VF 4601. Protected Disclosure State Employee CA Whistleblower PA Affirmative Defense Same Decision

VF-4601. Protected Disclosure by State Employee--California Whistleblower Protection Act--Affirmative Defense--Same Decision (Lab. Code, § 8547.8(c)) Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 We answer the questions submitted to us as follows: 1. Did [name of plaintiff] [specify protected disclosure, e.g., report waste, fraud, abuse of authority, violation of law, threats to public health, bribery, misuse of government property]? ____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. Did [name of plaintiff]'s communication [disclose/ [or] demonstrate an intention to disclose] evidence of [an improper governmental activity/ [or] a condition that could significantly threaten the health or safety of employees or the public]? ____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. Did [name of plaintiff] make this communication in good faith [for the purpose of remediating the health or safety condition]? ____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 VF-4601. Protected Disclosure by State Employee--California Whistleblower Protection Act--Affirmative Defense--Same Decision (Lab. Code, § 8547.8(c)) Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 presiding juror sign and date this form. 4. Did [name of defendant] [discharge/specify other adverse action] [name of plaintiff]? ____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]'s communication a contributing factor in [name of defendant]'s decision to [discharge/other adverse action] [him/her]? ____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]'s conduct a substantial factor in causing harm to [name of plaintiff]? ____ 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. VF-4601. Protected Disclosure by State Employee--California Whistleblower Protection Act--Affirmative Defense--Same Decision (Lab. Code, § 8547.8(c)) 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 7. Would [name of defendant] have [discharged/specify other adverse action] [name of plaintiff] anyway at that time, for legitimate, independent reasons? ____ Yes ____ No If your answer to question 7 is no, then answer question 8. If you answered yes, stop here, answer no further questions, and have the presiding juror sign and date this form. 8. What are [name of plaintiff]'s damages? [a. Past economic loss [lost earnings [lost profits [medical expenses [other past economic loss Total Past Economic Damages: $ $ $ $ $ ] ] ] ] ] [b. Future economic loss [lost earnings [lost profits $ $ ] ] VF-4601. Protected Disclosure by State Employee--California Whistleblower Protection Act--Affirmative Defense--Same Decision (Lab. Code, § 8547.8(c)) 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 [medical expenses [other future economic loss $ $ ] ] ] ] ] Total Future Economic Damages: $ [c. Past noneconomic loss, including [physical pain/mental suffering:] $ $ $ [d. Future noneconomic loss, including [physical pain/mental suffering:] TOTAL 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 December 2015; Revised December 2016