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 3: BUSINESS OF INSURANCE
In Southern Insurance. Co. v. WCAB (2017) B278412, the 2nd District Court of Appeal held that workers' compensation insurance policies could be rescinded under Insurance Code 650. In that case, a trucking company applied for workers' compensation insurance, declaring that its employees did not travel out of state and did not have a travel radius greater than 200 miles.
CHAPTER 5: INJURY
In Newberry v. San Francisco Forty Niners, 2017 Cal. Wrk. Comp. P.D. LEXIS 143, the WCAB held that a professional football player sustained a single cumulative trauma injury through Nov. 11, 2009, while employed by three different football teams.
CHAPTER 7: MEDICAL TREATMENT
In Zamudio v. Starco Enterprises, 2017 Cal. Wrk. Comp. P.D. LEXIS 151, the WCAB upheld a WCJ's order granting a defendant's petition to compel a home care assessment with a registered nurse, but rescinded an order allowing the defendant's attorney to be present in the applicant's home during the assessment.
In Mata v. Supermercado Mi Tierra, LLC, 2017 Cal. Wrk. Comp. P.D. LEXIS 166, the WCAB held that an applicant was entitled to cervical fusion surgery that was approved by UR, even though the defendant asserted it was contesting liability for treatment on grounds other than medical necessity.
In Ingle v. Department of Motor Vehicles, 2017 Cal. Wrk. Comp. P.D. LEXIS 137, the WCAB upheld a WCJ's decision that a defendant's UR decision was untimely based on an applicant attorney’s assertion that he received only the first 20 pages of the 25-page decision via fax from the defendant.
In Hacker v. County of San Bernardino-Public Health Department, 2017 Cal. Wrk. Comp. P.D. LEXIS 162, the WCAB reversed a WCJ's decision that an IMR determination to deny medication was plainly erroneous because the IMR was performed by a physician with a specialty in family practice rather than a specialist in chronic pain/pain management.
In Aguirre v. County of Los Angeles, 2017 Cal. Wrk. Comp. P.D. LEXIS 152, the WCAB rescinded an order staying all liens of Landmark Medical Management, LLC and PharmaFinance, LLC even though it was asserted that the individuals associated with the lien claimants had been criminally indicted for workers' compensation fraud.
CHAPTER 9: TEMPORARY DISABILITY
In Bounthon v. Safe Streets USA, LLC, 2017 Cal. Wrk. Comp. P.D. LEXIS 127, the WCAB upheld a WCJ's decision that an applicant was not entitled to temporary disability when he refused alternative modified work arranged by his employer at the Salvation Army.
In Venancio v. White Labs, Inc., 2017 Cal. Wrk. Comp. P.D. LEXIS 181, the WCAB upheld a WCJ's determination that an applicant, who was an undocumented worker, was not entitled to temporary partial disability benefits after federal agents notified the employer that the applicant was not authorized to work in the United States.
CHAPTER 10: PERMANENT DISABILITY
In Ricablanca v. California Department of Corrections and Rehabilitation, 2017 Cal. Wrk. Comp. P.D. LEXIS 147, the WCAB rescinded a WCJ's finding that an applicant was not entitled to an increase in permanent disability, per LC 4660.1, for any psychiatric disorder arising out of the coronary artery disease.
In Madson v. Michael J. Cavaletto Ranches, 2017 Cal. Wrk. Comp. P.D. LEXIS 165, the WCAB denied the defendant's petition for reconsideration and affirmed its prior decision that an applicant's psychiatric disability arose directly from the events of employment and was not subject to LC 4660.1(c).
CHAPTER 14: DISCOVERY AND SETTLEMENT
In Morgan v. National Steel and Shipbuilding Company, 2017 Cal. Wrk. Comp. P.D. LEXIS 141, the panel majority held that a defendant was not entitled to discovery of an employee's medical records pertaining to HIV/AIDS when the employee's widow alleged that his death was caused by industrial exposure to asbestos, not by industrial exposure to HIV/AIDS.
In Hasley v. Frito-Lay, Inc., 2017 Cal. Wrk. Comp. P.D. LEXIS 134, the WCAB granted removal of a WCJ's order denying an applicant's request for an additional QME panel, and remanded for the WCJ to determine whether and when claim forms were filed and if so, what was the nature of the injuries claimed.
CHAPTER 16: TRIAL AND APPEAL
In Page, Hansen. v. Acting Administrative Director of the Division of Workers’ Compensation, (2017) 82 CCC 352, the California Superior Court held that it lacked jurisdiction over the plaintiffs' allegations that the workers' compensation system unlawfully discriminates on the basis of sex in the calculation of permanent disability benefits.
In Garcia v. WCAB, 2017 Cal. Wrk. Comp. LEXIS 37 (writ denied), the 4th District Court of Appeal denied an applicant's petition for writ of review as untimely because it was not filed with the court within 45 days.