California's Worker's Compensation Act (WCA) provides an employee's exclusive remedy against his or her employer for injuries arising out of and in the course of employment. (Lab. Code, § 3600 et seq.; Wright v. State of California (2015) 233 Cal.App.4th 1218, 1229; Palestini v. General Dynamics Corp. (2002) 99 Cal.App.4th 80, 86.) An injured employee may also bring an action at law against any employer who fails to secure the payment of compensation. (Lab. Code, § 3706.)

Legal Standard

To succeed on a claim under Section 3600 of the Labor Code, the plaintiff must present admissible evidence of each of the following:

1. That plaintiff was defendant’s employee;
2. That defendant had workers’ compensation insurance covering plaintiff at the time of injury; and
3. That plaintiff’s injury occurred while he was performing a task for or related to the work defendant hired him to do.

(Melendrez v. Ameron Internat. Corp. (2015) 240 Cal.App.4th 638-639; State Compensation Ins. Fund v. Workers' Comp. Appeals Bd. (1982) 133 Cal.App.3d 643, 652.)

The term “employee” is defined broadly, and, ordinarily, “[a] person who renders service to another is presumed to be an ‘employee.’” (County of Los Angeles v. Workers' Comp. Appeals Bd. (1981) 30 Cal.3d 391, 396, 179 Cal.Rptr. 214, 637 P.2d 681.) “‘Employee’ means every person in the service of an employer under any appointment or contract of hire or apprenticeship, express or implied, oral or written, whether lawfully or unlawfully employed.” (Brassinga v. City of Mountain View (1998) 66 Cal.App.4th 195, 214.) “[T]he reality of the situation, not the parties’ characterization of the relationship, controls the outcome.” (Brassinga v. City of Mountain View (1998) 66 Cal.App.4th 195, 214.)

“The WCA instructs that its provisions are to be “liberally construed by the courts with the purpose of extending their benefits for the protection of persons injured in the course of their employment.” (Lab. Code, § 3202.) “Any reasonable doubt as to whether the act of the employee is contemplated by the employment should be resolved in favor of the employee in view of the policy of liberal construction of the workmen's compensation laws.” (Tingey v. Industrial Acc. Commission (1943) 22 Cal.2d 636, 641.) This rule of liberal construction applies even though a particular plaintiff might prefer to forgo a workers' compensation remedy in favor of a remedy at law; the courts construe the WCA “in favor of awarding work[ers'] compensation, not in permitting civil litigation.” (Arriaga v. County of Alameda (1995) 9 Cal.4th 1055, 1065, 40 Cal.Rptr.2d 116, 892 P.2d 150.)

Exclusive Remedy

“Where the conditions of compensation set forth in Section 3600 concur, the right to recover such compensation is... the sole and exclusive remedy of the employee or his or her dependents against the employer, and the fact that either the employee or the employer also occupied another or dual capacity prior to, or at the time of, the employee's industrial injury shall not permit the employee or his or her dependents to bring an action at law for damages against the employer.” (Lab. Code, § 3602(a).)

“[T]he legal theory supporting such exclusive remedy provisions is a presumed ‘compensation bargain,’ pursuant to which the employer assumes liability for industrial personal injury or death without regard to fault in exchange for limitations on the amount of that liability. The employee is afforded relatively swift and certain payment of benefits to cure or relieve the effects of industrial injury without having to prove fault but, in exchange, gives up the wider range of damages potentially available in tort. The function of the exclusive remedy provisions is to give efficacy to the theoretical ‘compensation bargain.’” (Shoemaker v. Myers (1990) 52 Cal.3d 1, 16.)

However, the exclusive remedy provisions are not applicable under circumstances where the employer stepped out of its proper role. (Shoemaker v. Myers (1990) 52 Cal.3d 1, 16.) The exclusivity provisions do not apply under circumstances “essentially defined as not stemming from a risk reasonably encompassed within the compensation bargain.” (Id.) Thus, “where [the] injury did not occur while the employee was performing service incidental to the employment and which would not be viewed as a risk of the employment” the exclusivity provisions do not apply. (Id.)

“Courts have also consistently held that injuries arising out of and in the course of the workers' compensation claims process fall within the scope of the exclusive remedy provisions because this process is tethered to a compensable injury. Indeed, every employee who suffers a workplace injury must go through the claims process in order to recover compensation.” (Charles J. Vacanti, M.D., Inc. v. State Comp. Ins. Fund (2001) 24 Cal.4th 800, 815 (Vacanti).) Thus, the Supreme Court has barred all claims based on “disputes over the delay or discontinuance of [workers' compensation] benefits.” (Marsh & McLennan, Inc. v. Superior Court (1989) 49 Cal.3d 1, 7 (Marsh); Stoddard v. Western Employers Ins. Co. (1988) 200 Cal.App.3d 165, 168–169; Mottola v. R.L. Kautz & Co. (1988) 199 Cal.App.3d 98, 109.)

Determining whether a claim is barred by the exclusivity provision of the Worker’s Compensation Act involves a three step analysis. First, “the trigger for workers' compensation exclusivity is a compensable injury,” (Vacanti, supra, 24 Cal.4th at p. 813.)

The second prong of the analysis is determining whether the alleged claims raised in the complaint are “collateral to or derivative” of the compensable injury; claims which are collateral to or derivative of the compensable injury are barred under the exclusivity clause. (Vacanti, supra, 24 Cal.4th at p. 813.)

Finally, in “adjudicating whether a claim falls within the workers' compensation system, all doubt should be resolved in favor of finding jurisdiction within the workers' compensation system.” (Mitchell v. Scott Wetzel Services, Inc. (1991) 227 Cal.App.3d 1480; Fremont Indemnity Co. v. Superior Court (1982) 133 Cal.App.3d 879, 881; Gilford v. State Compensation Ins. Fund (1974) 41 Cal.App.3d 828, 834.)