Cope v. West American Insurance
4 A.L.R. 5th 1101, 309 Or. 232, 785 P.2d 1050 (1990)
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Rule of Law:
An injury sustained by an employee while going to or coming from work is compensable under workers' compensation law, making it an exclusive remedy and precluding other claims, only if the injury "arises out of and in the course of employment," typically requiring the employer to exercise some control over the accident scene or create special hazards there.
Facts:
- Plaintiff was an employee of the Modoc Lumber Company in Klamath Falls.
- Modoc Lumber Company leased a parking lot across a public street from its workplace, which was available free of charge to its employees.
- On September 25, 1985, plaintiff parked her vehicle in this leased parking lot.
- While walking on foot from the parking lot, somewhere near its edge, on her way to work, plaintiff was struck by a vehicle driven by a co-employee, who was also on his way to work.
- Plaintiff sustained injuries in the incident.
- Plaintiff's personal automobile insurance policy included underinsured motorist coverage, which provided that defendants (her insurers) would pay damages she was "legally entitled" to recover from an underinsured motor vehicle owner or operator.
Procedural Posture:
- Plaintiff filed a claim against her employer for workers' compensation benefits, which was denied on the basis that her injury was not work-related.
- Plaintiff then made a claim against the co-employee and his liability insurance carrier and received $25,000, the limit of that policy.
- Plaintiff subsequently filed an underinsured motorist claim with defendants (her personal insurers), alleging damages beyond what she had received, but this claim was denied.
- Plaintiff filed a declaratory judgment action in circuit court (trial court) against defendants, seeking a declaration that she was covered under her policy and entitled to a judgment for her remaining damages.
- Defendants moved for summary judgment in the circuit court, contending that plaintiff was not "legally entitled" to recover damages because workers' compensation benefits were her sole remedy.
- The circuit court granted defendants' motion for summary judgment.
- Plaintiff appealed the circuit court's decision to the Court of Appeals (intermediate appellate court).
- The Court of Appeals reversed the circuit court's decision.
- Defendants (appellees at the Court of Appeals) appealed the Court of Appeals' decision to the Supreme Court of Oregon (highest court).
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Issue:
Does an injury sustained by an employee while traversing from an employer-leased parking lot across a public area to her workplace "arise out of and in the course of employment" such that workers' compensation is the exclusive remedy, precluding an underinsured motorist claim against her personal insurer?
Opinions:
Majority - Carson, J.
No, an injury sustained by an employee under these circumstances, specifically on a public sidewalk over which the employer has no control and where no employer-created hazards exist, does not necessarily "arise out of and in the course of employment" for workers' compensation purposes. The court reasoned that workers' compensation benefits are the sole remedy for a "compensable injury" sustained by an employee at the hands of her employer or co-worker, meaning she would not be "legally entitled" to recover from her co-worker through other means if the injury was compensable. A compensable injury is one "arising out of and in the course of employment," which Oregon courts determine using a unitary "work-connection" approach, asking if the relationship between the injury and employment is sufficient for compensability. The general "going and coming rule" holds that injuries sustained while traveling to or from work are not compensable. However, there are exceptions: 1) where employment exposes the employee to hazards in a greater degree than the common public (citing Nelson v. Douglas Fir Plywood Co.), or 2) where the injury occurs on the employer's premises, including an employee parking lot, or in a public place over which the employer exercises some control (citing Montgomery Ward v. Cutter and Montgomery v. State Ind. Acc. Com.). The critical factor for these exceptions is "some form of employer control" over the area where the injury is sustained, whether through property rights or employer-created hazards. The defendants conceded for the purpose of the appeal that the plaintiff was in an area (a public sidewalk) for which there was no evidence of employer control. The court declined to extend the "parking lot rule" to include injuries sustained on a public sidewalk over which the employer has no control and no employer-created hazards, even if the employee is traveling directly from the employer's parking lot. Because there was conflicting evidence regarding whether plaintiff was on the employer's parking lot or the public sidewalk at the time of the injury, a genuine issue of material fact remained, making summary judgment inappropriate. Therefore, the Court of Appeals' reversal of the circuit court's summary judgment was affirmed, and the case was remanded for further proceedings.
Concurring - Gillette, J.
Concurring with the majority's decision, Justice Gillette wrote separately to highlight an issue of "primary jurisdiction" that the court did not decide. The question, which the court posed to the parties but did not resolve, was under what circumstances a trial court, rather than the workers' compensation system, should initially determine whether a worker is within workers' compensation coverage. Primary jurisdiction is a court-created doctrine that suggests an administrative agency should make initial determinations on legal questions within its statutory authority. While some courts hold that courts and workers' compensation agencies have concurrent jurisdiction, allowing the first tribunal to address the issue to decide it, others hold that the workers' compensation system has primary jurisdiction. Justice Gillette noted that this issue was not raised in the trial court and thus was not properly before the Supreme Court, leaving the matter for future resolution.
Analysis:
This case significantly clarifies the application of the "going and coming rule" and its exceptions within Oregon's workers' compensation framework, particularly concerning injuries sustained in transit near employer-provided facilities. By declining to extend the "parking lot rule" to adjacent public areas without explicit employer control or created hazards, the court reinforces a strict interpretation of the work-connection requirement. This decision underscores the crucial distinction between injuries occurring on employer-controlled premises and those on public thoroughfares, making factual determinations of the accident's location paramount for establishing workers' compensation eligibility. It suggests that employees injured in such ambiguous locations may face a higher hurdle in proving compensability, potentially leading to increased litigation over the precise boundaries of "employer control."
