King v. CompPartners, Inc. (Aug. 23, 2018, S232197) __ Cal.5th __ [2018 WL 4017874]
Plaintiff Kirk King was prescribed the psychotropic medication Klonopin by his treating physician for anxiety and depression associated with a work-related back injury. Another physician, Dr. Naresh Sharma, later conducted a workers’ compensation utilization review pursuant to Labor Code section 4610, subdivision (a), determined the Klonopin was medically unnecessary, and decertified it. King and his wife then sued Dr. Sharma and CompPartners, Inc. (Dr. Sharma’s employer) under various tort theories, seeking damages for seizures caused by the immediate withdrawal of the Klonopin. The trial court sustained a demurrer without leave to amend, ruling that the Kings’ claims were preempted by the Workers’ Compensation Act (WCA) because they arose out of a utilization review decision. The Court of Appeal affirmed the order sustaining the demurrer but reversed the denial of leave to amend, finding that the exclusivity provisions of the WCA did not apply to the extent King complained of Dr. Sharma’s failure to warn King of the adverse consequences of abruptly stopping Klonopin.
The Supreme Court granted review, holding that the trial court’s order sustaining the demurrer should be affirmed in full. The Court explained that California’s workers’ compensation system provides the exclusive remedy not only for workplace injuries but also for injuries “ ‘ “collateral to or derivative of” ’ ” workplace injuries. Because the Kings’ alleged injuries derived from a compensable workplace injury, their claims fell within the scope of the workers’ compensation bargain. Even though the Kings sought damages against a third-party utilization review organization and its employees—instead of the claimant’s employer—the Court held the WCA exclusive remedy rule applied because utilization reviewers are alter egos of employers for purposes of preemption. The statutory provisions governing utilization review, viewed in the broader context of the WCA, evince the Legislature’s intent that the workers’ compensation system encompass all disputes concerning utilization review, whether they result from actions taken by the employer, the employer’s insurer, or by a third-party utilization review organization hired to handle the review for an employer. Finally, the Court acknowledged that the exclusive remedy rule does not bar a tort claim based on conduct that was “ ‘so extreme and outrageous that’ the defendant ‘in effect stepped outside of its role’ as contemplated by the worker’s compensation scheme.” However, that exception did not apply here, even though the Kings had pleaded a claim for intentional infliction of emotional distress against Dr. Sharma.
Prepared by H. Thomas Watson and Peder K. Batalden, Horvitz & Levy, LLP
California Society for Healthcare Attorneys
1215 K Street, Suite 800
Sacramento, CA 95814
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