CACI No. VF-2801. Fraudulent Concealment of Injury (Lab. Code, § 3602(b)(2))
Judicial Council of California Civil Jury Instructions (2024 edition)
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VF-2801.Fraudulent Concealment of Injury (Lab. Code,
§ 3602(b)(2))
We answer the questions submitted to us as follows:
1. Was [name of plaintiff/decedent] injured on the job?
1. Yes No
1. If your answer to question 1 is yes, then answer question 2. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
2. Did [name of defendant] know [name of plaintiff/decedent] had
suffered a job-related injury?
2. Yes No
2. If your answer to question 2 is yes, then answer question 3. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
3. Did [name of defendant] conceal this knowledge from [name of
plaintiff/decedent]?
3. Yes No
3. If your answer to question 3 is yes, then answer question 4. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
4. Was [name of plaintiff/decedent]’s injury made worse as a result of
this concealment?
4. Yes No
4. If your answer to question 4 is yes, then answer question 5. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
5. What are [name of plaintiff]’s total damages?
[a. Past economic loss
[lost earnings $ ]
[lost profits $ ]
[medical expenses $ ]
[other past economic loss $ ]
[a. Total Past Economic Damages: $ ]
160
[b. Future economic loss
[lost earnings $ ]
[lost profits $ ]
[medical expenses $ ]
[other future economic loss $ ]
[b. Total Future Economic Damages: $ ]
[c. Past noneconomic loss, including [physical
pain/mental suffering:] $ ]
[d. Future noneconomic loss, including [physical
pain/mental suffering:] $ ]
[d. TOTAL $
5. Answer question 6.
6. What are the damages that [name of plaintiff/decedent] would have
sustained if [name of defendant] had not concealed the injury?
[a. Past economic loss
[lost earnings $ ]
[lost profits $ ]
[medical expenses $ ]
[other past economic loss $ ]
[a. Total Past Economic Damages: $ ]
[b. Future economic loss
[lost earnings $ ]
[lost profits $ ]
[medical expenses $ ]
[other future economic loss $ ]
[b. Total Future Economic Damages: $ ]
[c. Past noneconomic loss, including [physical
pain/mental suffering:] $ ]
[d. Future noneconomic loss, including [physical
pain/mental suffering:] $ ]
[d. TOTAL $
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6. Answer question 7.
7. Subtract the total amount in question 6 from the total amount in
question 5. This is the amount [name of plaintiff] is entitled to
recover. $
Signed: Presiding Juror
Dated:
After [this verdict form has/all verdict forms have] been signed, notify
the [clerk/bailiff/court attendant] that you are ready to present your
verdict in the courtroom.
New September 2003; Revised April 2007, December 2010, December 2016
Directions for Use
This verdict form is based on CACI No. 2802, Fraudulent Concealment of
Injury - Essential Factual Elements.
The special verdict forms in this section are intended only as models. They may
need to be modified depending on the facts of the case.
If specificity is not required, users do not have to itemize all the damages listed in
questions 5 and 6, and do not have to categorize “economic” and “noneconomic”
damages, especially if it is not a Proposition 51 case. The breakdown of damages is
optional depending on the circumstances.
If there are multiple causes of action, users may wish to combine the individual
forms into one form. If different damages are recoverable on different causes of
action, replace the damages tables in all of the verdict forms with CACI No. VF-
3920, Damages on Multiple Legal Theories.
If the jury is being given the discretion under Civil Code section 3288 to award
prejudgment interest (see Bullis v. Security Pac. Nat’l Bank (1978) 21 Cal.3d 801,
814 [148 Cal.Rptr. 22, 582 P.2d 109]), give CACI No. 3935, Prejudgment Interest.
This verdict form may need to be augmented for the jury to make any factual
findings that are required in order to calculate the amount of prejudgment interest.
VF-2801 WORKERS’ COMPENSATION
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