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Case Summaries

Workers’ Comp

[06/22] State Compensation Insurance Fund v. WCAB

In an action seeking review of a decision of the Workers’ Compensation Appeals Board regarding the medical necessity of proposed treatment requested by an employee of the California Highway Patrol (CHP), involving Labor Code Section 4610.6, which created a new procedure–independent medical review (IMR)–that an injured worker may use to challenge an employer’s timely denial, delay or modification of a request for authorization of proposed medical treatment, the Board’s decision is reversed where the 30-day time limit in section 4610.6(d), is directory and, accordingly, an untimely IMR determination is valid and binding upon the parties as the final determination of the director.

[05/11] SSA Terminals and Homeport Ins. Co. v. Carrion

In an action brought by a claimant seeking disability benefits under the Longshore and Harbor Workers’ Compensation Act, an employer/insurer’s petition for review of a decision by the Benefits Review Board is denied where: 1) the claimant timely filed his claim against his employer; 2) claimant’s knee injury was a permanent, rather than a temporary, disability; and 3) the doctrines of exhaustion and waiver were inapplicable because claimant presented his claim of permanent disability well before the conclusion of the administrative process and neither the employer nor the agency was blindsided by the argument.

[05/02] Matthews v. Liberty Assignment Corp.

In a case dealing with the issue of whether a judgment, based on a structured settlement of an employee’s workers’ compensation claims against his employer and others, which was agreed upon by the parties and entered as an award in the workers’ compensation proceeding, may be assigned by the injured employee, the trial court’s denial of a motion for an order approving the assignment of plaintiff’s structured settlement payment judgement is affirmed where the assignment was prohibited by statute.

[04/27] Guerra v. WCAB

In a Workers’ Comp case in which claimant died from a pulmonary hemorrhage while taking out the garbage at work, the Workers’ Compensation Appeals Board rejection of a doctor’s opinion as speculative and ruling that it had not been shown that claimant’s death arose out of and in the course of his employment, is annulled and remanded where the death arose out of and in the course of employment.

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