VF-2900. FELA Negligence Plaintiffs Negligence at Issue

VF-2900. FELA--Negligence--Plaintiff's Negligence at Issue Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 We answer the questions submitted to us as follows: 1. Was [name of plaintiff/decedent] employed by [name of defendant]? ____ Yes ____ No 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. Was [name of defendant] a common carrier by railroad? ____ Yes ____ No 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. Was [name of defendant] engaged in interstate commerce? ____ Yes ____ No 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. Did [name of plaintiff/decedent]'s job duties further, or in any way substantially affect, interstate commerce? VF-2900. FELA--Negligence--Plaintiff's Negligence at Issue Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 ____ Yes ____ No If your answer to question 4 is yes, then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. Was [name of plaintiff/decedent] acting within the scope of [his/her] employment at the time of the incident? ____ Yes ____ No If your answer to question 5 is yes, then answer question 6. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form. 6. Was [name of defendant] negligent? ____ Yes ____ No If your answer to question 6 is yes, then answer question 7. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form. 7. Was [name of plaintiff] harmed? ____ Yes ____ No If your answer to question 7 is yes, then answer question 8. If you answered no, stop here, answer no further questions, and have the VF-2900. FELA--Negligence--Plaintiff's Negligence at Issue Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 presiding juror sign and date this form. 8. Was [name of defendant]'s negligence a cause of [name of plaintiff/decedent]'s [harm/death]? ____ Yes ____ No If your answer to question 8 is yes, then answer question 9. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form. 9. What are [name of plaintiff]'s damages? Do not reduce the damages based on the fault, if any, of [name of plaintiff/decedent]. [a. Past economic loss [lost earnings [lost profits [medical expenses [other past economic loss Total Past Economic Damages: [b. Future economic loss [lost earnings $ ] $ $ $ $ $ ] ] ] ] ] VF-2900. FELA--Negligence--Plaintiff's Negligence at Issue Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 [lost profits [medical expenses [other future economic loss $ $ $ ] ] ] ] ] ] Total Future Economic Damages: $ [c. [d. Past noneconomic loss, including [physical pain/mental suffering:] Future noneconomic loss, including [physical pain/mental suffering:] TOTAL $ $ $ If [name of plaintiff] has proved any damages, then answer question 10. If [name of plaintiff] has not proved any damages, then stop here, answer no further questions, and have the presiding juror sign and date this form. 10. Was [name of plaintiff/decedent] negligent? ____ Yes ____ No If your answer to question 10 is yes, then answer question 11. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form. VF-2900. FELA--Negligence--Plaintiff's Negligence at Issue Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 11. Was [name of plaintiff/decedent]'s negligence a cause of [his/her] harm? ____ Yes ____ No If your answer to question 11 is yes, then answer question 12. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form. 12. What percentage of responsibility for [name of plaintiff]'s harm do you assign to: [Name of defendant]: [Name of plaintiff/decedent]: TOTAL: Signed: 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. ____________________________________________________________________________ Presiding Juror % % 100 % New September 2003; Revised April 2007, December 2010, December 2016