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

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
Case No. ADJ2562535 (BAK 0151733)
Regular
Jan 07, 2014

STEVE ADAMS vs. COUNTY OF KERN, Permissibly Self-Insured

The Workers' Compensation Appeals Board reversed a finding that the defendant did not unreasonably delay compensation payments. The applicant sustained an industrial injury to his pulmonary system, and medical evidence confirmed the injury was work-related. The Board found that despite the existence of an agreed medical examiner's report confirming the injury, the defendant's denial of liability persisted for an unreasonable period. Consequently, the defendant was found to have unreasonably delayed payments for temporary disability, permanent disability, and mileage reimbursement, with the penalty amount to be determined.

Industrial InjuryPulmonary SystemCode Compliance OfficerPermanent DisabilityReconsiderationLabor Code 5814Delay PenaltiesAgreed Medical ExaminerPulmonary DiseaseOccupational Asthma
References
Case No. ADJ864227 (LBO 350573) ADJ1635667 (LBO 350607)
Regular
Dec 29, 2008

LUIS ECHEVARRIA vs. FALCON WEST, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and reversed the trial judge's award of attorney's fees under Labor Code section 5814.5. The Board reasoned that section 5814.5 requires an award of attorney's fees to be "in addition to" increased compensation under section 5814, which was not sought or awarded here. Furthermore, the Board found that any delay in payment was not unreasonable due to a good-faith dispute over the net settlement amount.

WORKERS' COMPENSATION APPEALS BOARDLUIS ECHEVARRIAFALCON WESTINC.STATE COMPENSATION INSURANCE FUNDADJ864227ADJ1635667OPINION AND ORDER GRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONFindings and Orders
References
Case No. ADJ10330377
Regular
Jul 10, 2017

Taylor Baugh vs. Action Holdings, Inc., XL Specialty Insurance

This case concerns a defendant's petition for reconsideration regarding a 10% penalty for underpayment of temporary disability benefits. The Workers' Compensation Appeals Board granted reconsideration and amended the original decision. The penalty was adjusted to apply only to the specific amount of temporary disability that was delayed, not the entire awarded sum, in accordance with Labor Code section 5814.

Labor Code section 5814Petition for ReconsiderationTemporary DisabilityUnderpaymentPenaltyWCJWorkers' Compensation Appeals BoardFindings and AwardDecision After Reconsiderationunreasonable delay
References
Case No. ADJ3857516 (VNO 0505788)
Regular
Sep 20, 2013

ALBERTO ALCAZAR vs. PACTIV CORPORATION

This case involves a worker's compensation claim where the employer, Pactiv Corporation, was found to have unreasonably delayed necessary medical treatment, including transportation and home care. The Appeals Board modified a prior decision, finding the unreasonable delay occurred from December 20, 2010, to March 2, 2011, and reduced the penalty from 25% to 15% of the delayed benefits. The Board reversed the penalty for two instances of transportation failure by a hired company, deeming it not the employer's unreasonable conduct. Finally, attorney fees were reduced as some services were deemed unnecessary for the period of unreasonable delay.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactAward and OrderUnreasonable DelayMedical TreatmentTransportationHome Care AssistanceLabor Code section 5814Penalty
References
Case No. ADJ3885285 (FRE 0248529) ADJ3795787 (FRE 0247126)
Regular
Dec 30, 2008

Larry Shores vs. CITY OF MADERA; ACCLAMATION FRESNO

This case concerns a worker's compensation claim for a back and spine injury sustained by Larry Shores. The Board granted reconsideration, rescinded sanctions imposed on the defendant for litigation tactics, and rescinded a penalty for delayed temporary disability payments. However, it otherwise affirmed the finding of industrial injury, awarded penalties for unreasonable delay in medical treatment, and upheld the need for ongoing medical care, including surgery.

Workers' Compensation Appeals BoardLarry ShoresCity of MaderaAcclamation FresnoADJ3885285ADJ3795787Opinion and Order Granting ReconsiderationFindings and AwardWCJIndustrial Injury
References
Case No. ADJ8336291
Regular
Feb 11, 2015

AIDA RAMOS vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration in this case. The Board adopted the findings of the Administrative Law Judge, concluding that the employer unreasonably neglected to furnish medical treatment to the applicant. This unreasonable neglect stemmed from the employer misdirecting an authorization for medical treatment by faxing it to the wrong number, resulting in a significant delay in the applicant receiving necessary orthopedic reevaluation. The Board emphasized that any consequences of such delays will be borne by the employer, not the injured employee, citing Labor Code § 4616.3(b).

Medical Provider NetworkMPNauthorizationfax numbermisdirectedunreasonable neglectfurnish medical treatmentdelayinjured employeeLabor Code § 4616.3(b)
References
Case No. ADJ2607862 (SDO 0334155)
Regular
Feb 17, 2012

JAVIER HERNANDEZ vs. SWEETWATER UNION HIGH SCHOOL DISTRICT, Permissibly Self-Insured, Administered By CORVEL CORPORATION

This case concerns an employer's unreasonable delay in providing a new treating physician to an applicant with a psyche injury, leading to a penalty under Labor Code section 5814. The defendant argued the delay was not unreasonable and was applicant's fault, but the Board found the employer has an affirmative duty to actively provide medical care. Based on the WCJ's report, which indicated no evidence of the defendant's efforts to locate a physician, reconsideration was denied. The Board affirmed the finding of unreasonable delay and the imposition of a penalty.

Labor Code section 5814unreasonable delaymedical treatmenttreating physicianpenaltypsyche injuryhealth care technicianCORVEL CORPORATIONSWEETWATER UNION HIGH SCHOOL DISTRICTpermanent disability
References
Case No. ADJ3603721 (ANA 0385798) ADJ3874014 (ANA 4689669) ADJ4689669 (ANA 0388899)
Regular
Nov 07, 2014

CAROL HILL vs. UNILAB CORPORATION/QUEST DIAGNOSTICS, TRAVELERS INSURANCE COMPANY

This case involves an applicant seeking reconsideration of a WCJ's decision regarding unreasonable delays in benefit payments. The Board granted reconsideration and affirmed the finding of unreasonable delay for temporary disability indemnity, awarding a 25% penalty. However, the Board deferred the issue of permanent disability indemnity advance penalties for further analysis due to record ambiguity. The Board also found no unreasonable delay in medical treatment benefits and reversed an award of attorney's fees under LC 5814.5, but allowed fees from the temporary disability penalty recovery.

Workers' Compensation Appeals BoardUnreasonable DelayTemporary Disability IndemnityPermanent Disability Indemnity AdvancesLabor Code Section 5814 PenaltyMedical Treatment BenefitsAttorney's FeesPetition for ReconsiderationAdministrative Law JudgeJoint Findings and Award
References
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
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