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

Case No. POM 240908, LAO 712097
En Banc

Juan A. Rivera, Calvin Crump vs. Tower Staffing Solutions, State Compensation Insurance Fund, Los Angeles Unified School District, Helmsman Management Service

The Workers' Compensation Appeals Board holds that the 10 percent penalty for late payment under Labor Code section 4650(d) applies only to periodic indemnity payments and not to the lump sum proceeds of commutations or Compromise and Release (C&R) agreements.

En Banc DecisionLabor Code § 4650(d)CommutationCompromise and Release (C&R)Periodic Indemnity PaymentsLump SumDeath BenefitsVocational Rehabilitation Maintenance Allowance (VRMA)PenaltiesLabor Code § 5814
References
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
Case No. ADJ9332840
Regular
Aug 01, 2017

ANA BARAJAS vs. VF CORPORATION, ACE AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a Findings and Order, but only to strike the ordered $10\%$ penalty and interest. The Board affirmed the original order awarding applicant $\$ 5,598.65$ pursuant to a prior Compromise and Release agreement. Defendant's contention that penalties and interest were improperly applied to the commuted lump sum settlement had merit and was adopted by the Board. The Board found defendant's petition for reconsideration was timely filed concerning the May 26, 2017 Findings and Order.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderCompromise and Releasepermanent disability advancesmutual mistakepenaltiesfuture indemnity paymentslump sumtimeliness
References
Case No. POM 240908, LAO 712097
Significant

Juan A. Rivera, Applicant vs. Tower Staffing Solutions, State Compensation Insurance Fund

The Workers' Compensation Appeals Board, in an en banc decision, holds that the 10 percent penalty for late indemnity payments under Labor Code section 4650(d) applies only to periodic payments and not to lump-sum proceeds from commutations or Compromise and Release agreements.

En BancReconsiderationLabor Code Section 5814Labor Code Section 4650(d)Commuted AwardCompromise and ReleaseDeath BenefitsVocational Rehabilitation Maintenance AllowancePeriodic Indemnity PaymentsLump Sum Proceeds
References
Case No. ADJ9913035
Regular
Sep 20, 2019

CLAUDIA KNIGHT vs. TRIDENT USA HEALTH SERVICES, AMERICAN CASUALTY COMPANY OF READING, PA

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to award applicant's attorney a 15% fee on a lump sum temporary disability (TD) payment. The WCAB found that the employer's carrier received notice of the attorney's request to withhold fees from the TD payment, despite a dispute over fax receipt. By failing to withhold the requested fees, the defendant became liable for an additional attorney's fee of $4,835.88. This decision overturns the prior administrative law judge's denial of the fee.

Workers' Compensation Appeals BoardReconsiderationAttorney's FeesTemporary DisabilityLump Sum PaymentQualified Medical Examiner (PQME)Declaration of Readiness (DOR)Objection to DORFaxNotice of Lien
References
Case No. ADJ558286
Regular
Dec 13, 2010

DEBORAH McCALLUM (Deceased) WINONA McCALLUM vs. AGRO-TECH LANDSCAPE CONTRACTORS, STATE COMPENSATION INSURANCE FUND

This case involves a deceased worker's dependent seeking commutation of future annuity payments to a lump sum due to alleged financial hardship. The Workers' Compensation Appeals Board (WCAB) denied the petition for reconsideration. The WCAB found that even though the judge's ruling on jurisdiction over the annuity company was flawed, the applicant's request was procedurally defective. Specifically, the applicant's interests are intertwined with his sister's, and their payments are managed by a guardian ad litem, preventing the applicant from acting independently.

Workers' Compensation Appeals BoardPetition for ReconsiderationJurisdictionAnnuity Companycommutationlump sumStatute of LimitationsLabor Code section 5804Order Approving Compromise and Release (OACR)dependency claim
References
Case No. ADJ9066614
Regular
Sep 08, 2015

James Stewart vs. California Department of Corrections and Rehabilitation, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted the applicant's petition for reconsideration, overturning the WCJ's denial of a lump-sum commutation of his permanent disability award. The Board found sufficient evidence of applicant's extensive debts, including significant amounts owed to family and friends for living expenses, supporting a partial commutation. However, the commutation will exclude the car loan, as applicant's current income is deemed sufficient to manage that debt. The matter is returned to the trial level to determine the precise commutation amount.

CommutationPermanent Disability AwardFinancial HardshipPetition for ReconsiderationStipulated AwardCumulative TraumaHypertensionCorrectional OfficerDebt ObligationsLump Sum
References
Case No. ADJ12080314
Regular
Aug 26, 2019

VICTORIA TRUJILLO vs. CHEVRON, BROADSPIRE

Applicant seeks reconsideration of an order approving a compromise and release for $\$ 25,000.00$ for bilateral wrist, hand, and finger injuries. Applicant contends the settlement was underpaid and did not reflect the negotiated agreement. The Appeals Board dismissed the petition for reconsideration as premature because no evidence was presented to support the applicant's claims regarding the payment dispute. The matter is remanded for a hearing to create a record for the WCJ to determine if good cause exists to set aside the compromise and release.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Approving Compromise and Releasebilateral wristsbilateral handsbilateral fingersbusiness analystlump sum paymentnegotiated settlement agreementunderpaid settlement proceeds
References
Case No. ADJ212916 (VNO 0334702)
Regular
Feb 09, 2011

PETER L. WASCHER vs. AIDS HEALTHCARE FOUNDATION INC., CIGA FOR CAL. COMP. (IN LIQUIDATION), STATE COMPENSATION INSURANCE FUND

This case involves a dispute over reimbursement for workers' compensation payments made by CIGA (California Insurance Guarantee Association) on behalf of an insolvent insurer. The arbitrator initially ordered State Compensation Insurance Fund (SCIF) to reimburse CIGA only $105,511.94, pending further proof of payment. CIGA petitioned for reconsideration, arguing it had provided sufficient evidence of payment for the full $719,238.12. The Workers' Compensation Appeals Board granted the petition, finding CIGA's payment records were reliable and unrebutted. Consequently, SCIF was ordered to reimburse CIGA the entire $719,238.12.

CIGASCIFreimbursementarbitrationreconsiderationindustrial injuryAids Healthcare FoundationCal Compmedical paymentsproof of payment
References
Case No. ADJ3872960
Regular
May 06, 2013

ALONZO WATKINS vs. LONG BEACH UNIFIED SCHOOL DISTRICT

This case concerns applicant Alonzo Watkins' petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision denying his claim for unpaid benefits totaling $14,269.10. The WCAB denied reconsideration, finding that Watkins failed to provide substantial evidence of non-payment, as the employer presented proof of payment via checks issued over 16 years prior. The WCAB also ruled that Watkins raised the issue of the employer's failure to produce payment records for the first time on appeal, which is impermissible. Furthermore, the WCAB clarified that the record retention requirements for adjusting agencies do not mandate indefinite maintenance of claim files.

Petition for ReconsiderationFindings and OrderIndustrial InjuryBack InjuryLower ExtremitiesTeacherCompromise and ReleasePayment RecordsProof of PaymentNon-Payment
References
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