CIGA Ordered to Administer Medical Care for Both Specific and Cumulative Trauma Injuries: Cal. Comp. Cases December Advanced Postings (12/23/2011)

CIGA Ordered to Administer Medical Care for Both Specific and Cumulative Trauma Injuries: Cal. Comp. Cases December Advanced Postings (12/23/2011)

Featured Case of the Week: CIGA ordered to administer medical care for both specific and cumulative trauma injuries

California Insurance Guarantee Association (insurer for MB Painting), administered by Intercare Insurance Services, on behalf of Credit General Insurance Company, in liquidation, and administered by Intercare Insurance Services, on behalf of United Pacific Insurance Company, in liquidation, Petitioner v. Workers' Compensation Appeals Board, MB Painting (insured by ACE), Martinez Painting and Wall Covering (insured by State Farm Insurance Company), (Salvador Paz), Respondents, 2011 Cal. Wrk. Comp. LEXIS 190

California Insurance Guarantee Association—Covered Claims—Other Insurance—WCAB upheld WCJ’s finding that CIGA was liable for medical treatment benefits owing to applicant/painter as result of specific injuries and WCJ’s order that CIGA administer medical treatment benefits owing to applicant for both specific injuries and cumulative trauma injuries, subject to claims of contribution against two solvent carriers that had proportionate shares of medical treatment liability for applicant’s cumulative trauma injuries, when WCAB found that applicant’s specific and cumulative trauma injuries caused permanent total disability, that disability was apportioned 72 percent to specific injury and 28 percent to cumulative trauma injury pursuant to Benson v. Workers' Comp. Appeals Bd. (2009) 170 Cal. App. 4th 1535, 89 Cal. Rptr. 3d 166, 74 Cal. Comp. Cases 113, that CIGA had liability for applicant’s specific injury on behalf of insolvent carrier, that specific injury caused need for medical treatment to body parts also injured in cumulative trauma, that CIGA was not shielded from liability for specific injury pursuant to Insurance Code § 1063.1(c)(9), and that, since CIGA initiated medical care for specific injury, it was appropriate for CIGA to continue administration of all future medical care.

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Here’s the rest of the fourth batch of advanced postings for the December 2011 issue of Cal. Comp. Cases. Lexis.com subscribers can link to the complete headnotes and summaries.

San Luis Obispo Tribune, LLC, PSI, administered by York Risk Services Group, Inc., Petitioner v. Workers' Compensation Appeals Board, Arthur Ecker II, Respondents, 2011 Cal. Wrk. Comp. LEXIS 194

Injury to Psyche AOE/COE—Good Faith Personnel Actions—WCAB held that applicant sustained injury AOE/COE to psyche and circulatory system (in form of hypertension) and that applicant’s injury to psyche was not barred by good faith personnel action defense of Labor Code § 3208.3(h), based on opinions of agreed medical evaluator, when WCAB found that…

Seabright Insurance Company, insurer for All American Asphalt, Petitioners v. Workers' Compensation Appeals Board, Carlos Lopez, Respondents, 2011 Cal. Wrk. Comp. LEXIS 193

Petitions for Writ for Review—Court of Appeal denied petition for writ of review, vacated WCAB decision denying petition for reconsideration, and remanded for WCAB to…

Larry Hamilton, Petitioner v. Workers' Compensation Appeals Board, California Insurance Guarantee Association (insurer for Toyota of Poway), administered by Cambridge Integrated Services, on behalf of Fremont Compensation Insurance Company, in liquidation, 2011 Cal. Wrk. Comp. LEXIS 191

Removal to WCAB—WCAB denied petition to remove case to itself, citing 8 Cal. Code Reg. § 10843 and holding that petitioner/applicant did not show irreparable harm or substantial prejudice if removal was not granted regarding WCAB’s denial of applicant’s request for expedited hearing filed 6/30/2011, when applicant…

Nora Medearis, Petitioner v. Workers' Compensation Appeals Board, County of Los Angeles, PSI, Respondents, 2011 Cal. Wrk. Comp. LEXIS 192

Stipulations With Request For Award—Payment of Award—WCAB held that defendant delayed paying stipulations with request for award approved 11/30/2009 for applicant’s two industrial injuries (5/17/2004 and 7/7/2004) and awarded applicant unpaid temporary and permanent disability benefits, increase in benefits under Labor Code § 4650(d), and penalties under…

Temporary Disability—Credit for Overpayment—WCAB held that defendant took credit for alleged overpayment of temporary disability benefits but did not prove credit and ordered defendant to reimburse applicant amount of credit ($651.48) plus 25-percent increase of that amount under Labor Code § 5814, when WCAB found…

Temporary Disability—Credit for Overpayment—WCAB gave defendant credit for temporary disability defendant paid for periods after 6/15/2006 when defendant …

Stipulations With Request for Award—Sanctions for Delay in Payment—WCAB denied applicant’s request for sanctions under Labor Code § 5813 because of defendant’s delay in paying stipulations with request for award, when WCAB found…