Case Law Library
Case Name: | SCIF v. WCAB (Stuart) | 08/20/1998 | |
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Summary: | On or about April 28, 1995, Chu received a letter from Rosenberg informing SCIF he was relocating his law office to Beverly Hills. Goldfarb's secretary called Arago on May 18, 1995, and Goldfarb himself called SCIF the next day. We conclude the WCJ's initial decision concluding SCIF unreasonably delayed payment of Stuart's benefits is not supported by substantial evidence. Following the WCJ's decision in this matter, SCIF sought reconsideration, citing Kampner, supra, 86 Cal. App. 3d 376, apparently for the first time. As noted, ante, SCIF understood this deadline and had made timely semimonthly payments for over three years. | ||
Note: | Clerical mistake attributing to the employee a change of address for the employer led to a one-week delay in the employee's benefit check is not unreasonable delay under 5814. | ||
Citation: | 18 Cal.4th 1209 | ||
WCC Citation: | WCC 30241998 CA | ||
Case Name: | SCIF v. WCAB (Welcher) | 08/08/1995 | |
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Summary: | SCIF petitioned for reconsideration, and the Workers' Compensation Appeals Board (Board) denied reconsideration, upholding the WCJ. SCIF sought review in this court, contending that the WCJ had erred in finding applicant's injuries compensable in view of the extensive medical record demonstrating nonindustrial causation. (The records, designated exhibit 20, which were extensive, were admitted at trial after being subpoenaed by defendant SCIF. The WCJ's ruling barring the testimony of the SCIF claims adjuster was highly significant, in that SCIF was thus unable to avoid the application of the presumption. SCIF then had to assume the burden of proof on the primary issue in the case, which was industrial causation. | ||
Note: | Failure to reject claim within 90 days created presumption of compensability; Testimony inadmissible b/c not identified as witness at MSC. | ||
Citation: | 37 Cal.App.4th 675 | ||
WCC Citation: | WCC 24921995 CA | ||
Case Name: | SCIF v. WCAB (Wimberly) | 01/28/1972 | |
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Summary: | State Fund, as the employer's compensation carrier, raised among other issues, the question of prior disability. Applicant thereupon filed an application for Subsequent Injuries Fund benefits and both claims were jointly heard. The only proof of service accompanying the petition for reconsideration was of service by mail upon applicant's attorney of record. Failure to file proof of such service shall constitute valid grounds for dismissing the petition for reconsideration. 'The appeals board may require the petition for reconsideration to be served on other persons designated by it. ' | ||
Note: | Time limits for proper service of Petition for Recon. ('forthwith' filing) may be read strictly by Board; dismissal warranted. | ||
Citation: | 37 CCC 860 | ||
WCC Citation: | WCC 27281972 CA | ||
Case Name: | SCIF v. WCAB, CIGA | 06/24/2004 | |
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Summary: | Apple One's insurer is in liquidation and the claims are administered by California Insurance Guarantee Association (CIGA). CIGA was dismissed and State Fund was ordered to pay the entire award. CIGA argues that Chavira is distinguishable because it does not consider the definition of disability in section 5412. Furthermore, CIGA conceded in its answer to the petition that Rodarte knew the injury was work related. Even though CIGA covered some of the period, it was relieved of liability on the ground that this is a single cumulative injury and there is other insurance available. | ||
Note: | 'Disability' for statute of limitations in 5500.5 may be either temporary or permanent disability. | ||
Citation: | 119 Cal.App.4th 998 | ||
WCC Citation: | WCC 29912004 CA | ||
Case Name: | SCIF vs. Low | 10/30/2002 | |
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Summary: | Fund v. Low CA1/4 NOT TO BE PUBLISHED IN OFFICIAL REPORTS California Rules of Court, rule 977(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 977(b). IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA FIRST APPELLATE DISTRICT DIVISION FOUR STATE COMPENSATION INSURANCE FUND, Plaintiff and Appellant,v. HARRY LOW, as Insurance Commissioner, etc. , Defendant;F. MCCLINTOCKS, INC. , Real Party in Interest and Respondent. Generally, the greater the "loss experience" of an employer, the higher its workers' compensation insurance premiums are likely to be. Part one provides insurance coverage for claims for benefits arising out of on-the-job injuries subject to the Act. Part two of such policies, known as employers' liability insurance, provides so-called "gap-filler" coverage (see, e. g. , Producers Dairy Delivery Co. v. Sentry Ins. | ||
Note: | Attorney fees expended in providing defense under Coverage B properly reportable to WCIRB. | ||
Citation: | Unpublished | ||
WCC Citation: | WCC 28922002 CA | ||
Case Name: | SCIF vs. WCAB (Silva) | 06/27/1977 | |
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Summary: | The applicant, an employee of the Oakland Unified School District, was injured on January 22, 1975, in the course of his duties as a schoolteacher. In addition to receiving treatment for his physical injuries, the applicant consulted a psychiatrist for attendant emotional problems. Several months after the incident, when first notified of the psychiatric [71 Cal. App. 3d 136] treatment, petitioner arranged for the applicant to be examined by another psychiatrist. Before a hearing was held on that petition, the applicant on February 19, 1976, gave notice of his choice of physician. If there is unnecessary and extravagant treatment the employer or his insurer should not bear the cost of such treatment. | ||
Note: | Change in right to medical control procedural, not substantive. | ||
Citation: | 71 Cal.App.3d 133, 42 CCC 493 | ||
WCC Citation: | WCC 30121977 CA | ||
Case Name: | SCIF vs. WCAB, Cardoza | 12/18/1967 | |
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Summary: | STATE COMPENSATION INSURANCE FUND, Petitioner, v. WORKMEN'S COMPENSATION APPEALS BOARD and JOHN RAYMOND CARDOZA, Respondents. John R. Cardoza, then aged 23, entered the employment of Poso Canal Company on March 17, 1964, as a mechanic. Cardoza dived into the water from the canal bank, struck his head, and suffered injuries for which the award here at issue was made. Cardoza testified that Poso employees were accustomed to take coffee breaks or work breaks, as respites from their labors. Poso sometimes parked equipment on the bank of the canal and Cardoza and other employees on occasion worked on it there. | ||
Note: | Injury incurred during activity break for comfort of employee is AOE/COE. | ||
Citation: | 67 Cal.2d 925 | ||
WCC Citation: | WCC 29821967 CA | ||
Case Name: | Scott v. WCAB (Moore's Western, et. al.) | 03/24/1998 | |
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Summary: | Joe Scott, Petitioner v. Workers' Compensation Appeals Board, Moore's Western Nursery, State Compensation Insurance Fund, Mark and Irene Richardson, dba Windows Express, illegally uninsured, Respondents. The WCJ issued an F&A awarding 5 1/4 percent PPD against Windows Express, and no PPD against Moore's Nursery, denying SCIF's lien claim against the PPD award. SCIF Petitioned for Reconsideration and the WCAB found that Applicant had already received the full amount of PPD due, and SCIF was entitled to contribution from Windows Express for the PPD SCIF paid. The WCAB also held that Applicant was not entitled to further PPD from Windows Express since he had already received the full PPD benefits from SCIF. The WCAB denied reconsideration and Applicant filed a Petition for Writ of Review, which was denied. | ||
Note: | Credit allowed for overpaid disability benfs. in another case. | ||
Citation: | 63 CCC 488 (Writ Denied) | ||
WCC Citation: | WCC 25151998 CA | ||
Case Name: | Scott v. WCAB (Time Fire & Cas.) | 08/25/1981 | |
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Summary: | RODMAN R. SCOTT, Petitioner, v. WORKERS' COMPENSATION APPEALS BOARD and TIME FIRE & CASUALTY COMPANY, Respondents. Mr. Velthoen hired Mr. Scott to assist in building a personal home for Velthoen; Scott was to install some 'sandwich panels' for the walls and place roof trusses. Scott testified he was to be paid an hourly wage and he received two paychecks totalling $480 from Velthoen for the work. This order contained a finding that Insurance Code section 11590 extended compensation insurance coverage for the injury sustained by Scott. The Board also concluded that an election to cover Scott under Labor Code section 4151 was precluded because Scott came within the exclusion of section 3352, subdivision (h). | ||
Note: | WCAB without jurisdiction to reconsider if claimant was 'employee' since employer failed to petition within 20 days. | ||
Citation: | 122 Cal.App.3d 979 | ||
WCC Citation: | WCC 26591981 CA | ||
Case Name: | Sea-Land Service, Inc. v. WCAB | 12/02/1996 | |
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Summary: | Subsequently, the California Workers' Compensation Appeals Board (WCAB) awarded Lopez scheduled permanent partial disability indemnity of $9,020. The WCAB denied reconsideration of the judge's determination, and the Court of Appeal summarily denied Sea-Land's petition for writ of review. As this very case illustrates, application of category-by-category credit would effectively require Sea-Land to pay more in compensation than if the WCAB award had come first. Second, in the absence of an agreement, the WCAB has discretion to allow credit where the employer voluntarily made payments described in the statute. Accordingly, in the WCAB proceedings, Sea-Land took the position that '[w]hen the LHWCA permanent disability payment of $7,040. 88 is credited against the WCAB liability for permanent disability of $9,020. 00, the remainder owed is $1,979. 12. ' -FN 4. | ||
Note: | Overpaid federal disability benefits can be credited 'dollar for dollar' against state liabilities.. | ||
Citation: | 14 Cal.4th 76 | ||
WCC Citation: | WCC 24541996 CA | ||