To keep Sullivan on Comp up to date on a monthly basis, our team dives into each panel decision and new laws to include an explanation of how each case fits within the workers' compensation scheme. Below is a sampling of this month's updates.
CHAPTER 7: MEDICAL TREATMENT
In Bissett-Garcia v. Peace and Joy Center, 2016 Cal. Wrk. Comp. P.D. LEXIS 174, the WCAB held that a defendant's UR decision was timely when the request for treatment initially was sent only to the defense attorney, and that attorney immediately sent the request to the defendant's UR process.
In Czech v. Bank of America, 2016 Cal. Wrk. Comp. P.D. LEXIS 257, the WCAB determined that a defendant failed to timely complete UR when a request for authorization was served on a defense attorney, rather than the claims administrator or UR organization, and the attorney did nothing with the request.
In Martinez v. County of Riverside, 2016 Cal. Wrk. Comp. P.D. LEXIS 294, the WCAB held that it could rely on the opinion of the applicant's treating physician to award temporary disability, even though the physician was outside of the defendant's MPN.
CHAPTER 10: PERMANENT DISABILITY
In Smith v. Lee's Concrete Materials, Inc., 2016 Cal. Wrk. Comp. P.D. LEXIS 274, the WCAB rescinded a WCJ's order that if the applicant met with the defendant's vocational rehabilitation expert, the applicant's attorney would be entitled to LC 5710 fees for that meeting.
CHAPTER 12: DEATH BENEFITS
In CR England v. WCAB (Dupont), 2016 Cal. Wrk. Comp. LEXIS 74 (writ denied), the WCAB held that an employee's death from a seizure at home was compensable when substantial evidence established that it was a consequence of an industrial head injury occurring 3½ months earlier. The coroner testified that the death was due to a pre-existing seizure disorder, but could not exclude the head trauma as the cause of the employee's post-injury seizures.
CHAPTER 13: PENALTIES AND SANCTIONS
In Fuentes v. The Cheesecake Factory, 2016 Cal. Wrk. Comp. P.D. LEXIS 286, the WCAB upheld a WCJ's decision that it had jurisdiction to impose penalties under LC 5814 for unreasonable delays in providing the supplemental job displacement benefit.
CHAPTER 14: DISCOVERY AND SETTLEMENT
In Smith v. Action Roofing, 2016 Cal. Wrk. Comp. P.D. LEXIS 304, the WCAB upheld a WCJ's order setting a case for trial and rejecting the applicant's request for a stay despite the applicant’s argument that he could not fully participate in the workers' compensation trial without waiving his Fifth Amendment right against self-incrimination while criminal charges were pending.
In Dodley v. Professional Security Consultants, 2016 Cal. Wrk. Comp. P.D. LEXIS 258, the WCAB held that an AME's reports were not inadmissible when the applicant waived any potential ex parte communication by the defendant by proceeding with the examination.
In Jarjour v. County of Los Angeles, 2016 Cal. Wrk. Comp. P.D. LEXIS 291, the WCAB upheld a WCJ's decision allowing a defendant to send a QME an unredacted police report over the applicant's objection that the report was unreliable and prejudicial.
In Alvarenga v. Scope Industries, 2016 Cal. Wrk. Comp. P.D. LEXIS 252, the WCAB rescinded an order approving a compromise and release that included a Medicare Set-Aside (MSA), which the parties did not submit to the Center for Medicare Services (CMS) for approval.
CHAPTER 15: LITIGATION
In Duenas, Altemeyer v. Chiquita Brands International, Inc., dba Fresh Express, 2016 Cal. Wrk. Comp. P.D. LEXIS 259, the WCAB upheld a WCJ's decision refusing to disqualify a law firm representing injured workers after it hired an attorney who actively participated in seven cases for the defendant.
In Gonzalez v. R. Moody Construction, Inc., 2016 Cal. Wrk. Comp. P.D. LEXIS 289, the WCAB rescinded a WCJ's order disallowing liens on the basis that there was no valid appearance by the lien claimants at trial.
CHAPTER 16: AWARDS AND APPEALS
In Sanchez v. La Brea Auto Body, 2016 Cal. Wrk. Comp. P.D. LEXIS 300, the WCAB, after granting a lien claimant's petition for reconsideration, appointed a WCJ to conduct a commissioner's conference at its direction and on its behalf for the sole purpose of affording the parties an opportunity to resolve their dispute.