September 25, 2012

Texas: Coming and Going, Going, Gone

One of the most compelling issues in the compensability of workers comp claims is determining the moment when coverage begins. For most workers, coverage begins at the worksite, often in the employer's parking lot. Under the "coming and going" (or "to and fro") rule, the commute to and from work is generally not covered. There are exceptions, of course, and these exceptions become the focus of litigation when an injury occurs during a commute. When a serious injury or, in today's case, a fatality occurs, there is a lot at stake in the interpretation of this deceptively simple rule.

Juan de los Santos worked for Ram Production Services, a Texas company that services gas and oil leases. De los Santos was assigned to work on a gas lease located on a large piece of fenced ranchland. The employer furnished de los Santos with a company-owned truck and paid for work-related fuel expenses. The truck was not for personal use. De los Santos spent a significant part of his workday traveling to wells and job sites within a designated area known as the Buck Hamilton Ranch. De los Santos entered the ranch through the only entrance, a gate where he was signed in by a guard. De los Santos traveled to the exact same location each day to begin his work, which started at 6:00 a.m. He was a salaried employee, who was not paid extra for his travel.

One Fateful Day
In June of 2005, de los Santos was driving to work, on a public highway, when he was involved in an accident that resulted in his death. He was survived by his wife, Noela, and his daughter, Kimberly Ann. [Note that the litigation around the compensability of his death remained unresolved more than seven years later.] Noela filed for workers comp benefits, which were denied, then granted, and then finally resolved in the Texas Fourth Court of Appeals.

Mrs. de los Santos tried to develop a narrative of the accident that met the standard for a compensable claim: she noted that her husband was traveling in a company truck furnished as part of his employment contract, and that her husband's travel originated in the employer's business because he was taking a route to a remote job location, was on a "special mission" at the time of the accident, and was transporting tools and equipment to the worksite.

Deconstructed Narrative
The appeals court dismantled her narrative one piece at a time:
- Being in a company vehicle does not mean you are necessarily "in the course and scope" of employment;
- Yes, he was driving to a remote location, but that was his regular assignment, unchanging from week to week;
- Even though he was meeting a contractor at the jobsite, this did not mean he was on a "special mission" as he was headed to his usual workplace at the usual time;
- And the fact that he was carrying tools and equipment did not change the nature of the commute. [NOTE: had he been injured moving the equipment into the truck, he would have had a compensable claim.]

The court noted that "there is no bright line rule for determining if employee travel originates in the employer's business; each situation is dependent on the facts." And the facts, as the court interpreted them, did not favor the widow's claim. They reversed the trial court's ruling by rendering a "take-nothing" judgment. Take nothing, indeed.

Thus, after seven years, the case grinds to its conclusion. Mrs. de los Santos and her daughter are on their own.

Letter of the Law
The court was correct in its determination that de los Santos was on his ordinary commute to his regular workplace. While we all have moments when we might like to engage in social engineering - the widow and her daughter certainly could use a helping hand - the rules are the rules and the law is the law. Workers comp offers a formidable package of benefits to workers across America. The wage benefits are generous and the medical benefits superior to any conventional health plan. But the barrier to coverage is substantial: the injury - in this case, fatality - must arise "in the course and scope" of employment. In his drive seven years ago on that lonely and presumably quiet back road to his remote job site, de los Santos was commuting to work. He never made it to the Buck Hamilton Ranch. Now, years later, his widow must deal with the consequences of his not quite reaching the gate, where his compensable workday would have begun.

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About this Entry

This page contains a single entry by Jon Coppelman published on September 25, 2012 12:43 PM.

New Jersey: Usual, Customary and (Un)balanced was the previous entry in this blog.

Health Wonk Review, work fatalities, flu vaccines, litigation, kudos & more is the next entry in this blog.

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