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

Case No. ADJ4579659
Significant
Sep 09, 2008

Dee Anne Ramirez, Applicant vs. Drive Financial Services, One Beacon Insurance Co.

The Appeals Board, in an en banc decision, holds that penalties under Labor Code section 5814(a) are discretionary, successive penalties are permissible under specific circumstances, and attorney's fees under section 5814.5 apply to private employers for unreasonable delays occurring after January 1, 2003, regardless of the injury date.

WCABLabor Code section 5814Labor Code section 5814.5penaltyattorney feesen bancreconsiderationdiscretionary penaltysuccessive penaltyunreasonable delay
References
Case No. ADJ2353136 (STK 0213635)
Regular
Dec 19, 2016

AHMED SHOAIB vs. CAMBELL SOUP COMPANY

This case concerns a dispute over the payment of a workers' compensation settlement. The applicant, Ahmed Shoaib, settled a discrimination claim against Campbell Soup Company for $55,000. Campbell Soup unilaterally withheld over $19,000 from the applicant's share of the settlement for alleged payroll taxes. The Workers' Compensation Appeals Board denied Campbell Soup's petition for reconsideration, finding that the company unreasonably delayed payment by taking a unilateral credit. The Board affirmed the WCJ's decision and the awarded 25% penalty for the delayed payment.

Workers' Compensation Appeals BoardPetition for ReconsiderationStipulation and AwardLabor Code Section 132aAmended Petition for PenaltyDelayed PaymentLabor Code Section 5814Labor Code Section 5814.5Contract EnforcementUnilateral Credit
References
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
Case No. ADJ2529270 (MON0205624)
Regular
Dec 17, 2010

ZOI FOVOS vs. LOS ANGELES UNIFIED SCHOOL DISTRICT permissibly self insured c/o SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration of a prior decision that found an award was paid timely without penalties. Applicant contended the defendant failed to include interest with the award payment, entitling them to penalties and attorney fees. The Board found the WCJ's decision failed to address the timeliness of interest payment and the applicability of penalties under Labor Code sections 5814 and 5814.5. The case is returned to the WCJ for further proceedings and a new decision regarding potential penalties and attorney fees for the delayed interest payment.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings of FactAwardPenaltyAttorney's FeeInterest on AwardLabor Code Section 4650Labor Code Section 5814Labor Code Section 5814.5
References
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
Case No. VNO 113665 VNO 113666 VNO 113667 VNO 113668
Regular
Aug 06, 2007

MARIA A. GARCIA vs. CITY OF LOS ANGELES LIBRARY SERVICES

The Workers' Compensation Appeals Board granted reconsideration and reversed a WCJ's award of penalties and attorney fees against the City of Los Angeles for delayed payment of home healthcare charges. The Board found that while payments were delayed, Labor Code section 5814(e) bars penalties when the only dispute concerns the payment of a provider's bill, not a denial of treatment. Furthermore, the Board found no basis to assess penalties under Labor Code section 5814.6 for a pattern of business practice violation.

Labor Code 5814Labor Code 5814.5Labor Code 5814.6unreasonable delayhome health carebilling disputemedical treatmentnursing servicespenaltyattorney fees
References
Case No. ADJ8835104
Regular
Feb 21, 2023

SHERRY DULANEY vs. JOHN MUIR MEDICAL CENTER, SAFETY NATIONAL CASUALTY COMPANY

The Workers' Compensation Appeals Board granted reconsideration to clarify that Labor Code section 5814 penalties for delayed compensation are payable to the applicant, not their attorney. The Board affirmed the WCJ's decision to award penalties due to the defendant's unreasonable delay in paying a settlement award. The issue of separate section 5814.5 fees was deferred for further consideration. The decision confirms the applicant's entitlement to penalties for late payment of compensation.

WCABPetition for ReconsiderationLabor Code section 5814penaltiesunreasonable delayattorney feesStipulation with Request for AwardAdjudication Numberpermanent disabilityindustrial injury
References
Case No. ADJ9487589
Regular
Feb 25, 2020

DONNA KNIGHT (DECEASED) vs. MARISAN GROUP, SENTINEL INSURANCE COMPANY, THE HARTFORD

This case concerns the deceased worker's estate's claim for penalties and attorney's fees related to delayed death benefit payments. The Appeals Board affirmed the Workers' Compensation Judge's decision, finding the defendant was entitled to a credit for an overpayment. The majority ruled that the penalty under Labor Code section 4650(d) did not apply because payments were made before the award became final for appellate purposes. A dissenting commissioner argued for the application of penalties and attorney's fees due to the defendant's failure to pay accrued interest.

Labor Code section 4650(d)Death benefitsPenaltyAttorney's feesCreditInterestReconsiderationFinality of awardEquitable creditUnilateral mistake of law
References
Case No. ADJ2786953 (ANA 0317684), ADJ3789377 (ANA 0393014), ADJ3880205 (ANA 0317683), ADJ808964 (ANA 0317682)
Regular
Oct 04, 2011

OSCAR ORTEGA vs. DATA ANALYSIS; CHARTIS INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration regarding a penalty award. The Board rescinded the prior award, finding the Administrative Law Judge erred in applying penalty provisions and attorney fees without sufficient findings on unreasonable delay and a proper consideration of relevant factors. The case is returned to the trial level for further proceedings to determine the reasonableness of the delay and the appropriate penalty amount, with a requirement for the WCJ to explain their reasoning. Any claims for attorney fees should be properly submitted with supporting documentation.

WCABIndustrial InjuryPenaltyLabor Code Section 5814Labor Code Section 5814.5Petition for ReconsiderationAmended Findings and AwardCompromise & ReleaseSelf-Imposed PenaltyUnreasonable Delay
References
Case No. LAO 843759
Regular
Jul 16, 2007

JOSE GALARRETA vs. H.R. STAFFING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a prior administrative law judge's (WCJ) award due to confusion regarding the defendant's compensation payments, the applicant's penalty claims, and the WCJ's reasoning. The WCAB returned the case to the trial level for clarification on specific payment delays, penalty calculations, and the basis for attorney's fees awarded under Labor Code § 5814.5. The WCAB emphasized the need for specific findings on what compensation was delayed, when it was due and paid, and why any penalty was imposed to ensure fair and substantial justice between the parties.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardLabor Code § 5800Labor Code § 4650Labor Code § 5814Labor Code § 5814.5Attorney's FeesUnreasonable DelayPenalty
References
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