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. Complete discussions of these topics can be found on Sullivan on Comp.
Chapter 2: Jurisdiction and Subrogation
In Escamilla v. Cacique, Inc., 2018 Cal. Wrk. Comp. P.D. LEXIS 49, the WCAB held that a defendant was not entitled to credit pursuant to LC 3861 for an employee’s legal malpractice recovery against her civil attorney.
Chapter 3: the Business of Insurance
In San Diego County Schools Risk Management Joint Powers Authority v. Liberty Insurance Corp. (2018) 83 CCC 255, the U.S. District Court for the Southern District of California issued a tentative ruling in a case involving two excess insurers that the second excess insurer was fully liable for expenses exceeding $100,000 for two cumulative trauma injuries.
Chapter 5: Injury
In Molar v. State of California Department of Corrections and Rehabilitation, 2018 Cal. Wrk. Comp. P.D. LEXIS 35, the WCAB held that, per LC 3212.8, a correctional officer was entitled to the presumption of compensability regarding his herpes/Epstein-Barr virus exposure.
In SCIF v. WCAB (Guzman) (2018) 83 CCC 185, the 6th District Court of Appeal held that an employee’s psychiatric injury was not caused by a sudden and extraordinary employment condition for the purposes of LC 3208.3(d) when he was using a 95-pound compactor on a hillside with a 45-degree slope.
In Garcia v. Reynolds Packing Co., 2018 Cal. Wrk. Comp. P.D. LEXIS 29, the WCAB held that an applicant’s psychiatric claim was compensable when the defendant failed to produce evidence that her claim was barred by the six-month requirement in LC 3208.3(d).
Chapter 6: Statutes of Limitations
In Galland v. Los Angeles Unified School District, 2018 Cal. Wrk. Comp. P.D. LEXIS 28, the WCAB upheld an earlier decision that an applicant’s claim was barred by the statute of evidence when the defendant presented evidence that it provided him with a claim form and that he did not file an application for adjudication until more than four years later.
Chapter 7: Medical Treatment
In Visger v. San Francisco 49ers, 2018 Cal. Wrk. Comp. P.D. LEXIS 42, the WCAB upheld a WCJ’s award of 120 days of inpatient treatment and an additional one year post-inpatient treatment at an assisted living facility for a traumatic brain injury when the defendant did not timely act after receiving the RFA form.
In Villa v. Los Angeles Unified School District, 2018 Cal. Wrk. Comp. P.D. LEXIS 61, the WCAB rescinded a WCJ’s order requiring a provider to pay $18,559.15 to a defendant for overpaid treatment provided to an applicant.
Chapter 9: Temporary Disability
In County of San Diego v. WCAB (Pike), 2018 Cal. App. LEXIS 184, the 4th District Court of Appeal annulled the WCAB’s award finding that an applicant with an injury after Jan. 1, 2008, was entitled to temporary disability payment for periods occurring more than five years after the date of injury.
In Bautista v. Smith’s Group Services Corp., 2018 Cal. Wrk. Comp. P.D. LEXIS 44, the WCAB rescinded a WCJ’s finding that an applicant did not suffer a severe burn pursuant to LC 4656(c)(3)(D) when he focused solely on whether the burn itself was severe.
In Martinez v. Parco, Inc., 2018 Cal. Wrk. Comp. P.D. LEXIS 55, the WCAB held that removal of bone from the applicant’s thumb, combined with its shortening by 7 mm, was a result of the surgeries for the treatment of his industrial injury, and constituted an amputation for the purposes of applying the LC 4656(c)(3)(C) exception to the 104-week limit on temporary disability.
Chapter 14: Discovery and Settlement
In Rayo v. Certi-Fresh Foods, Inc., 2018 Cal. Wrk. Comp. P.D. LEXIS 58, the WCAB upheld a WCJ’s decision finding that an applicant’s procurement of a chiropractic panel per LC 4060 was premature and invalid, as the qualifying event for obtaining such a panel — the “mailing of a request for a medical evaluation pursuant to Section 4060” — had not taken place.
In Angel v. Able Engineering, 2018 Cal. Wrk. Comp. P.D. LEXIS 25, the WCAB held that an applicant was not entitled to a replacement panel QME in dentistry, based on his claim that the QME was not licensed to practice dentistry at the West Covina location where his medical-legal evaluation took place.
Chapter 15: Pretrial Litigation
In Marroquin v. County of Orange, 2018 Cal. Wrk. Comp. P.D. LEXIS 33, the WCAB upheld a WCJ’s order taking a case off calendar even though the applicant was evaluated by a QME and a treating physician. .
In Hernandez v. Henkel Loctite Corp. (2018) ADJ6726149, the WCAB en banc held that lien declarations under LC 4903.05(c)(1), for liens filed prior to Jan. 1, 2017, were timely if they were filed by 5 p.m. Monday, July 3, 2017.