of Ohio's workers' compensation statute in favor of the employees, which would result in a finding that his 90-day letter, which was sent within 90 days of his learning of his discharge was timely. The appellate court rejected this notion, stating there was no need for liberal-construction because R.C.4123.90 was unambiguous in setting the starting date for counting 90 days as the date of the actual discharge.

The Supreme Court disagreed, concluding that:

R.C. 4123.90 when viewed in conjunction with R.C.4123.95 and read in pari materia, places an implicit affirmative responsibility on an employer to provide its employee notice of the employee's discharge within a reasonable time after the discharge occurs in order to avoid impeding the discharged employee's 90-day notification obligation under R.C.4123.90.

The Court held it is not unreasonable, nor does it burden employers to require them to provide reasonably prompt notice of discharge to an employee. According to the Lawrence decision, so long as the employer communicates the discharge decision within a reasonable time the 90-day period would still begin to run on the actual discharge date. The Court further noted that the determination of whether a discharge decision was communicated within a reasonable time requires "an inquiry dependent on the facts of each situation," but also noted that "[a] delay of several days would not prevent the 90-day period … from commencing to run on the discharge date."

But the Court did not stop there: "Even if an employer does not communicate the discharge to the employee within a reasonable time, if the employee nonetheless becomes otherwise aware of the discharge or should have become aware of it in the exercise of due diligence within a reasonable time, then the period of 90 days must still be counted from the actual discharge date."

Therefore, based on Lawrence, the actual date of discharge will commence the running of the 90-day period unless: (1) the employee did not become aware of the fact of his discharge within a reasonable time after the discharge occurs, and (2) he could not have learned of the discharge within a reasonable time in the exercise of due diligence. If both of those prerequisites are met, "the 90-day time period for the employer to receive written notice of the employee's claim that the discharge violated R.C. 4123.90 commences on the earlier of the date that the employee becomes aware of the discharge or the date the employee should have become aware of the discharge." (emphasis added).

In Lawrence, the City lacked evidence of face-to -face or other oral notification of the termination and had not sent Lawrence a certified letter to prove that it notified Lawrence of his termination within a reasonable period of time. Therefore, based on the evidence before it, the Court held the City may have timely received Lawrence's 90-day letter alleging a retaliatory discharge 58 days after Lawrence may have learned of the discharge and therefore held that the letter was timely delivered.

What employers should know

To eliminate any doubt that a former employee has received reasonably prompt notice of discharge, Ohio employers should do one of the following:

  • notify the employee face to face regarding his or her termination;
  • hand deliver notice; or
  • send a certified letter.

Doing so will avoid causing any uncertainty as to whether the employee has complied with the statutory timelines for filing a workers' compensation retaliation lawsuit.
 

Recession Rebound Could Create Risks

In Ohio and nationally, experts are reporting that the unemployment rate is decreasing. Further, the number of job openings is increasing. With returning employees and hiring new employees, employers are at a risk for increased workers' compensation claims. Although we generally presume that workers who change employment are at a higher risk for injuries, re-hired employees may also pose safety concerns when returning to their former employers after an extended time away from the job. As a result, it is equally important for employers to pay attention to safety training for new employees as well as re-hired employees. Training not only on how to perform the job, but basic safety precautions may assist an employer in reducing its further workers' compensation claims.
 

Workers' Compensation Considerations When Purchasing a Company

When a purchase of a business takes place in Ohio, the purchaser often overlooks the fact that it will assume the sellers' workers' compensation claims experience either in part or in whole. The Bureau of Workers' Compensation ("BWC") has taken a fairly strict line in combining and transferring coverage to purchasers.

When a new owner wholly assumes the former employer's business, the BWC transfers all of the employer's claims experience to the purchaser. If the new owner purchases a portion of the business, only a part of the former employer's experience will be transferred. Even if the parties enter into asset purchase agreements, which demonstrate that the entities are not undergoing an acquisition or merger, the BWC frequently determines that the purchaser is a successor to the predecessor employer's risk. As a result, the Bureau of Workers' Compensation transfers any and all existing and future liabilities and/or credits of the predecessor employer. As a result, the purchaser may find themselves obtaining an undesirable claims experience. Further, should the predecessor business fail to report payroll, fail to pay its premiums and/or penalties, these liabilities are transferred to the successor. As a result, a purchaser may inherit significant workers' compensation costs.

The BWC transfers a predecessor's obligations regardless of whether the predecessor's transfer to the successor was voluntary, through an asset purchase agreement, or through an intermediary bank or receivership. This is contrary to the concept of successor liability arising out of other types of contracts.

Therefore, it is critical for purchasers to evaluate a predecessor business' workers' compensation rates as part of the due diligence in undertaking a purchase of another business in whole or in part.
 

Scalia v. Aldi--A Mixed Bag for Employers

The Ohio Court of Appeals for the Ninth Appellate District recently issued a decision that has potential to create more questions than answers when it comes to workers' compensation retaliation and disability discrimination law in Ohio.

While employed at Aldi, Maria Scalia injured her elbow. Her claim for workers' compensation was granted, and she was off work receiving workers' compensation benefits while her restrictions impaired her ability to perform her job. A year later, Aldi ordered an independent medical examination which found Ms. Scalia had reached maximum medical improvement, which resulted in the termination of Ms. Scalia's workers' compensation benefits. That medical examination also found that she could work without restrictions, even though Ms. Scalia's personal physician still had some restrictions in place. Shortly after her benefits were terminated, Aldi terminated her employment under its "no fault" attendance policy that required termination of any employee who had performed no work in the past 12 months.

Ms. Scalia claimed retaliation for participation in the workers' compensation system, wrongful discharge in violation of public policy, and violation of Ohio disability discrimination law because Aldi perceived her as having a disability and fired her for that reason.

What's the good news for Ohio employers?
The court found that Aldi's policy of terminating employees who had performed no work in the past 12 months to be "facially neutral" and that Scalia's termination was not "retaliation per se" for her participation in the Ohio workers' compensation system.

What's the bad news?
The court, in remanding Scalia's case back to the trial court, did not foreclose that Scalia could otherwise support a retaliation claim, saying that their conclusion of no retaliation per se "should not be interpreted to say that an employee can never allege a statutory retaliation claim based on action taken under an attendance policy, or that an employer's use of a facially neutral attendance policy can never be a pretext for retaliation."

Considering this, employers with these types of "no-fault" attendance policies should be mindful of the risks related to retaliation where all or even some of the days missed under the policy are due to protected types of activity or leave, including workers' compensation, FMLA, or leave provided as a reasonable accommodation under the ADA—particularly if application of the policy frequently involves consideration of absences covered by these types of statutes. Though courts in Ohio won't automatically find that application of such policies is retaliatory, employees who can show that protected activity (such as participation in the workers' compensation system) factored into the employer's decision are likely to succeed in getting their cases to trial. From the perspective of the workers' compensation retaliation claim under Ohio law, employers still should be protected so long as they apply the no fault attendance policy evenhandedly and consistently regardless of whether the employee was absent due to a workers' compensation injury.

As an aside, the Scalia decision also addresses technical distinctions between the definition of "disability" under Ohio discrimination law and the definition under the federal ADAAA. Rather than cause heads to explode dissecting the court's nuanced opinion on this issue, it is probably better to recognize that the ADAAA definition has become quite expansive and employers therefore will be better served in the vast majority of situations by assuming the employee with a physical or mental impairment has a "disability" and by addressing the reasonable accommodation question first.

Supreme Court Says No Duty To Defend Employer Intentional Tort Claims Under Stop Gap Insurance Endorsements

Under Ohio law, employees may sue their employer to recover damages for an employer intentional tort – even when the injuries are otherwise covered by workers' compensation.  Because these cases can be costly to defend, employers historically have purchased commercial general liability policies with “stop-gap” insurance endorsements for years, believing these provisions imposed a duty to defend the employer against an employer intentional tort lawsuit.

On July 6, however, the Ohio Supreme Court decided Ward v. United Foundries, Inc., determining that Gulf Underwriters Insurance Company did not have a duty to defend United Foundries, Inc. under such a stop-gap endorsement in an employer intentional tort action.

In the policy, the stop gap endorsement contained standard language for intentional injuries:

This insurance does not apply to:

e. Bodily injury intentionally caused or aggravated by you, or bodily injury resulting from an act which is determined to have been committed by you with the belief that an injury is substantially certain to occur.

(Emphasis added.)

The certified conflict to the Supreme Court addressed whether the underlined language requires a final determination made by either a judge or jury before the defense of a claim for a substantial certainty tort can be denied. The parties agreed that the stop-gap endorsement excluded coverage for a “substantial-certainty” intentional tort and that if the employer was ultimately liable to the employee, Gulf would have no duty to indemnify. The only question was whether the policy required Gulf to defend United Foundries in the underlying action.

In a unanimous decision authored by Justice Stratton, the Ohio Supreme Court held that the stop-gap provision does not require such a duty to defend:

An exclusion in a commercial generally liability insurance policy or stop-gap endorsement stating that the insurance does not apply to bodily injury intentionally caused or aggravated by an insured, or bodily injury resulting from an act that is determined to have been committed by an insured with the belief that an injury is substantially certain to occur does not require a final determination by either a judge or a jury before the insurer can refuse to defend a claim alleging a substantial-certainty employer intentional tort.

In so holding, the Court held that the specific language in the stop gap endorsement is clear and unambiguous, disagreeing with the reasoning of the Third District Court of Appeals in Cooper Tire & Rubber Co. v. Travelers Cas. & Sur. Co. The Court further held that the endorsement as interpreted is not illusory, as it provides some limited form of coverage. And finally, in response to the employer’s claim that the policy does not provide it with the coverage it intended to purchase, the Court stated: “But this is an argument for United to assert against the insurance agency and broker who procured the policy, not against the insurer.”

Notably, the injury at issue predated the 2005 enactment of Ohio’s latest intentional tort statute, R.C. 2745.01, which defines “substantially certain” to mean “that an employer acts with deliberate intent to cause an employee to suffer an injury, a disease, a condition, or death.” Thus, the Court followed the earlier line of cases holding that a substantial-certainty intentional tort occurs “when [an] employer does not directly intend to injure [an] employee, but acts with the belief that injury is substantially certain to occur,” citing Penn Traffic Co. v. AIU Ins. Co. It is unclear how the Court would have applied the statute.

Justice Pfeifer concurred in the judgment only.
 

Will GINA Impact Ohio Employers' Ability to Conduct Medical Investigations In Workers' Compensation Claims?

In the day-to-day administration of their Ohio workers’ compensation programs, self-insured employers (or a TPA or law firm on their behalf) often will obtain a medical authorization from the injured worker and then obtain medical records as part of the employers’ medical investigation. Though the authorization is often limited to specific injuries or body parts, they are just as likely not to be so limited. In addition, despite HIPAA requirements, healthcare providers often produce records in excess of what has been authorized (presumably because they don’t want to take the time or effort to cull through the records and produce only what has been asked for.)  As a result, the records obtained frequently will include medical information wholly unrelated to the alleged workers’ compensation injuries and sometimes that information reveals genetic information, such as whether an individual had a test done to determine whether she is at greater risk for breast cancer.  Hospital records are notorious for including family history information that may reflect, for instance, that a parent died of cancer or a heart attack at a relatively young age, even when the individual went to the hospital only to have an injured knee looked at.

As a result, in the workers’ compensation context, employers are frequently obtaining genetic information even though they really haven’t asked for it.  Should the EEOC’s final rule on Title II of GINA then have any impact on employers’ approaches to their medical investigations conducted in the defense of workers’ compensation claims?  Though the rule states that GINA is not intended to “limit or expand the protections, rights, or obligations of employees or employers under applicable workers’ compensation laws,” does that language provide clearance to employers to obtain through its workers’ compensation administration what otherwise would be protected genetic information?  According to the EEOC, “genetic information” does not include the fact that an individual has a diagnosed disease, disorder, or pathological condition, so it is difficult (at least for me) to come up with examples of situations when an employer would need genetic information on an employee to assist in the defense of a workers’ compensation claim.  Therefore, one could argue that application of GINA to an employer’s medical inquiries and examinations for workers’ compensation purposes does not limit an employer’s rights or expand an employee’s protections under the workers’ compensation laws.

 

Even if GINA ultimately is interpreted as applying to medical inquiries and examinations in the workers’ compensation context, employers can protect themselves.  GINA provides an exception for the “inadvertent” acquisition of genetic information through a lawful request for medical information, but  only if the employer directed the individual and/or health care provider from whom it requested medical information not to provide genetic information.  The EEOC suggests the following model language for requests for medical information:

 

"The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits employers and other entities covered by GINA Title II from requesting or requiring genetic information of an individual or family member of the individual, except as specifically allowed by this law. To comply with this law, we are asking that you not provide any genetic information when responding to this request for medical information. ‘Genetic information’ as defined by GINA, includes an individual’s family medical history, the results of an individual’s or family member’s genetic tests, the fact that an individual or an individual’s family member sought or received genetic services, and genetic information of a fetus carried by an individual or an individual’s family member or an embryo lawfully held by an individual or family member receiving assistive reproductive services."

 

That is certainly a mouthful, but in many cases, employers can avoid providing this notice by narrowly tailoring a request for medical information failure such that it is not ‘‘likely to result in a covered entity obtaining genetic information’’ Why, however, leave the appropriate scope of the request open to interpretation?  The safer approach is probably to include the model language.  With respect to employer requested medical examinations, however, there will be no escaping GINA if it applies in a workers’ compensation context.  According to the EEOC, employers must tell health care providers not to collect genetic information, including family medical history, as part of a medical examination intended to determine the ability to perform a job, and must take additional reasonable measures within its control if it learns that genetic information is being requested or required. Such reasonable measures may depend on the facts and circumstances under which a request for genetic information was made, and may include no longer using the services of a health care professional who continues to request or require genetic information during medical examinations after being informed not to do so.  

 

Again, it is not clear from the regulatory language that this provision is directed towards independent medical examinations under workers’ compensation laws, but it may be better to be safe than sorry.  Remedies available under Title II of GINA are the same as those available under Title VII of the Civil Rights Act, which include compensatory and punitive damages up to the maximum caps.  In addition, employers should recognize that the unlawful acquisition of genetic information may also be used by the employee down the line as evidence to support a claim for discrimination or retaliation in violation of GINA.  The EEOC’s Rule goes into effect on January 10, 2011.

Ohio BWC Creates New Rule Circumventing the Ohio Supreme Court's Decision

In June 2009, we reported on the Ohio Supreme Court’s decision to create a narrow exception to the broad BWC successor rules. The Ohio Supreme Court’s decision in State ex rel. Valley Roofing, LLC v. Ohio Bureau of Workers’ Compensation created a small exception to the BWC’s broad authority to impose successorship liability when it held that a business that acquired another business's assets via a bank foreclosure was not a successor to the previous business.

Ohio’s courts have long held that the workers’ compensation statute authorizes the BWC to find successorship whenever “any employer transfers a business in whole or in part or otherwise reorganizes the business.” This broad definition permits the BWC to transfer the experience of a predecessor business to the purchasing business if the purchaser is succeeding the predecessor in some part of the operations of the business. Based on whether the purchase was of all or part of the operations, the BWC will transfer all or part of the predecessor’s experience, rights and obligations to the purchaser.

 

The Supreme Court’s holding is now invalidated by a recent change to Ohio Administrative Code 4123-17-02. Effective October 28, 2010, the BWC has implemented a new rule for evaluating when a business is deemed to be a successor in interest to another business. Pursuant to the new rule, the BWC will transfer a predecessor’s experience under the workers’ compensation law to the successor, regardless of whether the predecessor’s transfer to the successor was voluntary or through an intermediary bank or receivership.  With the new rule, even if the transfer was to an intermediary bank or a receivership, the BWC will find successorship. Effectively, this permits the BWC to find a successorship in almost all situations, regardless of the nature of the transaction. As a result, any company purchasing the assets of an experience rated company will be held responsible for the experience of the purchaser, potentially including premiums attributable to bad claims and penalties for lapses in payment of premiums or failure to report payroll. 

 

The BWC’s determination to transfer the predecessor’s rights and obligations under workers’ compensation law to the purchaser may be challenged, but the changes to the rule tightens the BWC’s authority and lessens the likelihood of success of such a challenge.

 

Many businesses, when looking to purchase the assets of other struggling businesses, do not consider the workers’ compensation liability of the selling company. Now more than ever it is vital to evaluate the workers’ compensation history of a selling company as part of any due diligence when purchasing the assets of another company, particularly a struggling business.  

Ohio Supreme Court Reaffirms Narrow Exception to Broad BWC Successor Rules

The Ohio workers' compensation successor-in-interest rules frequently catch even the most seasoned corporate M&A attorney off guard. Most M&A attorneys reasonably expect that a straight asset purchase will not result in the assumption of any workers' compensation liability in Ohio. As it relates to companies that pay premiums directly into the Ohio state workers' compensation fund, that expectation more often than not will turn out to be wrong. In short, Ohio's courts have long held that the workers' compensation statute authorizes the BWC to find successorship whenever "any employer transfers a business in whole or in part or otherwise reorganizes the business."

Frequently deferring to BWC determinations that successorship justifies a transfer of the seller's experience to the purchaser, the courts simply have defined a successor in interest as a "transferee of a business in whole or in part." This broad definition generally has resulted in the asset purchaser being held to have succeeded to the experience rating of the selling company even when the asset purchase agreement expressly states that the purchaser assumes none of the liabilities of the selling company. (Indeed, it has even resulted in a finding of successorship when a company retained another company's employees as it took over a lease of that company.)

When the selling company's workers' compensation experience in Ohio is negative, the purchaser often is very surprised when they are left holding the bag and responsible for continuing to pay premiums attributable to some very bad claims. As a result, any company that is purchasing the assets of (or is otherwise taking over the business of) a company that is experience rated for workers' compensation in Ohio would be wise to evaluate whether the selling company is merit or penalty-rated and, if the latter, to either take that into consideration in arriving at a purchase price or to create a mechanism to recoup payments made for the workers' compensation claims it inherits.

With these successor principles as a backdrop, we now consider the Ohio Supreme Court's decision yesterday in State ex rel. Valley Roofing LLC v. Ohio Bureau of Workers' Compensation, which upholds a tiny, but significant, gap in the BWC's broad authority to find successorship. In that case, Valley Roofing purchased the assets of Tech Valley Contracting, Inc. from PNC Bank after the bank had foreclosed on Tech. When Valley Roofing applied for workers' compensation coverage, the BWC transferred Tech's experience rating to Valley Roofing. Valley Roofing objected on the ground that it was not a successor to Tech; instead, it had acquired Tech's assets from an intermediary bank. The Ohio Supreme Court, relying on its prior decision in State ex rel. Crosset v. Conrad, found that Valley was not a successor to Tech because Tech did not transfer its business to Valley Roofing, but instead transferred its assets to the bank, which foreclosed on them and then the bank transferred those assets to Valley Roofing. Valley Roofing undoubtedly saved a substantial amount of money as a result of the structure of this transaction.

In this economic climate and perhaps more so as the economy hopefully enters a recovery, we suspect that there may be businesses that are looking to purchase the assets of other more struggling businesses. In structuring these deals, many purchasers do not consider the workers' compensation history of the selling company. But shrewd purchasers can structure the deal in order to avoid a nasty surprise once the transaction has closed and it is time to obtain workers' compensation coverage for the new entity.

 

Ohio BWC Eliminates DFWP Discount for Group-Rated Employers

In a controversial decision issued yesterday, the Ohio Bureau of Workers' Compensation Board of Directors voted to eliminate the Drug-Free Workplace Program (DFWP) discounts for group-rated employers. Instead, only non-group-rated employers will be eligible for the DFWP discount The elimination of the DFWP discount for group rated employers, combined with the reduction of the maximum available discount under the BWC's group rating program from 85%-77% effective July 1, 2009, may deal a significant financial blow to many Ohio employers. These changes are consistent with the BWC's previously stated belief that the group rating program was actuarially unsound and its intent to reduce the premium rates for employers that did not qualify for group rating. The elimination of the DFWP program for group-rated employers is likely to raise a fair bit of concern that the group-rated employers will no longer be incentivized to adopt, maintain and enforce drug and alcohol testing programs. Hopefully, these employers will recognize the value these programs have on the overall safety of their workplaces and that the potential reduction in industrial injuries will provide sufficient incentive to keep their workplaces drug and alcohol free. Only time will tell.