Extension of An Employer’s Exclusive Remedy Protections to Entities Providing Services on Behalf of the Employer—A Review of King v. CompPartners

by David Kim (October 12, 2018)

In King v CompPartners, the California Supreme Court held that the exclusive remedy provisions under California Labor Code § 3602(a) limit one’s ability to proceed outside the WCAB for injuries alleged to have occurred as a result of the Utilization Review (UR) process.

After his medication Klonopin was not certified through Utilization Review, Kirk King suffered four seizures. King then filed a civil action against UR vendor, CompPartners, and UR physician, Dr. Sharma, alleging that he suffered the seizures as a result of the abrupt termination of his medication. King brought claims of professional negligence, intentional infliction of emotional distress and loss of consortium against CompPartners and Dr. Sharma.

At the trial court level, both defendants demurrered on the basis of exclusive remedy provisions under Cal. Lab. Code § 3602(a), and Dr. Sharma for lack of a duty of care. The Court of Appeal affirmed the trial court’s order sustaining the demurrer except that it concluded Dr. Sharma owed a duty of care to King and viewed Sharma’s failure to provide a warning as to the risks of abrupt termination of the medication as a separate act and not part of the UR process. The Court of Appeal could not determine based on the information provided whether Dr. Sharma breached his duty of care and allowed for leave to amend. The Supreme Court upheld the demurrer, and indicated that the complaint failed to state a cause of action. It reversed the Court of Appeal ruling allowing leave to amend and stated:
    [W]here the remedy is available as an element of the compensation bargain, it is exclusive of any other remedy to which the worker might otherwise be entitled from the employer.
The Supreme Court stated that King sought to recover civilly for injuries that arose during the treatment of his industrial injury, but because the injury arose out of an alleged error in the utilization review process, a process that employers are statutorily required to establish to determine medical necessity for an applicant’s industrial injury per Cal. Lab. Code § 4610, King’s remedy could only be sought through the WCAB. The Court explained that insurance carriers are “alter egos” of the employer, and claims administrators and adjusters are hired by carriers to handle workers’ compensation claims. Just like claims adjusters and administrators, Cal. Lab. Code 3602(a) preempts tort claims against utilization reviewers hired by employers to carry out their statutory duty of determining medical necessity under Cal. Lab. Code § 4610.

Cal. Lab. Code § 4610.5(a) defines an “employer” to include, employer, insurer of an employer, a claims administrator, or utilization review organization acting on behalf of any of them. This definitional provision reinforces the notion that the Legislature considers utilization review organizations an extension of the employer, and the decision in King v. CompPartners should provide relief to employers and carriers alike knowing that the extent of their exposure in workers’ compensation cases such as this will be limited to the remedies available through the WCAB.

This article was written by David Kim, an attorney in Bradford & Barthel’s Fresno office. Mr. Kim has practiced law since 2009 in areas of civil litigation, corporate law, real property, transactional law, intellectual property, and workers’ compensation. Feel free to contact him at david.kim@bradfordbarthel.com or (559) 221-6500.

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