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

Case No. FRE 0202405
Regular
Sep 17, 2007

JOHN WEST vs. LIBERTY TRANSPORTATION INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For SUPERIOR NATIONAL INSURANCE CO.

The California Workers' Compensation Appeals Board (WCAB) granted reconsideration to reverse a finding of unreasonable delay in paying permanent disability benefits. The WCAB determined that conflicting medical evidence and potential legal doubts about liability provided a "genuine doubt" defense, negating the unreasonable delay claim. Consequently, the WCAB rescinded the prior award of penalties under Labor Code sections 5814 and 4650(d) and denied the applicant's petition for penalties.

Workers' Compensation Appeals BoardPermanent Disability AdvancesLabor Code Section 5814Section 4650(d) PenaltyUnreasonable DelayStipulated AwardPetition for PenaltiesGenuine DoubtMedical EvidenceLegal Doubt
References
1
Case No. ADJ6678537
Regular
Oct 07, 2011

DOTTIE BRANDON-LEGGET vs. SECURITAS SECURITY SERVICES, INC.

This case involves a security guard's claim for industrial injury to her shoulder and knee. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, affirming the findings of industrial injury and temporary total disability. However, the WCAB reversed the administrative law judge's (ALJ) penalty award under Labor Code §5814, finding that the defendant's delay in paying temporary disability was not unreasonable due to genuine doubt about its liability. The WCAB emphasized that a penalty under §5814 requires unreasonable delay or refusal, and here, the defendant's doubts were not unreasonable given the applicant's delayed treatment and lack of contemporaneous complaints.

Labor Code § 5814Unreasonable DelayTemporary Total DisabilityIndustrial InjuryRight ShoulderRight KneeReconsiderationWCJ FindingsGenuine DoubtMedical Treatment
References
13
Case No. ADJ2107498
Regular
Nov 24, 2009

Carlos Davis vs. Praja Construction Company, State Compensation Insurance Fund

The WCAB rescinded a prior decision imposing penalties for unreasonable delay in paying attorney fees, finding that the defendant had a genuine doubt about the fee amount due to an unclear WCJ award.

Labor Code Section 5814Labor Code Section 5814.5Petition for ReconsiderationFindings and AwardPermanent Total DisabilityAttorney FeeCommutationPresent ValueDisability Evaluation Unit (DEU)Genuine Doubt
References
8
Case No. ADJ8526809
Regular
Nov 08, 2016

DEBORAH CARTER vs. CALIFORNIA DEPARTMENT OF CORRECTIONS

The Workers' Compensation Appeals Board granted reconsideration, rescinding the prior award of a $5814 penalty on \$12,875.86. The Board found the defendant had a genuine doubt regarding the payment of attorneys' fees, making a penalty on that amount unwarranted. However, a 25% penalty, totaling \$258.44, was affirmed on the \$1,033.74 in accrued permanent disability indemnity that was unreasonably delayed. The defendant had overpaid the penalty, with the excess to be credited toward future indemnity.

Workers Compensation Appeals BoardPetition for ReconsiderationPermanent Disability IndemnityLabor Code Section 5814Attorneys' FeesCommutationUnreasonable DelayGenuine DoubtAmbiguous AwardLegally Uninsured
References
3
Case No. ADJ3406569 (SAC 0323378)
Regular
Jan 28, 2009

JOSEPH NOVAK vs. SIERRA PACIFIC INDUSTRIES, SIERRA PACIFIC REDDING

The Workers' Compensation Appeals Board granted reconsideration and modified the prior decision. While upholding the finding of industrial injury and the need for a dorsal column stimulator, the Board rescinded the penalty and attorney's fees previously awarded. This modification was based on the finding that the defendant's delay in providing the stimulator was not unreasonable, as it stemmed from a genuine doubt arising from utilization review. The Board also affirmed the denial of the defendant's petition to change physicians, emphasizing the importance of the doctor-patient relationship and existing medical history.

Workers' Compensation Appeals BoardJoseph NovakSierra Pacific Industriesdorsal column stimulatorUtilization Reviewunreasonable delaypenaltyattorney's feesemployer-designated physicianAdministrative Director
References
4
Case No. ADJ4538958 (VNO 0407145)
Regular
Aug 18, 2010

MARTHA QUEVEDO vs. UNION FIDELITY LIFE, GENERAL ELECTRICAL FINANCIAL ASSURANCE COMPANY

The Appeals Board granted reconsideration, affirming the applicant's 100% permanent disability award without apportionment. However, it rescinded the WCJ's penalty against the defendant for unreasonable delay in paying permanent disability benefits. The Board found that there was genuine doubt regarding the applicant's total permanent disability until the doctor's deposition in September 2009, thus the defendant's payment rate prior to that was not unreasonable. Finally, the Board vacated the WCJ's reservation of jurisdiction over COLA increases as the date of injury predates the relevant statute.

Workers Compensation Appeals BoardIndustrial InjuryNeck InjuryShoulder InjuryElbow InjuryHand InjuryGastrointestinal InjuryCardiovascular InjuryPsychological InjuryPermanent Disability
References
4
Case No. ADJ613281
Regular
May 03, 2016

AMANDINA ANDRADE vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board granted reconsideration, amending the judge's decision to find applicant entitled to penalties for unreasonable delay in permanent disability payments under Labor Code sections 5814 and 4650(d). The Board found the defendant failed to provide evidence of a genuine doubt for the delay after receiving multiple medical reports indicating permanent disability. The matter was returned to the trial level for further proceedings to determine the amount of penalties due, while affirming the judge's decision regarding a credit for overpayment of temporary disability.

WCABPetition for ReconsiderationFindings and AwardProbation Group SupervisorIndustrial InjuryNeckBackLeft KneeGastrointestinal SystemPsyche
References
8
Case No. ADJ2174020 (FRE 0248107) ADJ3815143 (FRE 0248106)
Regular
Oct 27, 2014

KIMBERLY JONES vs. TULARE DISTRICT HOSPITAL

The Workers' Compensation Appeals Board granted reconsideration, rescinding the prior award. The Board found applicant entitled to temporary disability indemnity from April 26, 2010, to November 12, 2010, reducing the original finding of a longer disability period. Defendant was found not to have unreasonably delayed or refused temporary disability payments due to a genuine doubt about liability based on conflicting medical opinions. Issues regarding permanent disability, future medical care, and attorney fees related to permanent disability remain deferred.

Workers' Compensation Appeals BoardTulare District Hospitalregistered nursecumulative injurysleep disorderdepressiontemporary disabilityLabor Code section 5814return to work offeragreed medical evaluator
References
3
Case No. ADJ6869590
Regular
Nov 07, 2013

EDMOND HAKAKHA vs. CVS PHARMACY, NEW HAMPSHIRE INSURANCE COMPANY, GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, adopting the findings of the administrative law judge. The judge determined the applicant was not entitled to temporary disability benefits beyond a specific period, as medical reports and the applicant's own testimony indicated he was able to work. Furthermore, penalties under Labor Code Section 5814 were denied because there was no prior award of temporary disability, and the employer had a genuine doubt regarding the correct wage rate and period of disability. Attorney fees were awarded at 15% on accrued temporary disability, but not under Section 5814.5.

WORKERS' COMPENSATION APPEALS BOARDCVS PHARMACYNEW HAMPSHIRE INSURANCE COMPANYGALLAGHER BASSETT SERVICESINC.ADJ6869590ADJ6869586Petition for ReconsiderationWCJSupplemental Petition for Reconsideration
References
0
Case No. ADJ2855152
Regular
Apr 23, 2009

KAM PING CHU vs. WESTIN ST. FRANCIS HOTEL/STARWOOD HOTELS & RESORTS, ZURICH INSURANCE INSURANCE

This case involves an applicant's petition for reconsideration of a workers' compensation award. The Workers' Compensation Appeals Board (WCAB) denied reconsideration, upholding the judge's finding that the applicant sustained industrial injuries to her lower extremities. The judge awarded a $16\%$ permanent disability and also found that the defendant unreasonably delayed paying an interpreter's fees, leading to a $25\%$ penalty. However, the judge found no unreasonable delay in other areas, no frivolous conduct, and therefore no additional attorney fees or sanctions. The applicant argued the initial claim denial was untimely, precluding claims of genuine doubt, but the WCAB adopted the judge's reasoning in denying the petition.

Workers' Compensation Appeals BoardIndustrial InjuriesLower ExtremitiesFeetHousekeeperZurich InsuranceUnreasonably DelayedInterpreter's FeesLabor Code Section 5814Permanent Disability
References
0
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