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Significant Legal Decisions

The Legal Department of State Fund prepares analyses of recently published decisions of the California Supreme Court, courts of appeal, and Workers' Compensation Appeals Board (WCAB) in cases pertaining to workers' compensation. These analyses are for general information only, not for specific legal advice or application to a specific factual situation.

Dwight Smith v. WCAB and California Youth Authority, et al. and David Amar v. WCAB and Mel Clayton Ford, et al - The Supreme Court’s decision in Smith/Amar validates State Fund’s practice of not paying attorney fees of employees’ counsel even if they successful challenge utilization review (“U.R.”) denials of medical treatment.

Foster v. Workers' Comp. Appeals Board  - Where independent injuries result in concurrent periods of temporary disability, the 104-week limitation likewise runs concurrently. 

Rachel Chang v. WCAB and State Compensation Insurance Fund - The adjusted permanent disability rating schedule adopted on January 1, 2005 applies to all pending matters regardless of the date of injury. The only cases it does not apply to are those claims arising before January 1, 2005 in which, prior to January 1, 2005, there is a comprehensive medical-legal report or treating physician report indicating the existence of permanent disability, or the employer was required to provide notice to the injured worker pursuant to Labor Code § 4061.

Brodie v. WCAB, and Welcher, Strong, Lopez & Williams v. WCAB - The Supreme Court ruled the Legislature did not intend to overrule Fuentes v. Workers’ Comp. Appeals Bd. (1976) 16 Cal.3d 1, when it repealed former Labor Code § 4750.

Sonoma State University and Octagon Risk Services v. WCAB and Lesley Hunton - Eternal vigilance is the price of reform.Court of Appeal protects 1989 and 1993 reforms requiring predominant industrial causation for psychiatric injuries.

Stan Brodie v. Workers' Comp. Appeals Bd., and Contra Costa County Fire Protection District et al. - The decision on apportionment in Welcher, Strong, Lopez and Williams from the Court of Appeal in Sacramento conflicts with the decisions in Gallo/Dykes from the Court of Appeal in Fresno, and in Brodie and Nabors from the Court of Appeal in San Francisco.

Nabors v. WCAB, Piedmont Lumber Co. and SCIF Court of Appeal - The Court of Appeal for the First District, Division Two has followed the decision of the Fifth District (Fresno) in E&J Gallo v. WCAB (Dykes) to hold that when carrying out apportionment the dollar value of the prior disability is subtracted from value of the current overall disability. Like the Court in Dykes, the Nabors Court did limit its holding to the facts presented.

Vargas v. Atascadero State Hospital Workers’ Compensation Appeals Board - New apportionment rules apply to the increased PD alleged in any petition to reopen still pending when SB 899 Was enacted.

Zenith Insurance Company v. Workers’ Comp Appeals Board - Lien claimants have to prove proper licensure or accreditation in order to prove entitlement to reimbursement. If this burden is not satisfied, awards to lien claimants are not supported by substantial evidence.

McCarthy v. Workers’ Comp. Appeals Board, Best Sanitizers, Inc. et. al. - New Labor Code § 5814 applies to all claims of unreasonable delay or refusal to pay compensation that were pending as of June 1, 2004.

Nunez v. Workers’ Comp. Appeals Bd./Cortez v. Workers’ Comp. Appeals Bd. - Court of Appeal Upholds WCAB “En Banc” Decision in Simi v. Save-Max Foods, Inc.

E & J Gallo Winery  v. WCAB and David Dykes Court of Appeal, 5th Appellate District [Fresno] - Apportionment of permanent disability. Court of Appeal disapproves Nabors. Subtract dollars not percentages.

County of San Luis Obispo v. Workers' Comp. Appeals Board [Art Martinez] - It is no longer legally correct to use the criteria identified in Barns v. Workers' Comp. Appeals board to establish a prima facie violation of Labor Code § 132a.

Rio Linda Union School District v. WCAB - SB 899's new apportionment rules apply to all claims not reduced to a final judgement as of April 19, 2004

Nabors v. Piedmont Lumber & Mill Company, State Comp. Ins. Fund - Apportionment to a pre-existing disability under the new Labor Code sections 4663 and 4664 requires subtraction of disability percentages, not dollars. The monetary savings for a subtraction of percentages is substantial.

Marlene Escobedo v. Marshalls; and CNA Insurance Co. - An en banc decision from the Board which sets forth what determinations a reporting physician must make with respect to apportionment and what standards the WCAB must use in deciding apportionment under SB 899.

Green v. WCAB  - Labor Code § 5814 as amended by SB 899 applies to all claims not reduced to final judgement as of June 1, 2004.

Kleeman v. WCAB  - This case holds that SB 899’s new apportionment rules apply to all claims not reduced to a final judgment as of July 19, 2004.

Honeywell v. WCAB [Wagner]  - In this case, the California Supreme Court held that the 90-day period within which to deny a claim commences with the filing of a claim form, unless evidence of egregious, intentional employer misconduct can be established.

Myron Abney v. Aera Energy; and Liberty Mutual Insurance Company  - This is an en banc decision on the application of the recent amendments to Labor Code 5814 and SB 899. The WCAB held that penalty under the new amendments apply to all dates of injury, even when the underlying misconduct occurs prior to June 1, 2004.

Scheftner v. Rio Linda School District - In this case, the WCAB, in an En Banc decision found that SB 899's new apportionment rules apply to all pending cases except where submission orders, or orders closing discovery issued before April 19, 2004.

Mitchell v. The Union Central Life Ins. Co.  - In this case, the Court of Appeal, Second District, held that the general release language in a C and R did not include settlement of applicant’s ongoing discrimination case filed in Superior Court where the C and R did not specifically mention the civil action, and there was no evidence that the parties intended to include the civil lawsuit in the C and R. This case basically follows the prior Supreme Court case Jefferson v. California Dept. of Youth Authority (2002) 28 Cal.4 th 299, which held that the C and R of the workers’ compensation claim did not include the separate civil suit where extrinsic evidence showed no intent to include both. 

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