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A recent Maryland Court of Special Appeals decision, Washington Metropolitan Area Transit Authority v. Williams, 2012 Md. App. LEXIS 46 (Md. Ct. Spec. App. 2012) has clarified the status of the law in Maryland with respect to the causal relationship required to demonstrate that a second injury (which is not physically related to the original injury, such as where a knee injury causes back pain) is causally related to an original injury, and thereby compensable.

Jan Williams, the claimant, was a mechanic for WMATA and was working for his employer in 2008 when he injured his back and left knee on the job.  In March of 2009, Mr. Williams was injured while returning from lunch to physical rehabilitation for the first injury when a driver backed into him, causing injury to Williams' right knee.  The Maryland Workers' Compensation Commission found the second injury to be causally related to the original injury, and the Maryland Circuit Court for Prince George's County affirmed that finding.  However, the Court of Special Appeals reversed, and found that the second injury was not causally related to the original injury.

WMATA relied upon a 1996 Maryland Court of Appeals decision, Mackin v. Harris, 342 Md. 1 (1996) in support of its assertion that the second injury was not causally related to the original injury.  In Mackin, the employee had slipped and fallen on a patch of ice on his way to obtain physical therapy for a work-related injury.  Id. at p. 2-3.  The Mackin court noted that for a subsequent injury to be compensable, it must be the "direct and material result of a compensable primary injury."  Id. at 7.  The Mackin court went on to note that while Professor Lex. K. Larson, a noted authority in the field of Workers Compensation law, advocated a "but-for causation" approach to the issue, the Mackin court felt this was too broad a standard, and that acceptance of that standard "leads to rather extraordinary results."  Id. at p. 9.

The Williams court found that while the Prince George's County Circuit Court had utilized Mackin in its analysis of the issue, the Circuit Court had missed the fact that the Mackin court advocated for a much more narrow standard-- namely, that the subsequent injury must have been a "direct causal connection" between the original compensable injury and the subsequent injury in order to have been proximately caused by the original injury.  2012 Md. App. LEXIS at p. 11.  Using that standard, the Williams court concluded that Mr. Williams second injury directly resulted from a cause unrelated to the first injury-- namely, the driver's actions in striking Mr. Williams with his car in the parking lot.  Id. at p. 12.  Because the driver's actions had no connection whatsoever to the original injury, there was no proximate cause between the original injury and the subsequent injury.  (Had the same situation been presented using the "but-for" standard of causation, the claim would arguably have been compensable-- as but for the original injury, Mr. Williams would not have been in the parking lot and would not have been struck.)

While the Court reversed the Circuit Court's findings, it remanded the matter in order to resolve a different issue-- whether the subsequent injury would be compensable as a new work-related injury, standing alone.  As such, the matter was remanded to the Maryland Workers' Compensation Commission to determine that issue. 

In Christy v. Mercury Casualty Company, No. 102138 (March 2, 2012), the Supreme Court of Virginia held that an exclusion in an automobile insurance policy barred the insured from receiving any payment for medical expenses where a portion of medical expenses had already been paid by workers' compensation benefits.

 
The plaintiff police officer was a passenger in a car driven by a Washington County sheriff's deputy.  The car was struck from behind, and the plaintiff sustained a number of injuries.  The parties did not dispute that the accident arose out of and occurred during the course of the plaintiff’s employment with the town.  Among other injuries, the plaintiff’s physician opined that he experienced a tear of the labrum in his left shoulder as a result of the accident, that required surgery.

 
At the time of the accident, the plaintiff was covered by three different insurance policies.  The Town of Abington obtained its workers’ compensation coverage through the Virginia Municipal League Insurance Programs ("VMLI").  The plaintiff received his primary health insurance coverage through a physician-hospital organization ("PHO").  Additionally, the plaintiff was insured under an automobile liability policy issued by Mercury Casualty Company.  The Mercury policy included coverage for medical expenses incurred as a result of injuries arising out of the use of a motor vehicle.  In relevant part, the policy provided that it did not apply "to bodily injury sustained by any person to the extent that benefits therefor[] are in whole or in part payable under any [workers'] compensation law."

 
The workers’ compensation insurance carrier, VMLI, paid a portion of the plaintiff's total medical expenses.  However, VMLI denied claims for the plaintiff’s surgery to repair his labrum, asserting that the injury was a pre-existing condition and therefore not compensable under the workers’ compensation policy.  The balance of the plaintiff's medical expenses was either paid or resolved by the plaintiff and the PHO.

  
The plaintiff subsequently submitted a claim to Mercury demanding payment under the medical expense coverage of his policy.  Mercury denied the claim, asserting that the exclusion provision barred coverage due to the fact that some of the plaintiff’s medical expenses were, in part, payable under workers’ compensation law.

 
On appeal, the plaintiff argued that the exclusion applied only “to the extent” that some portion of his medical expenses were paid by workers' compensation benefits.  The plaintiff argued that the exclusion acted only to offset any amount actually paid by the workers' compensation carrier, without regard to whether he successfully pursued a claim for all medical expenses.  In doing so, the plaintiff argued that the policy language operates to prevent a "double recovery" by not allowing the insured to receive full payment for medical expenses from both a workers' compensation provider as well as an automobile insurance provider.

 
Defendant Mercury argued its interpretation of the exclusion, asserting that it excluded all coverage if any portion of plaintiff’s medical expenses were subject to workers’ compensation.

   
The Court ultimately found in favor of defendant Mercury Casualty, holding that the policy exclusion limited the scope of coverage for medical expenses, rather than the amount of coverage in the form of a set-off against workers’ compensation benefits.  The court noted the fact that VMLI did pay a portion of plaintiff’s medical expenses pursuant to its workers' compensation policy.   The court also noted that there was no dispute over whether the accident arose out of and in the course of the plaintiff's employment.  Accordingly, the Court held that the clear and unambiguous language of the exclusion permitted defendant Mercury Casualty to deny coverage where the expenses were payable under workers’ compensation law.   Thus, the exclusion permitted Mercury Casualty to deny coverage for any expenses which would have been subject to workers' compensation coverage by VMLI without regard to whether all of those expenses were actually paid by VMLI.

In Garrity v. IWIF, No. 1185, September Term, 2010 (Md. App. February 9, 2012), appellant was a part-time bailiff at the District Court for Baltimore City, where he was involved in an automobile accident as he was returning to the courthouse.  Appellant had already arrived at work earlier in the morning but realized the tie he was wearing, a Christmas themed tie, was inappropriate for work.  Additionally, shortly after realizing his tie did not conform to his usual work attire, Appellant spilt coffee on his shirt and tie, which prompted him to go home to change.  Believing it was ok to run this errand, Appellant asked the other bailiff assigned to the courtroom to cover for him.  While traveling back from his house to the courthouse, Appellant was struck head-on by another vehicle.  The Workers’ Compensation Commission found that Appellant’s injury arose out of and was in the course of his employment.  A Petition for Review was filed and Appellant attempted to show that his claim was compensable under the special mission and dual purpose exceptions to the going and comings rule, as well as the personal comfort exception.  The Circuit Court for Baltimore City reversed the Commission’s findings and Appellant filed an appeal with the Court of Special Appeal where the Circuit Court’s decision was ultimately upheld.
 
The special mission exception, first recognized in Maryland in Reisinger-Siehler Co. v. Perry, 165 Md. 191, (1933), is “when an employee is acting in the course of employment when traveling on a special mission or errand at the request of the employer and in furtherance of the employer’s business, even if the journey is one that is to or from the workplace.”  Here, Appellant relied upon the “Policy on Appropriate Attire and Appearance,” which governs Appellant’s dress code at work.  Appellant argued that the policy “mandated” that he leave work and change his shirt and tie once he spilled coffee on them.  The Court of Special Appeals correctly identified that the special mission exception is raised when an employee, acting at the direction of their employer, is injured on the job.  Here, Appellant was not directed by his employer to go home and change his shirt and tie, therefore the special mission exception must fail.  The Court of Special Appeals went further, stating that the policy which Appellant relied upon simply provides “guidance on professional attire,” and is not a mandate requiring employees to leave work when they realize their attire is out of compliance. 
 
While the Court of Special Appeals determined that the “Policy on Appropriate Attire and Appearance” did not provide express authority to leave work, Appellant contends that it contained implied authority.  In support of this belief, Appellant argued that a liberal policy existed for bailiffs to run errands.  Even if bailiffs were able to run minor errands without authorization, the Court of Special Appeals determined that this practice was never approved or acquiesced to by supervisors.
 
The dual purpose doctrine, as outlined in Stotskin v. Bd. of Ed. Montgomery County, 11 Md. App. 355 (1997), is applicable when a “trip involves the performance of a service for the employer which would have caused the trip to be taken by someone even if it had not coincided with the personal injury.”  Relying upon this doctrine, Appellant reasoned that because he had his radio with him to monitor courtroom communications and that the dress policy stated that an employee must maintain “a professional and appropriate image . . .,” his injury should be compensable.  The Court of Special Appeals determined that neither express nor implied authority to leave the courthouse without authorization was provided.  Furthermore, Appellant’s decision to take his radio with him could not remedy the situation because if he was needed, there would be no way for him to comply.  The Court reasoned that only if Appellant’s supervisors authorized him to leave and take his radio with him, would the dual purpose doctrine apply.
 
Appellant also relied upon the personal comfort exception as set forth in King Waterproofing Co. v. Slovsky, 71 Md. App. 247 (1987).  In Slovsky, Claimant was a part-time telephone solicitor who was struck by an automobile while on a paid break.  At the time Claimant was struck, he was crossing the street in order to get food and a drink from a nearby restaurant.  To determine whether Claimant’s injury was compensable, the Court considered whether the Claimant sustained his accidental injury while engaged in some personal comfort activity incidental to his employment.  The Court reasoned that an injury during an off-premises coffee break could easily occur during an on-premises coffee break; therefore, the injury was compensable.
 
Here, the Court of Special Appeals recognized that in order for the personal comfort exception to apply, there must be some mutual benefit between the employee and employer.  While Appellant believes the personal comfort exception was applicable because he would have been compensated while running personal errands, this activity was neither encouraged nor accepted by his supervisor and his argument must therefore fail.
 
The Court of Special Appeals affirmed the Circuit Court’s ruling finding that Appellant did not suffer a compensable injury arising out of and in the course of employment.

For further information concerning the defense of Maryland workers' compensation matters, call  Steve Schwinn at 202-496-2806.

I understand that state Workers' Compensation statutes cover work-related injuries that may be sustained by me. . . . As a result, and in consideration of Allied Security offering me employment, I hereby waive and forever release any and all rights I may have to:

- make a claim, or

- commence a lawsuit, or

- recover damages or losses

from or against any customer (and the employees of any customer) of Allied Security to which I may be assigned, arising from or related to injuries which are covered under the Workers' Compensation statutes.