August 2013 Case Law Update
Tuesday, August 13, 2013 | 0
The following is a summary of important updates to California workers' compensation law.
JURISDICTION AND SUBROGATION
In Williams v. New York Knickerbockers, 2013 Cal. Wrk. Comp. P.D. LEXIS 234, the WCAB held that it had jurisdiction over an applicant's cumulative trauma claim when he played 24 games in California during his career, including three games in his final season.
THE BUSINESS OF INSURANCE
In State Farm General Insurance Co. v. WCAB (2013) B240742, the 2nd District Court of Appeal held that CIGA was barred by the doctrine of res judicata from asserting a claim for reimbursement against an insurer when the WCAB had found repeatedly that the claim for reimbursement was barred by a 2002 stipulated award and five-year limitation period of LC 5804.
EMPLOYMENT
In City of Los Angeles v. WCAB (Ceja), 2013 Cal. Wrk. Comp. LEXIS 108 (writ denied), the WCAB concluded that pursuant to LC 3600.2, an applicant was injured while working as a police officer, rather than as a security guard for a concert promoter, even though he was injured while arresting a concert patron shortly after his concert shift had ended.
INJURY
In Bates v. Serologicals Corp., 2013 Cal. Wrk. Comp. P.D. LEXIS 194, the WCAB rescinded a WCJ's denial of an insurer's lien for reimbursement from another carrier.
STATUTES OF LIMITATIONS
In Kindelberger v. City of Los Angeles, 2013 Cal. Wrk. Comp. P.D. LEXIS 209, the WCAB rescinded a finding that a lien for medical services from 1999 to April 14, 2007, was barred by the statute of limitations under LC 4903.5.
MEDICAL TREATMENT
In Mulford v. El Toro RV, Inc., 2013 Cal. Wrk. Comp. P.D. LEXIS 219, the WCAB held that LC 4600(h), which provides that home health care services are allowed as medical treatment only if the care is prescribed by a physician and surgeon, applies to all cases prospectively from the effective date of Jan. 1, 2013, regardless of the date of injury.
In Roger v. Corvel Healthcare Corp. (2013) 78 CCC 638, the 4th District Court of Appeal issued an unpublished opinion holding that a medical provider network was within its rights in terminating the contract of an orthopedic surgeon who provided treatment within the network when: (1) he was unreachable by independent reviewing physicians hired by the network to evaluate four nonstandard treatments he regularly prescribed for his workers' compensation patients; and (2) he prescribed those nonstandard treatments on a wholesale basis and did not justify their application to particular patients.
PERMANENT DISABILITY
In Lumb v. City of Chula Vista, 2013 Cal. Wrk. Comp. P.D. LEXIS 213, the WCAB majority rescinded a WCJ's decision denying credit against an applicant's permanent disability indemnity in his cumulative trauma injury case for overpayment of permanent disability indemnity in his specific injury case.
DISCOVERY AND SETTLEMENT
In Nehdar v. Washington Mutual, 2013 Cal. Wrk. Comp. P.D. LEXIS 221, the WCAB held that an applicant's attorney violated LC 4062.3 and CCR 35 by impermissibly sending an AME and QME a nurse's report requesting home health care without giving the defendant 20 days to object.
LITIGATION
In Townsend v. County of Los Angeles, 2013 Cal. Wrk. Comp. P.D. LEXIS 231, the WCAB rescinded a WCJ's finding of contempt and imposition of a $250 fine against a lien representative for his direct refusal to comply with an order of the WCJ to repeat the WCAB policy regarding bifurcation of cases.
In Garate v. Leading Edge Aviation Services, 2013 Cal. Wrk. Comp. P.D. LEXIS 203, the WCAB affirmed a decision dismissing a lien for failure to pay the activation fee per LC 4903.6, and held that the order of dismissal was not defective because the WCJ delegated service of it, as the order was not subject to CCR 10500(b), which applies to final orders after submission.
In Ramos v. KDK Investment, Inc., 2013 Cal. Wrk. Comp. P.D. LEXIS 227, the WCAB rescinded an order dismissing a lien for failure to timely pay the lien activation fee when the lien claimant submitted evidence
In Valiente v. Custom Furniture and Cabinets Inc., (2013) ADJ7271105 (panel decision), the WCAB granted reconsideration of a WCJ's order taking a case off calendar and deferring the issue of service medical reports to nonphysician lien claimants.
In Chamberlain v. Irwin Industries, Inc., 2013 Cal. Wrk. Comp. P.D. LEXIS 199, the WCAB dismissed an employer's petition for dismissal for lack of jurisdiction and held that a former union member was not bound by an ADR agreement and could pursue his claimed injuries at the WCAB.
Complete discussion of these topics can be found in Sullivan On Comp available to subscribers at http://www.workcompcentral.com/sullivan.
Michael Sullivan is the founder of Michael Sullivan & Associates LLP, a workers' compensation defense firm with four offices in Southern California, and author of "Sullivan on Comp," a treatise on California workers' compensation law.
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