Benefits and Burdens of Public Safety Claims & Innovative Settlement Solutions Wednesday, September 11, :00 am – 12:15 pm
Presenters Paula White Senior Managing Partner - Mullen & Filippi Lynn Cavalcanti Senior VP Operations - AIMS Alex Wong Attorney at Law – Jones, Clifford, Johnson & Johnson LLP Joe Kriskovich Administrative Services Director – City of Manteca
Goals of Session Explain the Defense of Public Safety Officer Injury Presumptions Explore the Impact on Retirement and Labor Code Section 4850 Benefits
Presumptive Injuries Labor Code §3212 Through Initial Analysis: What Presumption is being raised? Does the Public Safety Officer Qualify? Read Statutes (16 Presumptions)
Presumptions Commonly Pled Cancer Heart, Including Hypertension Low Back – Gun Belt Presumption
Cancer Presumption Initial Analysis: Who Does It Apply To? How Long Can It Continue After the Last Date Of Active Service? When Did Public Safety Officer Develop Illness?
Cancer Presumption Continued Applicant Must Demonstrate: Exposure to Carcinogens; Development of Cancer; and, Service as a Police Officer/Firefighter. No Minimum Threshold for Dose or Length of Exposure. (Faust and Garcia) To rebut, Defendant has to Demonstrate : The Primary Site of the Cancer; and, No Reasonable Link Between the Particular Type of Cancer and the Carcinogens to which the Injured Worker was Exposed What is not Considered “No Reasonable Link?” What is the Impact of Latency?
Cancer Presumption Continued Impact of Shifting the Burden: Disprove Reasonable Link Establish Primary Site of Cancer Discovery Considerations (AME vs. QME): Reasonably Associated with Public Safety Officer’s Position Handling Adverse Medical Findings
Heart Presumption Initial Analysis: Who Does it Apply to? Definition of Heart Trouble Applicant Must Demonstrate: Heart Trouble To Rebut, Defendant Must Demonstrate: Contemporaneous Non-Work Related Event Can not be Rebutted by Preexisting Disease Process Contributing Factor in Death – Anti-Attribution Clause Applies
Heart Presumption Continued Discovery Considerations (AME vs. QME): Mitigation of Permanent Disability Exposure Application of Reverse Almarez/Guzman Expert Opinion on DFEC
Gun Belt/Low Back Presumption Initial Analysis: Who Qualifies? Length of Time Wearing Gun Belt Discovery Considerations: Long Term vs. Short Term Employee Surveillance to Substantiate Level of Disability
Anti-Attribution Clauses Labor Code §4663(e) – Applies to all Presumptions Evidence of Suffering from Condition will not Rebut Presumption Evidence of Congenital Defect or Family History will not Rebut Presumption Evidence of Contemporaneous, Non-Work Related Events may Rebut the Presumption
Resolution of Labor Code §4850 Benefits in Connection With an Industrial Disability Retirement Provisions of Labor Code §4850: Full Salary, Tax Free, One Year Subject to 104 Week Cap (Injuries on/after 1/1/08) Not Subject to 104 Week Cap ( Injuries prior to 1/1/08) Benefits Owed Even After P&S (MMI) Advanced Disability Retirement Pension Owed Once Application is Filed County Employees Retirement Act Differences: §4850 benefits continue after retirement County Board of Supervisors Grants Disability Retirements
Discussion of Hypothetical 4850 Claim with Disability Retirement Injury Facts: 50 Year Old, Sworn Police Officer 30 Years of Service Accepted Bi-Lateral Knee Injury – Requiring Total Knee Replacements Currently Working Light Duty with No Lost Time 1 st Surgery is Being Schedule w/Second to Follow Off Work Estimates of 1 Year Post Surgeries Employment Facts: Salary is $120,000 Per Year PERS 50 Small Public Agency Workers’ Compensation through Joint Powers Authority
Costs/Benefits For All Parties To Consider (Non-Medical) Employer = $200,000 1 Year 4850 Benefits ($120,000) Continued Health Benefits 1 Year ($30,000) Overtime Cost 1 Year ($50,000) JPA = $52,546 Total Temporary Disability for Minimum 1 $1,010.50/Wk Injured Worker = $120,000 1 Year Full Salary (Tax Free) 1 Year of Additional Service Credit (Additional 3% to Service Credit) 1 Year Health Benefits
Discussion of 4850 Buy Out & Disability Retirement Benefit to Employer = $60,000 50% of 1 Year 4850 Benefits = ($120,000) Savings of Health Benefits 1 Year ($30,000) No Overtime Costs & Ability to Permanently Fill Opening Cost to JPA = $60,000 50% of Total Temporary Disability for 1 $1,010.50/Wk Benefit to Injured Worker = $180,000 1 Year 90% x $120,000 = $108,000 (50% Tax Free) 50% Buy Out 4850 = $60,000 Loss Of Health Benefits Unless Offered Through Retirement
Questions…… How does this Settlement Affect the JPA? Who Pays What? JPA vs. Member Who Has the Authority to Make This Type of Settlement? If the Settlement Benefits the Employer (Member) and Adversely Affects the JPA Who Decides? Who Pays? How is Risk Dispersed Among Other Pool Members?
Thank You For Your Attention & Participation!