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

Case No. SDO 0327959
Regular
Aug 03, 2007

IRMA MENDEZ vs. SUNRISE SENIOR LIVING, AMERICAN HOME ASSURANCE

This Workers' Compensation Appeals Board case clarifies the commencement date for temporary disability payments under Labor Code section 4656(c)(1). The Board amended a prior order, ruling that the commencement date is the date the first payment is actually issued, not the date the disability is first owed. Consequently, the employer's liability for temporary disability is limited to 104 weeks within two years from the actual payment date of June 2, 2005.

Workers' Compensation Appeals BoardTemporary disability indemnityLabor Code section 4656(c)(1)Date of commencementFindings and OrderPetition for reconsiderationExpedited hearingApplication for Adjudication of ClaimStipulationCompensable weeks
References
1
Case No. SAC 349462
Regular
Mar 11, 2008

QAHER MOKDADI vs. HENDRICK AUTOMOTIVE, FEDERAL INSURANCE COMPANY

In this workers' compensation case, the Appeals Board clarified the commencement date for temporary disability payments under Labor Code section 4656(c)(1). Applying its en banc decision in *Hawkins v. Amberwood Products*, the Board held that the two-year period for temporary disability payments begins on the date indemnity is *first paid* to the worker, not when it is first owed or when unemployment benefits are reimbursed. Therefore, the commencement date was established as November 9, 2006, the date the applicant received his first temporary disability indemnity check.

Workers' Compensation Appeals BoardHendrick AutomotiveFederal Insurance CompanyQAHER MOKDADIauto service technicianleft shoulder and spine injuryEmployment Development Department (EDD)temporary disability indemnityLabor Code section 4656(c)(1)date of commencement
References
2
Case No. ADJ3853793 (SRO 0141299)
Regular
Feb 23, 2015

CHRISTINA LAURA LEPE DUARTE vs. FIDELITY NATIONAL TITLE COMPANY, HARTFORD INSURANCE COMPANY

This case concerns a defendant's petition for reconsideration regarding the end date of temporary disability payments. The Board previously amended an award to extend temporary disability to August 7, 2009. The defendant argued this violated Labor Code section 4656's two-year limitation. However, the Board denied reconsideration, reaffirming that under *Hawkins v. Amberwood Products*, the two-year period begins on the date of the first *payment* of temporary disability, not when it was first owed. Since the first payment was August 8, 2007, the 104-week period validly extended to August 7, 2009.

ADJ3853793FIDELITY NATIONAL TITLE COMPANYHARTFORD INSURANCE COMPANYLabor Code section 4656temporary disabilitycompensable weeksdate of commencement of temporary disability paymentHawkins v. Amberwood Productsindustrial injuryneck
References
1
Case No. SDO 0328208
Regular
Mar 17, 2008

ARMANDO ADAME vs. AUTOMOTIVE ENGINEERED PRODUCTS, INC. (dba JBA HEADERS), ZENITH INSURANCE COMPANY

The Appeals Board clarified that for Labor Code section 4656(c)(1) purposes, the commencement of temporary disability payments is the date the employer first mails a temporary disability indemnity check, not when EDD benefits begin. Furthermore, EDD benefits, even if reimbursed by the employer, do not count towards the 104-week cap on temporary disability payments. Consequently, the employer's liability for further temporary disability payments extends from the date of the first actual indemnity payment until October 6, 2007.

Workers Compensation Appeals BoardArmando AdameAutomotive Engineered ProductsZenith Insurance CompanyLabor Code section 4656(c)(1)Temporary Total DisabilityTemporary Disability IndemnityEmployment Development DepartmentUnemployment Compensation DisabilityHawkins v. Amberwood Products
References
2
Case No. SAL 0108252
Regular
Jul 11, 2007

LUIS HERRERA vs. RENT-A-CENTER, INC., SPECIALTY RISK SERVICES

This case clarifies that the 104-week limit for temporary disability under Labor Code section 4656(c)(1) begins from the date temporary disability payments are *first paid*, not the date for which they are owed. The Appeals Board affirmed the initial award, finding the two-year period began on the stipulated date of the first payment, April 27, 2005. Therefore, temporary disability was correctly awarded through April 26, 2007, unless the applicant's condition became permanent and stationary earlier.

Workers' Compensation Appeals BoardTemporary Total DisabilityLabor Code Section 4656(c)(1)Compensable WeeksDate of CommencementPetition for ReconsiderationEn Banc DecisionHawkins v. Amberwood ProductsBinding PrecedentStipulation
References
1
Case No. SFO 0485029
Regular
Aug 10, 2007

MARIA CARDENAS vs. GALAXY DESSERTS, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board affirmed a prior order denying the defendant's petition to terminate temporary disability indemnity. The Board held that the 104-week limitation under Labor Code section 4656(c)(1) begins from the date of the first temporary disability payment, not the date of injury or the first compensable period. This decision aligns with precedent establishing that the commencement date for the limitation is the actual date indemnity was first paid.

temporary disability indemnityPetition to Terminate LiabilityLabor Code section 4656(c)(1)104 compensable weeksfirst payment of temporary disability indemnityfirst date of compensable temporary total disabilityHawkins v. Amberwood Products
References
1
Case No. SAL 0107814
En Banc
Jun 13, 2007

VALERI HAWKINS vs. AMBERWOOD PRODUCTS, STATE COMPENSATION INSURANCE FUND

The Appeals Board held that the two-year limitation on temporary disability payments under Labor Code section 4656(c)(1) begins from the date the first payment is actually made, not the date for which the benefit is first owed.

Workers' Compensation Appeals BoardEn Banc DecisionTemporary Disability PaymentLabor Code Section 4656(c)(1)Commencement of PaymentDate of InjuryCompensable WeeksAggregate Disability PaymentsSB 899Legislative Intent
References
34
Case No. MISSING
Regular Panel Decision
Jun 15, 1999

In re the Arbitration between State Insurance Fund & Country-Wide Insurance

The Supreme Court, New York County, affirmed an order dated June 15, 1999. This order granted a workers' compensation insurer's application to vacate an arbitration award that had denied its claim against an automobile liability insurer as time-barred. The court also denied the automobile insurer's cross-motion to confirm the award. The case was remanded for a rehearing on the workers' compensation insurer's claim for payments made to an injured worker within the three-year Statute of Limitations, commencing from December 4, 1994, the date of the arbitration proceeding. The court found that the arbitrator's acceptance of the Statute of Limitations defense was arbitrary and capricious, as precedent establishes a three-year limitation period from the date of the first payment, not the date of injury, only precluding recovery of payments made more than three years prior to the commencement of suit.

Automobile LiabilityArbitration Award VacatedStatute of Limitations DefenseJudicial Review StandardArbitrary and Capricious RulingInter-insurer ClaimRemand for RehearingAppellate AffirmationLegal PrecedentClaim Timeliness
References
2
Case No. MISSING
Regular Panel Decision

Garden State Anesthesia Associates, PA v. Progressive Casualty Insurance

Garden State Anesthesia Associates (GSAA) sued Progressive Casualty Insurance Company for unpaid first-party no-fault benefits after providing services to Angela Gowan-Walker. Progressive delayed payment, citing the need for Gowan-Walker's examination under oath (EUO) and extensive medical and workers' compensation records. Although Gowan-Walker completed her EUO, Progressive continued to issue delay letters, requesting information primarily from third parties and Gowan-Walker's attorney, without directly contacting GSAA for verification. The court denied Progressive's motion for summary judgment, ruling that an insurer cannot indefinitely toll the 30-day payment period by requesting verification unrelated to the specific provider's claim or by failing to request verification directly from the provider.

No-fault benefitsSummary JudgmentInsurance LawVerification RequestDelay LetterEUOMedical RecordsInsurance ClaimsTimelinessTolling
References
9
Case No. VNO 0497522
Regular
Aug 10, 2007

MARGARET L. HESTER vs. COUNTY OF LOS ANGELES/USC MEDICAL CENTER, TRISTAR RISK MANAGEMENT

This case concerns a dispute over the start date for calculating the two-year limit on temporary disability payments under Labor Code section 4656(c)(1). The Board affirmed the Workers' Compensation Judge's award, holding that the "date of commencement of temporary disability payment" refers to when the indemnity is first paid, not when it is first owed. This decision is consistent with the Board's en banc ruling in *Hawkins v. Amberwood Products*.

Workers' Compensation Appeals BoardReconsiderationTemporary Disability IndemnityLabor Code Section 4656(c)(1)Date of Commencement of Temporary Disability PaymentCompensable WeeksIndustrial InjuryL.V.N.County of Los AngelesUSC Medical Center
References
1
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