CACI No. 2810

Workers’ Compensation

[Name of defendant] claims that [he/she/ nonbinary pronoun] is not

responsible for any harm that [name of plaintiff] may have suffered

because [he/she/ nonbinary pronoun] was [name of defendant]’s coemployee

and therefore can recover only under California’s Workers’

Compensation Act. To succeed, [name of defendant] must prove all of the

following:

1. That [name of plaintiff] and [name of defendant] were [name of

employer]’s employees;

2. That [name of employer] [had workers’ compensation insurance

[covering [name of plaintiff] at the time of injury]/was self-insured

for workers’ compensation claims [at the time of [name of

plaintiff]’s injury]]; and

3. That [name of defendant] was acting in the scope of

[his/her/nonbinary pronoun] employment at the time [name of

plaintiff] claims [he/she/ nonbinary pronoun] was harmed.

New September 2003; Revised October 2004, May 2020