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Case Law Database

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

Case No. ADJ4713554
Regular
Oct 19, 2010

JULIAN ARVIZU vs. COUNTY OF FRESNO

The Appeals Board rescinded the original award due to a factual error regarding the calculation of temporary disability indemnity and its interaction with Labor Code section 4656(c)(1). The case is remanded for the WCJ to re-determine the correct amount of the third-party credit and the overpayment of temporary disability indemnity. Crucially, any credit for overpayment of temporary disability indemnity must be applied before the third-party recovery credit to avoid double recovery. The WCJ must also reconsider whether credit against future medical treatment is appropriate based on case law.

Third-party recoverycredittemporary disability indemnityoverpaymentfuture medical treatmentLabor Code section 4850Labor Code section 4656(c)(1)permanent and stationary dateAgreed Medical Examinerrescinded decision
References
17
Case No. ADJ12340832
Regular
Sep 14, 2022

JOSE PEREZ vs. VILLA PARK LANDSCAPE, CALIFORNIA INSURANCE COMPANY, APPLIED RISK SERVICES

The applicant sought reconsideration of an award that found industrial injury to his back and entitled him to disability benefits, but also granted the defendant a credit for temporary disability overpayment. The Appeals Board affirmed the award of disability benefits but deferred the issue of the credit for temporary disability overpayment. This deferral is due to the defendant failing to present evidence or provide a clear explanation for the alleged overpayment, and the potential conflict between temporary and permanent disability indemnity purposes. Further proceedings are recommended to determine if the credit should be awarded.

WCABReconsiderationFindings of Fact and AwardIndustrial InjuryTree TrimmerTemporary DisabilityPermanent DisabilityCredit for OverpaymentAgreed Medical Examination (AME)Primary Treating Physician (PTP)
References
12
Case No. ADJ7054442
Regular
Jan 11, 2013

JARRAD JELSMA vs. WINE GROUP, INC.; TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The Board denied the defendant's petition for reconsideration of the WCJ's award of temporary disability indemnity. The defendant failed to demonstrate due diligence in producing a wage statement discovered after trial, which it claimed would lower the indemnity rate. While denying reconsideration of the retroactive award, the Board allowed the defendant to petition to reopen the award to prospectively adjust the temporary disability indemnity rate based on the disputed wage statement. The Board also denied credit to the defendant for any retroactive overpayment of temporary disability indemnity.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardAverage Weekly EarningsTemporary Disability IndemnityWage StatementDue DiligenceNewly Discovered EvidenceReopen AwardRetroactive Overpayment
References
0
Case No. MON 328728 MON 328729
Regular
Jan 30, 2008

RICARDO GARAY vs. INDUSTRIAL CONTAINER SERVICES, AMERICAN HOME ASSURANCE COMPANY, AIG CLAIM SERVICES

This case involves a dispute over temporary disability indemnity payments and a claimed overpayment by the defendant. The Appeals Board rescinded the prior findings on temporary disability due to conflicting evidence regarding payment dates and disability periods. The matter is returned to the trial level for further development of the record and new findings on temporary disability, potential overpayments, and the priority of liens, while affirming the findings of industrial injury, permanent disability, and the need for future medical treatment.

Workers Compensation Appeals BoardRicardo GarayIndustrial Container ServicesAmerican Home Assurance CompanyAIG Claim ServicesMON 328728MON 328729ReconsiderationJoint Findings and AwardWCJ
References
9
Case No. MON 0328875
Regular
Apr 29, 2008

LUIS I. MORA vs. COUNTY OF LOS ANGELES, CAMBRIDGE INTEGRATED SERVICES (Adjusting Agent)

The Workers' Compensation Appeals Board granted reconsideration to allow the defendant credit for temporary disability overpayments against permanent disability indemnity. The Board found that the overpayment resulted from a delayed medical report, not employer fault, and the credit was not significantly detrimental to the applicant. Consequently, the defendant is now entitled to offset the temporary disability overpayment from the permanent disability award.

Temporary disability overpaymentPermanent disability indemnityCredit for overpaymentLabor Code Section 4909Substantial evidenceMaximum recoveryResidual impairmentWage replacementEquitable estoppelAgreed Medical Evaluator
References
13
Case No. 2021 NY Slip Op 07401
Regular Panel Decision
Dec 23, 2021

Matter of Carola B.-M. v. New York State Off. of Temporary & Disability Assistance

Petitioners Carola B.-M. and Tiara M. challenged the denial of their supplemental nutrition assistance program (SNAP) benefits by the New York State Office of Temporary and Disability Assistance and the Orleans County Department of Social Services. The benefits were denied because they were deemed ineligible college students. The Appellate Division, Fourth Department, reversed this determination, holding that participation in the Adult Career and Continuing Education Services, Vocational Rehabilitation program (ACCES-VR) qualifies as a Job Training Partnership Act (JTPA) program. This status exempts the students from certain SNAP eligibility requirements. The court found that the original determination was based on an unreasonable interpretation of relevant regulations, annulled the decision, granted the petition, and remitted the case for a calculation of retroactive benefits.

SNAP benefitscollege student eligibilityJob Training Partnership ActACCES-VRvocational rehabilitationCPLR article 78regulatory interpretationpublic assistancefood stampsAppellate Division
References
28
Case No. MISSING
Regular Panel Decision

Claim of Bruzzese v. Guardsman Elevator Co.

In 1994, the claimant sustained head, neck, and back injuries at work, leading to an award for permanent partial disability, which included a wage expectancy adjustment under Workers’ Compensation Law § 14 (5). Following back surgery in 1998, the case was reopened, and the claimant was found to be temporarily totally disabled. Benefits for this temporary total disability were calculated based on the claimant's average weekly wage at the time of injury, without applying the wage expectancy adjustment. The claimant appealed, arguing that since the permanent partial disability preceded the temporary total disability, the wage expectancy adjustment should also apply to the latter period. The court disagreed, affirming the Workers’ Compensation Board's decision, citing established case law that Workers’ Compensation Law § 14 (5) is applicable only to awards for permanent partial disability and not temporary disability.

Wage expectancyTemporary total disabilityPermanent partial disabilityWorkers' Compensation benefitsBack injuryAppellate reviewDisability calculationWorkers' Compensation BoardAverage weekly wage
References
1
Case No. ADJ11672418
Regular
Mar 07, 2023

JOSE MARTIN vs. JORGE PERIBAN, FINISH LINE SELF INSURANCE GROUP

The Workers' Compensation Appeals Board granted reconsideration to correct arithmetic errors in the original award regarding temporary disability indemnity, net temporary disability owed, and attorney's fees. The Board amended the decision to reflect accurate calculations for temporary disability ($17,524.03 total, $5,597.06 net owed) and corresponding attorney's fees ($839.56). However, the Board denied the defendant's request for a credit against temporary disability for a supposed permanent disability overpayment, as the issue was not properly raised and equity did not support the claim.

Temporary disability indemnityNet temporary disabilityAttorney's feesPermanent disability indemnityCredit for overpaymentPetition for ReconsiderationWCJ decisionAmended Findings and AwardPermissibly Self-InsuredExercise rider
References
1
Case No. ADJ1747488
Regular
Dec 19, 2011

ADRIENNE BOYLAN vs. NEW COVENANT CARE GROUP, STATE COMPENSATION INSURANCE FUND

This case concerns the defendant's petition for reconsideration of a prior Board decision. The Board previously affirmed the dates of temporary disability for the applicant but amended the original award to grant the full value of temporary disability indemnity, rather than an apportioned percentage. The defendant argued against this full award, but the Board found that while liability for indemnity can be apportioned between defendants, an employee's entitlement to temporary disability indemnity cannot be apportioned. The Board denied the petition for reconsideration, reaffirming that the defendant is solely liable for the full value of temporary disability indemnity.

Temporary Disability IndemnityCumulative Trauma InjuryApportionment of LiabilityExclusive LiabilityLabor Code Section 3208.2FibreboardGranadoWCAB OpinionPetition for ReconsiderationSpecific Injury
References
7
Case No. MON 0322465
Regular
Jan 03, 2008

AFRA CORNEJO vs. COUNTY OF LOS ANGELES

This case involved separate appeals from the applicant and defendant regarding an administrative law judge's findings on permanent disability apportionment and temporary disability overpayment. The applicant argued against apportionment of permanent disability, while the defendant sought credit for alleged overpayment of temporary disability. The Workers' Compensation Appeals Board denied both petitions, affirming the administrative law judge's decision. The Board clarified that Labor Code section 4656(b) limits temporary partial disability, not temporary total disability, thus the defendant was not entitled to a credit for overpayment.

Workers Compensation Appeals BoardAgreed Medical EvaluatorApportionmentPermanent DisabilityTemporary Disability IndemnityLabor Code Section 4656(b)Temporary Partial DisabilityTemporary Total DisabilityCreditRestitution
References
1
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