Applicant Immigration Status Saves Employer From TTD

What happens when federal immigration laws overlap with California workers’ compensation?  A blog post, that’s what!  Let’s say an injured worker is evaluated by her physician who provides work restrictions.  The physician notes that, if the employer can not find work for applicant within his prescribed restrictions, the applicant is to be considered temporarily totally disabled.

The employer has a job waiting for applicant well within the doctor’s restrictions, but then comes the hiccup – applicant is an illegal immigrant and has no documentation of her right to work in the United States.

At trial the applicant’s attorney argues that no work is available for applicant, so she is entitled to TTD.  Defendant, of course, argues that it is ready and willing, but barred by federal law and applicant’s own actions in refusing to comply with United States immigration laws.

These are the facts of Sarahi Cubedo v. Leemar Enterprises, Inc. (a 2011 panel decision).  The Cubedo panel reversed the Workers’ Compensation Judge, ruling that if “defendant made a legitimate offer of modified work that applicant could not accept solely because of her residency status, defendant is not alternatively liable for temporary total disability benefits.”

In so ruling, the Workers’ Compensation Appeals Board relied on the case of Del Taco v. Workers’ Compensation Appeals Board (Jorge Gutierrez), which held that, with regards to entitlement to vocational rehabilitation services, if immigration status is the only bar to an applicant’s return to work, the injured worker is not entitled to vocational rehabilitation.

Once in a while, your humble blogger likes to report on the further developments of Labor Code section 4658(d).  If a worker’s immigration status prevents him or her from accepting an employer’s timely offer to return to the same, modified or original duty, will the employer still receive the benefit of a 15% decrease in permanent disability payments?  Or will the section just be held inapplicable?

If you’ve dealt with this and have a story to tell, don’t hesitate to drop your ever-attentive blogger a line: gregory@grinberglawoffice.com.

When “Presumptively Positive” is No Presumption at All

Would you have any concerns at all if your driver, pilot, or surgeon had tested “presumptive positive” for amphetamine in his or her blood just after commencing services?  “Ladies and gentlemen, we will be cruising at X thousand feet, although there is a storm in the landing area, I feel surprisingly confident because of the presumptive positive amount of amphetamine in my blood.”  Not a particularly encouraging thought.

Applicant Bart J. Johnson was injured while working for Beyette’s Tree Care (uninsured), rendering him a paraplegic.  While in the emergency room, a blood test came back presumptively positive for the presence of amphetamine.  Defendant asserted the intoxication defense of Labor Code section 3600(a)(4), but to no avail.

The Workers’ Compensation Judge concluded that the single report did not prove that applicant was intoxicated at the time of his injury, let alone that intoxication was a substantial cause in his injury.  The Workers’ Compensation Appeals Board and the Court of Appeals concurred.

If you would like to read the Order Denying Reconsideration or the Report and Recommendation of the WCJ, the Lexis citation is 2011 Cal. Wrk. Comp. P.D. Lexis 378, or please e-mail me for a copy: gregory@grinberglawoffice.com.

How is a defendant to prove its case in a situation such as this.  The amphetamine screen came back presumptively positive.  Although this is not a conclusive test, it should at least shift the burden to applicant to show that he was not under the influence of any illegal substance – after all, “presumptively positive” means more likely than not, also known as a preponderance of the evidence.

Although the defense could have provided a foreman witness to testify as to applicant’s behavior on that fateful day, what would the foreman testify to?  Your typical man-on-the-street, foreman, and (without a doubt) most charismatic and eloquent blogger all have experience with alcohol and its visible effects.  Is every employer and supervisor to be charged with expert knowledge in the effects of amphetamine use and its symptoms?

Even if the defense could have satisfied the intoxication defense requirement of showing intoxication, causation would have been another issue.  Could the defendant effectively prove that the injury was sustained as a result of the intoxication?  According to the WCJ, the answer is “no.”

In any case, your captain would like to use his first drink to toast to the safety of our flight.  Cheers!

“Sloppy, Unprofessional and Worthy of Sanctions…”

Have you ever had a petition come across your desk only to think to yourself, “gee, this sure is sloppy, unprofessional and worthy of sanctions?”  If you’re an adjuster or a defense attorney, the answer is probably yes; and then you went about responding to the citations made to the Civil Code of Fantasy Land or whatever else is being argued in the matter at hand.  Now we know, at least occasionally, the commissioners of the Workers’ Compensation Appeals Board find themselves in the same situation.

Sanctions cases are always fun.  For every time the defense community has been wronged, a sanctions case gives us hope that, the next time we’re being harassed, threatened, shaken down, and agitated by obsessed applicants, over-zealous attorneys, or frivolous lien-claimants, that we’ll petition for sanctions and we’ll get them.

In what is quickly becoming “sanctions week” at your humble blogger’s domain, I recently had case of David Hernandez v. Russell Fisher Partnership (insured by ICW Group/Explorer Insurance Company) brought to my attention.  There, applicant appealed from a Workers’ Compensation Judge’s  “take-nothing” order, arguing that the WCJ was mistaken in finding a defense witness credible and the applicant less than so.  The WCAB quickly dispatched the basis for the petition by recognizing that the WCJ is generally afforded an enormous amounts of deference in matters of judging credibility.

The WCAB then continued, noting that applicant’s attorney violated California Code of Regulations section 10842 by attaching as an exhibit the Further Minutes of Hearing and Summary of Evidence to her petition for reconsideration.  But, to take it one step further, this copy of the Minutes had something special: applicant’s hand-written notes and comments.  The WCAB allowed the attorney and the law firm to respond and explain its violation of section 10842.

In her response, applicant’s attorney apologized for “attaching ‘parts of the record already received’ to the petition,” but the WCAB was not impressed with her failure to address the “interlineations with hand-written arguments in the margin.”  The WCAB declared applicants attorney’s “actions to be sloppy, unprofessional and worthy of sanctions in the amount of $250.oo”  In somewhat of an understatement, the WCAB found that “[s]ubmitting an annotated version of the Minutes of Hearing and Summary of Evidence shows a lack of judgment.”

Your proud and upright blogger will decline to name names in this case.  Any readers determined to find the offending party can e-mail me for a copy of the panel opinion.  But I am pleased (my no doubt the constant, overriding goal for all judges in this fine State) with the WCAB standing up for the rules – without a doubt the defense had to absorb the litigation costs of this clearly baseless petition, and though the $250 will not bankrupt applicant’s attorney, perhaps the embarrassment and the record of sanction will help to curb the more egregious behavior.

A special thanks to Kent H. Ball, Esq., of ICW Group Insurance Companies for providing me with copies of these panel opinions.

Mileage Rate to Remain the Same on January 1, 2012

It looks like the mileage rate for treatment,  medical-legal evaluations, etc., will remain the same as of January 1, 2011, according to this release made by the Internal Revenue Service.  As previously discussed, the compensation for mileage is tied to the IRS’s rating, and applies to California Workers’ Compensation.

So remember, for every mile driven, you owe that applicant 55 cents!

But, also remember, that the mileage reimbursement is part of the Labor Code section 4600 duty imposed upon the employer to provide all treatment “reasonably required” to cure or relieve from the effects of the industrial injury.  This means that you can get MapQuest directions, with total mileage, and compensate the employee from his house (you know, the one you had to ship the hot-tub to) to the deposition and back, and no more.  If the employee starts submitting ridiculous mileage reimbursement requests, you might have to rein him in.

The Spooky Sanctions of Skeletal Petitions

Often enough, lien claimants will wage a war of attrition against defendants, hoping that the looming cost of litigation will soften the resolve of defendants in terms of paying undeserving liens.  I have had lien claimants tell me that their settlement demand is cheaper than me “coming down to the Board to litigate” the claim – I’m sure most of us have.  The recent decision in the case of Alfonso Alcaraz v. Hronis, Inc., presents such a situation, and the Workers’ Compensation Appeals Board sanctioned two lien claimants for such behavior.  (My earlier readers may recall a discussion, many blog posts ago, that advocated using sanctions to restrain the greedy little appetites of lien claimants.)

The underlying case was settled by compromise and release, and defendant agreed to pay, adjust, or litigate all liens of record.  The matter of two lien claimants, K. Rad Payman, M.D., and Silver Orthopedic Center, proceeded to trial.  Following the May 3 lien trial, the Workers Compensation Judge issued a Findings of Fact, Orders & Award on June 7.  Defendant filed a Petition for Reconsideration on July 1, and on July 14 the WCJ rescinded his Findings of Fact, Orders & Award, and set the matter for an additional hearing.  So here is where it gets weird…

On July 15, both lien claimants filed a petition for reconsideration, seeking relief from the WCJ’s original, and already rescinded, Findings.

The WCAB ordered the petitions dismissed as moot, but then continued in their opinion to note that the petitions would be dismissed in any case, because they were skeletal and untimely.  (Remember, petition for reconsideration must be filed and received by the Board within twenty days of the issuance of the underlying decision, plus five for mailing if the decision was served by mail.)

The petitions themselves were the very definition of skeletal – claiming new information was found without describing said information or how it would affect the case.  Employing the tactic of Scheherazade, the lien claimants hoped to fill the commissioners with an unyielding curiosity.  Needless to say, the Board was not amused.

On its own motion, the Board sanctioned both lien claimants for their petitions, which were “without merit and done solely for the purpose of causing unnecessary delay or a needless increase in the cost of litigation and are not justifiable.”

Realistically speaking, the sanctions imposed are not going to do much to deter such behavior.  $250 is a cost of doing business, not a “scared straight” event.  On the other hand, sanctions like these are a great thing for another reason – they build up a record that can be used in the future, like in the case of a certain hearing representative.

Aladdin would be proud…

Did You Remember to Include Those Exhibits with Your Appeal?

In the case of County of Mendocino v. Workers’ Compensation Appeals Board, the Court of Appeal denied a petition for writ of review because of a procedural error – it appears that the appellant failed to include exhibits pursuant to the California Rules of Court.

The rule, in pertinent part, reads:

“(1)A petition to review an order, award, or decision of the Workers’ Compensation Appeals Board must include:

(A)The order, award, or decision to be reviewed; and

(B)The workers’ compensation judge’s minutes of hearing and summary of evidence, findings and opinion on decision, and report and recommendation on the petition for reconsideration.”

Even in our time of electronic transmittals, one-click file-sharing, and EAMS connectivity, it appears that exhibits must still be attached to appeals.

From what your humble blogger can gather, the merits of the appeal were never reached.

Is a Venue Fight Worth It? Part 1 of 2

The venue of a workers’ compensation case might seem like a relatively unimportant issue for someone outside the workers’ compensation industry.  After all, the case-law, labor code and California Code of Regulations are all state-wide in application right?  Sadly, if the Easter Bunny, Santa Claus, and state-wide uniformity of workers’ compensation law were all helping you paint your house, you would be engaged in a solo project.  All three are, of course, figments of the imagination.

If you are not familiar with the sad reality of “local rules,” I am sorry to be the one to burst this proverbial bubble for you.  Each venue has its own rules as to procedure, filing deadlines, etc.  For example, the accepted custom at Fresno is to have all exhibits filed and served twenty days before the trial.  If there are more than twenty days left until trial, the other side does not want them, and neither does the Board.

On the other hand if you appear for a Mandatory Settlement Conference in Oakland without your exhibits (and an EAMS separator sheet for each one), with copies for the applicant, lien claimant, Board, and curious strangers passing by, you’re not going to have a lot of material to work with come trial.

Just about every administrative director, including the recently appointed Rosa Moran, has sworn to stamp out local rules for the various boards. Although the Workers’ Compensation Community is readily giving of its best wishes, its confidence in such a matter is considerably more shy and reserved.

Aside from local rules, issues such as cost of travel, reputation of judges (sadly, some Workers’ Compensation Judges are known to be more receptive to one side than the other), and availability of witnesses all play into the question of whether it is worthwhile for a party to fight for a change in venue.

So, now that you are thoroughly persuaded that venue does matter, come back tomorrow morning for the procedure and law behind it all.

Happy Thanksgiving!

A pessimist will tell you that circumstances couldn’t possibly be any worse, and an optimist will tell you that they most certainly could.  On Thanksgiving day, even your humble cynic, your loyal pessimist blogger, knows it could all be worse.  Though times can be rough, skies cloudy, and the future uncertain, we all have much to still be thankful for.

So enjoy the video, remember to say thanks, and have a great Thanksgiving!

Giving Even Less Credit Where Credit Is Due

A recent case (Sompo Japan Insurance Company of America v. Workers’ Compensation Appeals Board) popped up on my radar as an employer tried (and failed) to contract around workers’ compensation benefits.

Gerald Lark was employed by Canon Business Solutions when he allegedly sustained an injury to his back, left shoulder, psyche and internal system.  A few days after the date of injury, applicant entered into a “severance agreement and general release,” by which the employer would pay applicant 44 weeks of wages.  When applicant was released to work roughly a month after his date of injury, there was no job to return to.

Applicant filed a declaration of readiness to proceed to an expedited hearing, claiming he was owed temporary disability.  The Workers’ Compensation Judge concluded that applicant was entitled to ongoing temporary disability payments and that defendant was entitled to no offset or credit for the 44 weeks of severance already paid.

The Workers’ Compensation Appeals Board denied defendant’s petition for reconsideration, adopting the WCJ’s report and recommendation.  The WCJ argued, in his report and recommendation, that reconsideration should be denied because the severance agreement was not reviewed by a Workers’ Compensation Judge.

But… applicant got the money.

Temporary disability is paid out at 2/3rd of an applicant’s income, for up to two years.  Here, applicant is receiving his entire paycheck for 44 weeks (or 57 weeks of temporary disability), presumably all at once.

Yet, defendant is somehow not entitled to credit for money already paid.  Does it really matter what we call it?  Severance, temporary disability, get-well-soon fund, it shouldn’t matter.  Applicant received a benefit from his employer and, pocketing the money, now wants more.

Sadly, the Court of Appeal denied defendant’s petition for a writ of review, and thus declined to correct this injustice to an employer.