Case Name:	SCIF v. WCAB (Chacon)		08/28/1998
Summary:	In addition to other listed payments, SCIF was to pay $400,000 within 25 days of the order approving the C&R, which would include interest. SCIF also agreed to guarantee the payments but its obligation was to be discharged upon the mailing of a valid check for the correct amount. SCIF then purchased an annuity from Keyport Life Insurance Company (Keyport) and so advised Chacon. [66 Cal. App. 4th 1158] Chacon then advised SCIF by letter the payments were not in compliance with sections 4651 fn. SCIF also adds that the WCAB failed to explain according to section 5908. 5 fn.
Note:	Annuity checks not immediately negotiable and payable in cash are not unreasonably delayed payments.
Citation:	66 Cal.App.4th 1154
WCC Citation:	WCC 24791998 CA

Case Name:	SCIF v. WCAB (Denton)		05/24/1982
Summary:	With the addition of this evidence, the record discloses the Board's order denying reconsideration is not supported by substantial evidence. The Fund has challenged the award on the grounds there is no substantial evidence to sustain it. We are obligated in this instance to review 'the entire record which shall be certified by the appeals board. . . ' (Lab. The 'record of proceedings' includes exhibits marked but not received in evidence, 'notices, petitions, briefs, findings, orders, decisions and awards. 'The evidence is clearly part of the record certified by the Board, and is properly before us on this appeal.
Note:	Board must consider 'new' evidence if strong and failure to produce earlier is 'clearly excusable'.
Citation:	47 CCC 601
WCC Citation:	WCC 27301982 CA

Case Name:	SCIF v. WCAB (Dorsett)		11/10/2011
Summary:	Both employers were insured for purposes of workers' compensation by petitioner State Compensation Insurance Fund (SCIF). "*fn1 SCIF filed separate petitions for reconsideration on behalf of South Valley and A-Tek. SCIF filed separate petitions for reconsideration on behalf of South Valley Glass and A-Tek. On behalf of A-Tek, SCIF contended that "[a] cumulative trauma injury cannot be both a compensable consequence of an earlier injury and a second injury as well. DISCUSSION In this court, SCIF contends that the Board erred when "it determined apportionment of permanent disability did not apply" in this case.
Note:	A workers' compensation judge erroneously failed to apportion an injured worker's award pursuant to Benson v. WCAB, California's 6th District Court of Appeal concluded.
Citation:	H036724
WCC Citation:	WCC 38242011 CA

Case Name:	SCIF v. WCAB (Hancock)		11/22/2010
Summary:	State Compensation Insurance Fund (SCIF) unsuccessfully petitioned the Workers' Compensation Appeals Board (WCAB or Board) for reconsideration of the WCJ's findings and orders. We issued a writ of review in this case to consider whether the WCAB properly denied SCIF's petition for reconsideration. "The general clause relied upon by [SCIF] is at best oblique and only alludes to the issue waiver. "SCIF argues the WCAB therefore erred in rejecting the stipulation by reopening Hancock's award. The WCAB in this case relied on section 5803 as an alternative basis for permitting the reopening of Hancock's case.
Note:	The Workers' Compensation Appeals Board should not have granted an applicant's petition to reopen an award for an injury that he allegedly knew about before agreeing to a settlement, the 3rd District Court of Appeal ruled.
Citation:	C064985
WCC Citation:	WCC 36832010 CA

Case Name:	SCIF v. WCAB (Meier)		10/17/1985
Summary:	Meier submitted a bid on a sheet from a Pacific Structural Concrete scratch pad for $9,493, and the bid was accepted. While working on the remodeling job, Meier fell from a scaffold sustaining a broken neck which rendered him a quadriplegic. 3 Applicability of Section 2750. 5 Three Court of Appeal cases have concluded that the penultimate paragraph of section 2750. 5 is applicable in workers' compensation cases. [1] We have concluded that section 2750. 5, including the penultimate paragraph, must be interpreted as applying to workers' compensation cases. In any event the documents are not helpful in determining the effect of the last two paragraphs of the section.
Note:	LC 2750.5 in fact applies to work comp cases; Unlicensed contractor not estopped from asserting employment status.
Citation:	40 Cal.3d 5
WCC Citation:	WCC 3851985 CA

Case Name:	SCIF v. WCAB (Patterson)		05/19/1981
Summary:	STATE COMPENSATION INSURANCE FUND, Petitioner v. WORKERS' COMPENSATION APPEALS BOARD OF THE STATE OF CALIFORNIA and ROBERT J. PATTERSON, Respondents. COUNSEL: For petitioner--Vonk, Krimen & Evans, by Frank Evans For respondent employee--Jones, Brown & Clifford, by Yale I. Jones OPINION BY: Caldecott, P. J. 649], and later claimed an additional penalty for failure of defendants to reimburse him for self-procured medical treatment. Reconsideration was granted to consider the impact of the pending case of Gallamore v. Workers' Comp. The result was the same--a 10 percent penalty was imposed upon the full amount of the permanent disability award.
Note:	Attorney fee commuted from disability benefits is subject to separate penalty for delayed payment.
Citation:	46 CCC 552
WCC Citation:	WCC 25171981 CA

Case Name:	SCIF v. WCAB (Sandhagen)		07/16/2009
Summary:	The WCAB asserts, as a threshold matter, that its decision is not a final order and the petition for review is premature. Instead, the WCAB gave Fund a reasonable opportunity to obtain a section 4062, subdivision (a) evaluation to assess the reasonableness and necessity of treatment. *fn6 II RIPENESS The WCAB argues its November 16, 2004, decision is not a final order subject to a petition for writ of review. Therefore, the WCAB concludes, the order cannot be considered final since it failed to determine any substantive right or liability. DISPOSITION The WCAB's decision is annulled, and the matter is remanded to the WCAB for further proceedings consistent with this opinion.
Note:	[Unpublished] Utilization review process is mandatory and SCIF cannot resort to proceedings under 4062 as a method for disputing injured worker's treatment request.
Citation:	C048668
WCC Citation:	WCC 35432009 CA

Case Name:	SCIF v. WCAB (Sandhagen)		07/03/2008
Summary:	State Fund sought reconsideration by the Workers' Compensation Appeals Board (WCAB). Due to the important legal issues presented and in order to secure uniformity of future decisions, the matter was assigned to the WCAB as a whole for an en banc decision. *fn4 Accordingly, the WCAB vacated the workers' compensation judge's determination that Sandhagen was entitled to the MRI and instead gave State Fund an opportunity to proceed under section 4062. A. Statutory Scheme Requires Employers to Conduct Utilization Review When Resolving Requests for Medical Treatment Section 4610 requires that "[e]very employer . If the hearing failed to satisfy the parties, theycould seek reconsideration by the WCAB (§ 5900) and, ultimately, review by the Court of Appeal (§ 5950).
Note:	The Legislature intended to require employers to conduct utilization review when considering requests for medical treatment, and not to permit employers to use section 4062 to dispute employees' treatment requests. The language of section 4610 and 4062 mandates this result.
Citation:	S149257
WCC Citation:	WCC 33912008 CA

Case Name:	SCIF v. WCAB (Slotten)		01/04/1979
Summary:	Injured workers in need of rehabilitation had to seek aid outside the workers' compensation system through state and federally funded programs. Responding to the recommendation of the National Commission on State Workmen's Compensation Laws, the Legislature amended section 139. 5 (eff. Jan. 1, 1975) to make vocational rehabilitation at the expense of employers or their carriers a matter of right for qualified injured workers. The Attorney General rendered an opinion in 1975 that section 139. 5, as amended in 1974, applies only to employees in the private sector. The Workers' Compensation Appeals Board has likewise decided in this case that section 139. 5 covers both public and private employees.
Note:	Mandatory duty on public employers to provide employees with same rehab. benefits as private employees.
Citation:	88 Cal.App.3d 43
WCC Citation:	WCC 26391979 CA

Case Name:	SCIF v. WCAB (Stevens)		01/08/2017
Summary:	Click Here for a PDF version of SCIF v. WCAB (Stevens)
Note:	The California 1st District Court of Appeal has accepted an appeal by the State Compensation Insurance Fund that challenges the Workers' Compensation Appeals Board's authority to void provisions of the state’s medical treatment guidelines that conflict with other areas of the law.
Citation:	ADJ1526353
WCC Citation:	Decisions after remittitur from A143043

Case Name:	SCIF v. WCAB (Stuart)		08/20/1998
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
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
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
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
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
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
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
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
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
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