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A recent case helped determine the effect of the presumption which the treating
physician enjoys under Labor Code §4062.9.
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Late payment requiring self-imposed penalty does not necessarily require
Section 5814 penalty on the entire species of benefit.
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Employees claim of disability discrimination under Fair Employment
and Housing Act (FEHA) preempted by Labor Code §132a.
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recent
case helped determine the effect of the presumption
which
the treating physician enjoys under Labor Code §4062.9. The case is
that of Rex A. Minniear v. Mt. San Antonio Community College District 61
CCC 1055. This is an en banc decision from the WCAB.
In the Minniear case, the applicant sustained an admitted injury on March
17, 1994. He eventually treated with Dr. Burres, who performed surgery on
the applicants back. Dr. Burres found the applicant permanent and
stationary on January 4, 1995, and restricted him from heavy lifting, repeated
bending and stooping.
The applicants attorney apparently disputed Dr. Burres report
and obtained a report from Dr. David Wood. Dr. Wood found a restriction of
no heavy work.
On May 21, 1996, the case was tried. The WCJ ultimately provided a Findings
and Award based on the report of Dr. Wood. The defendants filed a Petition
for Reconsideration, arguing that Dr. Burres report had a presumption
which was not overcome.
The Board determined that Labor Code § 4062.9 affected the burden of
proof, because it was part of an effort by the Legislature to implement a
public policy of reducing medical-legal costs and expediting resolution of
medically related issues by such means as restricting the number of medical
evaluations. Although this Labor Code section appears to deal with only the
level of permanent disability, the WCAB specifically found that it applies
to all of the medical issues covered by Labor Code §§4061 and 4062.
The Board found that to rebut the treating physicians finding, it is
necessary to show a more thorough qualified medical evaluators
report by making reference to specific factors in the context
of the elements described in Board Rule 10606. |
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| In applying these factors to the Minniear case, the Board noted that
Dr. Wood did not refer to any error or inconsistency in Dr.
Burres report. The Board then examined in detail the findings in both
reports. The Board noted that the findings were essentially compatible. As
such, Dr. Burres report should have been followed. The Board then went
on to deduct the cost of Dr. Burres report from the applicants
award of permanent disability.
I have had applicant attorneys already cite the Minniear case for the proposition
that the reports from the primary treating physicians are essentially
bulletproof. However, I think that such an interpretation of the Minniear
case is grossly in error. The Board specifically made reference to Board
Rule 10606 regarding physicians reports as evidence. For the most part,
this rule makes reference to everything that is needed to make up a medical
report. In other words, the WCJ should consider whether the medical history
contained within the treating physicians report is correct. Consideration
should be given to the diagnosis vis-a-vis work limitations, etc. If anything,
the Minniear case makes it clear a greater burden is now placed on the WCJ
to very carefully scrutinize the medical reports in question. |
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Late Payment Requiring Self-Imposed Penalty Does Not Necessarily Require
Section 5814 Penalty on the Entire Species of Benefit
rank
Morgan sustained an admitted work-related injury on June 9, 1993, while working
for Service Systems Corporation. A Findings and Award issued which found
the applicant permanently totally disabled. A second trial was held on March
14, 1996, on the issue of penalties.
It was not disputed that three permanent-disability checks were delayed.
On two of the three checks, a 10% self-imposed penalty had been included
in the payment.
The WCJ awarded one 10% penalty against the entire period of permanent disability
and the defendant filed a Petition for Reconsideration, arguing that only
a 10% self-imposed penalty should have been awarded on the one payment which
did not include such a penalty.
The WCJ responded by stating that the penalty was for the pattern of
delay. The penalty was to provide an incentive for the defendants to
make timely payments of benefits in the future.
Service Systems Corporation v. WCAB, 61 CCC 1090.
EDITORS NOTE: The WCJ did state in this case that, To this judge, there
could be three penalties. I dont think three penalties would
have been reasonable in this case. Obviously, the WCJ didnt think that
such penalties were reasonable, either, or he would have assessed them.
I think that this case can be argued to stand for the proposition that penalties
on the entire species of benefits do not necessary follow automatically when
there is a self-imposed 10% penalty. For one thing, a self-imposed penalty
can be required when there is a delay as little as one day over the prescribed
time when payments are due. Obviously, the WCJ looked at the bigger picture
in this case. I think that this reflects the better position which is
well-founded in equity and reason. |
Future Medical Included Assistance with Activities of Daily Living and Child
Care
pplicant
Melody Yturralde sustained a work-related injury from hepatitis while working
for Kaiser Foundation Hospital as a registered nurse and lab technician.
A Findings and Award issued on April 6, 1991, awarding 8½% permanent
disability. When the applicants condition deteriorated, a Petition
to Reopen was filed. On February 20, 1996, Judge Bruce-Lyle found the applicant
100% disabled. The WCJ awarded future medical treatment to include home health
care which would assist the applicant with activities of daily living, as
well as child care. The defendants filed a Petition for Reconsideration,
arguing, among other things, that future medical care does not include daily
assistance in the applicants home with regard to activities of daily
living, as well as child care. The defendant also argued that the WCJ should
have retained jurisdiction over applicants permanent disability. The
WCJ had refused this.
The Board agreed with the WCJ, noting that the applicants condition
had deteriorated to the extent that she was unable to lift her children.
The applicant had three children, including three-year-old twins. One of
the twins, Michael, had cerebral palsy. The WCJ concluded: This WCJ
is of the opinion that the provision of daily assistance with activities
of daily living and child care is medically necessary and reasonable in this
case, and is supported by the medical and testimonial evidence.
A Petition for Writ of Review was filed and it was denied on August 12, 1996.
Kaiser Foundation Hospital v. WCAB, 61 CCC 876. |
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Employees Claim of Disability Discrimination Under Fair Employment
and Housing Act (FEHA) Preempted by Labor Code §132a
laintiff
David Cammack sued General Telephone Corporation (GTE) for damages for unlawful
disability discrimination under the FEHA. The plaintiff stated in his Complaint
that while employed at GTE, he sustained an industrial injury, bilateral
carpal tunnel syndrome. Due to the injury, the plaintiff became disabled.
Later, he attempted to return to work before his benefits had expired.
. . . He requested reasonable accommodation at his work station.
However, the employer refused to provide any reasonable accommodation
to plaintiff. . . . When the plaintiffs benefits expired on July
16, 1993, he was terminated. On June 21, 1994, the plaintiff received a right
to sue letter from the United States Equal Employment Opportunity Commission.
The defendants filed a demurrer to the Plaintiffs complaint, arguing
that workers compensation provided the exclusive remedy for
Plaintiffs physical disabilityand the alleged discrimination. The demurrer
was sustained without leave to amend. The plaintiff then filed an appeal.
The Court of Appeal noted that Labor Code §132a applies specifically
to bias directed at the disabled arising out of a workers compensation
claim. That was exactly the situation which existed in the present case.
The plaintiff argued that the FEHA provides greater protection to employees
who are discriminated against in the work place than does Labor Code §132a.
As such, it was argued that the FEHA provisions preempted the Labor Code
section provisions. The Court of Appeal did not accept this argument.
The Court of Appeal noted that in 1992, the Legislature amended the FEHA
to accommodate provisions of the Americans With Disabilities Act of 1990.
As part of the 1992 California legislation, Government Code §12933 was
amended. Pursuant to this section, the plaintiff argued that the employer
failed to provide reasonable accommodations.
The Court of Appeal held that the amendments to the Government Code did not
repeal either Labor Code §132a or the preemptive effect of the
Workers Compensation Act. The Court found that the type of discrimination
alleged was specifically covered by Labor Code §132a. The Court stated
that, despite the apparent public policy against physical-disability
discrimination, the Legislature has, through Labor Code §132a, placed
work-related-disability discrimination within the scope of the compensation
bargain.
David Cammack v. GTE Corporation, et al., 61 CCC 760.
This
is a particularly important case where there are overlapping issues about
reasonable accommodations and Labor Code §132a. For all
intents and purposes, this court has stated that Labor Code §132a eliminates
the ADA issue. Whether or not federal courts similarly interpret the sections
in question is yet to be seen.
For the time being, this case is good authority in arguing that the injured
worker only has Labor Code §132a as his remedy. |
| You Can Retire Rich
hat
is the idyllic way to spend your retirement years? Travel to all the exotic
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A growing number of two-income families are tightening their belts for the
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Doing so may require you to forego some luxuries in the present, but prudent
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