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Case Law Database

Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. ADJ6973825
Regular
May 21, 2012

MONICA BENARD vs. JENNY CRAIG, SEDGWICK CMS

This case concerns a penalty imposed on Jenny Craig for unreasonably delaying authorization for applicant Monica Benard's chiropractic treatment. The WCJ found a 25% penalty for the delay, which Jenny Craig appealed, arguing the delay was due to the applicant's choice of a chiropractor outside their Medical Provider Network (MPN). The Appeals Board affirmed the unreasonable delay finding but reduced the penalty to 20% of the delayed treatment's value, citing a failure in case management rather than intentional disregard. Jurisdiction was reserved for the parties to adjust the penalty amount.

Workers Compensation Appeals BoardMonica BenardJenny CraigSedgwick CMSADJ6973825ReconsiderationFindings and AwardLabor Code section 5814Medical Provider Network (MPN)chiropractic treatment
References
9
Case No. ADJ9932467
Regular
Oct 16, 2017

THERESA MCFARLAND vs. REDLANDS UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied an applicant's petition for reconsideration, affirming the WCJ's decision that "Return-To-Work" supplemental payments under Labor Code section 139.48 are not "compensation" as defined by Labor Code section 3207. Therefore, the applicant was not entitled to a second penalty under Labor Code section 5814 for the employer's delay in providing a Supplemental Job Displacement Benefit voucher, as that delay did not cause a delay in a compensable benefit. The Board found that the applicant's penalty claim for the voucher delay was already resolved and that imposing a second penalty for a non-compensable benefit delay would be unfair and against the principle of balancing justice.

Labor Code section 139.48Return-To-Work supplemental paymentscompensation definitionLabor Code section 3207Labor Code section 5814 penaltyLabor Code section 4658.7 voucherSupplemental Job Displacement Benefitcompromise and release agreementGage v. Workers' Comp. Appeals Bd.unreasonable delay
References
1
Case No. SBA 0076630
Regular
Mar 03, 2008

Janice Brackenridge-DeGraff vs. ACTMEDIA, INC., INTERCARE INSURANCE

The Workers' Compensation Appeals Board granted reconsideration, overturning a prior decision that denied penalties for delayed payment. The Board found the employer unreasonably delayed payment of the compromise and release agreement by 10 days beyond the agreed-upon 30-day deadline. Consequently, the Board awarded a 5% penalty on the delayed amount and a separate 5% penalty for the unreasonable delay in paying the legally owed interest.

Labor Code section 5814ReconsiderationCompromise and ReleasePenaltyUnreasonable DelayPaymentInterestAttorney's FeesCIGAWCJ
References
1
Case No. ADJ2464522 (OAK 0338150)
Regular
Feb 19, 2013

CHARLES COWART vs. JACK IN THE BOX, INC.

The Workers' Compensation Appeals Board granted reconsideration, rescinding the prior award of penalties for unreasonable delay in funding an annuity. The Board found that applicant's own delay in providing necessary information was the primary cause of the annuity funding delay, thus not warranting a penalty. However, the Board affirmed a $10,000 penalty for the employer's unreasonable delay in paying applicant's attorney's fees, to be paid to the applicant, not the attorney. Attorney's fees for enforcing the compromise and release were deferred for trial level resolution.

Workers' Compensation Appeals BoardCompromise and ReleaseLabor Code section 5814PenaltyUnreasonable DelayAnnuity FundingAttorney's FeesReconsiderationFindings and AwardDecision After Reconsideration
References
0
Case No. MISSING
Regular Panel Decision

Claim of Schell v. Right

A claimant was injured in April 1993, establishing accident, notice, and causal relationship. Compensation was stipulated at $225 per week for physical disability. Later, a consequential psychiatric condition was affirmed, setting a higher payment rate of $358.73 per week from 1994. The workers' compensation carrier failed to pay this higher rate retroactively after the August 9, 2000 determination. A Workers' Compensation Law Judge imposed a penalty under Workers’ Compensation Law § 25 (3) (f) for this failure, but the Workers’ Compensation Board rescinded it due to a lack of sufficient evidence. The claimant appealed, arguing that the penalty provisions are self-executing and mandatory for late payments. The appellate court reversed the Board's decision, finding no substantial evidence to support the rescission, and remitted the matter for further proceedings, emphasizing the mandatory nature of the penalty for delayed award payments.

Workers' CompensationPenalty AssessmentLate PaymentRetroactive BenefitsPsychiatric DisabilityCarrier LiabilityMandatory PenaltyBoard ReversalAppellate ReviewRemand
References
3
Case No. ADJ7191867
Regular
Mar 23, 2012

ARTURO ESCOBAR vs. HENRY WINE GROUP dba ZEPHYR EXPRESS, ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior decision because the WCJ's imposition of a 20% penalty for delayed payment did not adequately explain the penalty amount based on established legal factors. While a delay in payment was found, the Board remanded the case for the WCJ to re-evaluate penalties and interest by clearly applying factors from relevant case law and justifying the awarded amounts with specific evidence. The original decision also failed to separately address statutory interest owed on the delayed payment. The Board emphasized the need for decisions to articulate the evidentiary basis and reasoning for penalty assessments.

Labor Code section 5814Petition for ReconsiderationFindings and AwardWCJZurich American Insurance CompanyArturo EscobarHenry Wine GroupZephyr ExpressCompromise & Releasepenalty
References
7
Case No. ADJ1186395 (MON 0254521) ADJ1992738 (MON 0256181)
Regular
Jun 29, 2009

Lavon Leach vs. Los Angeles Unified School District, Adjusted by SEDGWICK CLAIMS MANAGEMENT

This case concerns penalties assessed against Los Angeles Unified School District for delayed or incorrect workers' compensation payments to Lavon Leach. The WCJ found the District liable for penalties under Labor Code sections 5814 and 4650(d) for various payment delays, including permanent disability, interest, and attorney fees. Both parties sought reconsideration; the applicant argued penalties should apply to the full award amounts, not just delayed portions, while the defendant contested liability for penalties and certain payment increases. The Appeals Board affirmed the WCJ's Supplemental Findings and Award, adopting the judge's reasoning and finding that claims not raised at trial could not be litigated.

Labor Code section 5814Labor Code section 4650(d)permanent disabilitypenaltiesinterestattorney's feesdelayed paymentsreconsiderationSupplemental Findings and AwardWCJ
References
0
Case No. ADJ6650899
Regular
Jan 04, 2013

IVAN MORENO vs. SOSA GRANITE & MARBLE, MAJESTIC INSURANCE COMPANY

In this workers' compensation case, the Board granted reconsideration to clarify an existing award. The administrative law judge had previously imposed a $10,000 penalty for unreasonable delay in paying permanent disability benefits, based on 25% of the overdue amount, capped as allowed by law. The defendants contended the penalty was improperly calculated on the total awarded benefits rather than the amount delayed. The Board affirmed the penalty and its amount, clarifying that it was based on the unpaid permanent disability indemnity due at the time of the award, not the total sum. This penalty was justified because the defendants unreasonably delayed paying any permanent disability advances for over three years after the applicant's condition became permanent and stationary.

permanent disabilityLabor Code section 5814penaltyunreasonable delayreconsiderationFindings of Fact and Awardadministrative law judgeSosa Granite & MarbleMajestic Insurance CompanyWCJ
References
0
Case No. ADJ207630 (VNO 0423900), ADJ4689357 (VNO 0462906)
Regular
Feb 11, 2015

MANUEL PASQUIER vs. VOLUTONE DISTRIBUTING COMPANY, VIRGINIA SURETY INSURANCE COMPANY

This case concerns applicant Manuel Pasquier's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision. The WCAB initially found that the defendant unreasonably delayed three lump sum payments, resulting in interest, a $10,000 penalty under Labor Code § 5814, and attorney's fees. Pasquier argued for multiple penalties, citing the distinct nature of the payments, while the WCAB affirmed the single penalty, viewing the late payments as one act of unreasonable delay. The majority also upheld the WCJ's attorney's fee calculation, disagreeing with Pasquier's claim for higher fees and hours. However, one Board member dissented, arguing that the three distinct payments (disability indemnity, MSA seed money, and attorney's fees) constituted separate acts of unreasonable delay, each warranting an individual penalty, and supported the higher attorney's fee rate.

Compromise and ReleaseJoint Findings of Fact and Orderunreasonable delaylump sum paymentsLabor Code section 5814attorney's feeLabor Code section 5814.5Petition for Reconsiderationworkers' compensation administrative law judgeseparate acts
References
12
Case No. ADJ3890427 SAC 0364747 ADJ6797951
Regular
Jun 07, 2012

JOHN ERICK RITCHIE vs. CMC/FONTANA STEEL, ACE USA

The applicant sought reconsideration of an award for industrial injuries, primarily arguing the $15\%$ penalty for delayed payments was too low. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, rescinded the original decision, and returned the matter for further proceedings. The WCAB clarified that statutory interest for delayed payments is $10\%$ and any accrued interest on attorney fees must be paid to the attorney. The WCAB also noted ambiguity regarding penalties for delayed attorney fees, stating such penalties are payable to the applicant.

WCABindustrial injurylow backpsycheiron workerpermanent disability indemnityattorney feesLabor Code section 5814penalty increasestatutory interest
References
4
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