It is not uncommon for an injured worker in Virginia to prove that an accident and injury arose out of his or her employment but then be denied benefits because the insurance company successfully defends the claim. One defense that employer's occasionally raise is the "willful misconduct defense". In an nutshell, in these cases, the employer tries to prove that the injured worker's violation of a know safety rule caused the accident. accident. The Virginia Court of Appeals has set out a 4 part test to assess whether the employer has proved a willful misconduct defense:
- That the safety rule was reasonable
- That the rule was known to the claimant (injured worker)
- That the rule was for the claimant's benefit
- That the claimant intentionally undertook the forbidden act.
In a recent case, the Virginia Workers Compensation Commission found that an injured worker could not recover wage loss and medical benefits because the injured worker intentionally circumvented a safety protocol established by the employer that de-energized a dangerous piece of machinery when the employee entered a particular area near the machine. The injured worker attempted to assert that the employer did not enforce the rule. The injured worker filed a claim for medical and wage loss benefits with the Virginia Workers Compensation Commission in October of 2017. A hearing was scheduled before a Deputy Commissioner (a workers compensation judge). The injured worker testified that his leg got caught in a machine which caused injury, disability and the need for medical treatment. The employer offered evidence that the injured worker did not follow a known safety rule because he did not enter the area around the machine called the "Shuttle Room". Entering through this way would have caused the machine to shut down. Instead, the injured worker entered the area where the machine was located through a opening in a fence that did not take him through the "Shuttle Room". The Deputy Commissioner denied the injured workers benefits and the Full Commission upheld the Deputy Commissioner's decision finding that the claimant's injury was caused by his failure to enter through the "Shuttle Room". The Commission also found that the employer properly enforced the rule.
Tip for Injured Workers: If this issue arises in your case, remember that it is the employer's burden to prove all 4 requirements noted above. Failure to prove any one of the points noted in the test means that the employer has not met its burden of proof. In addition, even if all 4 points are established, if the injured worker can show that the employer did not "enforce" the rule, the claim will not be barred. An injured worker is advised to be prepared at a hearing to offer his or her own testimony about the requirements and to call any other witnesses that can show that one of the 4 points was not met and/or that the rule was not enforced. These cases are often very complex.
If you need assistance with this issue or any other issue involving a workers compensation claim, don't hesitate to contact our office to review your case.