JURISDICTION AND SUBROGATION

In Walker v. Tampa Bay Buccaneers, 2015 Cal. Wrk. Comp. P.D. LEXIS 240, the WCAB affirmed a professional football player's award of 70% PD and declined to enforce a forum selection clause.

THE BUSINESS OF INSURANCE

In Kimco Staffing Services, Inc. v. State of California (2015) 80 CCC 420, the 2nd District Court of Appeal held that LC 3701.9, which prohibits temporary services employers (TSEs) and leasing employers (LEs) from self-insuring their workers' compensation liability, does not violate the equal protection provisions of the U.S. and California constitutions because a rational basis exists for treating TSEs and LEs differently from other employers with respect to self-insurance.

In Watkins, Bell v. New York Giants, 2015 Cal. Wrk. Comp. P.D. LEXIS 291, the WCAB upheld an arbitrator's decision that an insurer for the New York Giants from Sept. 24, 1975, to Jan. 1, 1977, had a duty to defend against the claims of former professional football players who were employed in the 1970s and played games in California while employed with the Giants.

INJURY

In Ramirez-Ramos, Ramirez v. Osteria Coppa, LLC, 2015 Cal. Wrk. Comp. P.D. LEXIS 262, the WCAB held that an employee's death was compensable when, under LC 5402(b), the employer failed to timely deny the claim within 90 days.

In Oyler v. County of Sonoma, 2015 Cal. Wrk. Comp. P.D. LEXIS 228, the WCAB  held that a defendant successfully rebutted the presumption that a deputy sheriff's kidney cancer was compensable under LC 3212.1 by showing that, due to the latency period, there was no reasonable link between his exposure to benzene during employment and development of the cancer.
 
In Lira v. Premium Packing, 2015 Cal. Wrk. Comp. P.D. LEXIS 299, the WCAB held that an applicant's post-termination claim for psychiatric injury was not barred by LC 3208.3(e)(1) when he established that the injury was caused by “sudden and extraordinary events of employment.”

MEDICAL TREATMENT

In Bassell v. International Brotherhood of Electrical Workers, Local 340, 2015 Cal. Wrk. Comp. P.D. LEXIS 247, the WCAB held that an applicant was not entitled to further medical treatment for an injury when she recovered from the effects of her industrial injury and her need for further treatment was only on a nonindustrial basis.

In Ferrona v. Warner Brothers, Time Warner Entertainment Co., 2015 Cal. Wrk. Comp. P.D. LEXIS 220, the WCAB held that, under LC 4600(h), an applicant is not required to obtain renewed or updated prescriptions in order to receive ongoing home health care.

In Tubbs v. Fresno Chaffee Zoo, 2015 Cal. Wrk. Comp. P.D. LEXIS 237, the WCAB majority rescinded a WCJ's award of lumbar spine surgery when it found that the applicant failed to prove the surgery was reasonable and necessary.

In Avila v. University of California Irvine Medical Center, 2015 Cal. Wrk. Comp. P.D. LEXIS 292, the WCAB held that per LC 4610.5(h)(1) and CCR 9792.10.1(b)(1), an IMR application must be received by the administrative director within 30 days of service of the written utilization review determination, and not merely mailed within that time period.

In Arredondo v. Tri-Modal Distribution Services, Inc., 2015 Cal. Wrk. Comp. P.D. LEXIS 209, the panel majority held that an IMR determination is valid even if it does not issue within the time frames of LC 4610.6(d), which provides that the determination must be made “within 30 days of receipt of the request for review and supporting documentation.”

The majority found no valid purpose was served by having a second IMR performed when the only demonstrated concern with the first determination was that it did not issue timely.

In Saunders v. Loma Linda University Medical Group, 2015 Cal. Wrk. Comp. P.D. LEXIS 311, the panel majority held that if an IMR determination does not issue within the time periods established by LC 4610.6(d), the medical treatment dispute no longer is covered by the LC 4610.5 IMR process, and it may be heard and decided by a WCJ at an expedited hearing, per the WCAB's authority under LC 4604.

The majority explained that by using the word “shall,” the Legislature intended to establish mandatory time frames within which IMR must be completed.

In Ribeiro v. Gus JR Restaurant, 2015 Cal. Wrk. Comp. P.D. LEXIS 310, the WCAB held that because an AME reported that the applicant's self-procured treatment was not medically necessary, the defendant was not liable for any permanent disability or temporary disability resulting from that surgery.

TEMPORARY DISABILITY

In Hernandez v. FSP Inc. Services, 2015 Cal. Wrk. Comp. P.D. LEXIS 296, the WCAB held that a defendant was not entitled to credit for reimbursement to the EDD against the 104-week cap for temporary disability indemnity when the parties stipulated that the cap commenced on the first day of the employer's payment of TTD benefits.

In Speer v. Commissioner of Internal Revenue (2015) 80 CCC 444, the U.S. Tax Court held that payments received by a former member of the Los Angeles Police Department on his retirement for unused vacation time and unused sick leave were not excludable from gross income when they were not received under workers' compensation as compensation for personal injuries or sickness.

PENALTIES AND SANCTIONS

In Reed v. Entertainment Partners, Inc., 2015 Cal. Wrk. Comp. P.D. LEXIS 264, the WCAB amended a WCJ's award of LC 5814 penalties and held that a defendant was liable only for penalties two years before the date the penalty petition was filed.

DISCOVERY AND SETTLEMENT

In Hanna v. United Staffing Solutions, Inc., 2015 Cal. Wrk. Comp. P.D. LEXIS 222, the WCAB reversed a WCJ's order excluding an applicant's deposition transcript at trial solely because the applicant was not listed as a witness.

In Murray v. County of Monterey, 2015 Cal. Wrk. Comp. P.D. LEXIS 304, the WCAB rescinded a WCJ's decision and found that a defendant's request for a QME panel was timely under LC 4062.2.

In Wan v. Community Health Network (San Francisco General Hospital), 2015 Cal. Wrk. Comp. P.D. LEXIS 243, the WCAB held that a defendant violated LC 4062.3 and CCR 35 by providing sub rosa surveillance video at the deposition of the QME without having served the video previously on the applicant.

LITIGATION

In Garcia v. Historic Santa Maria Inn, 2015 Cal. Wrk. Comp. P.D. LEXIS 221, the WCAB found good cause for a change of venue from the San Luis Obispo district office to the Santa Barbara office after the applicant changed attorneys.

In Bowman v. Sara Lee Corp., 2015 Cal. Wrk. Comp. P.D. LEXIS 211, the WCAB granted an attorney's petition to be dismissed as the applicant's attorney.

In Angelotti Chiropractic, Inc. v. Baker (U.S. Court of Appeals, 9th Cir., June 29, 2015, No. 13-56996), the 9th U.S. Circuit Court of Appeals affirmed the District Court's decision that the lien activation fee under LC 4903.06 did not violate the takings and due process clauses of the U.S. Constitution.

In Illinois Midwest Insurance Agency, LLC v. WCAB (Long), 2015 Cal. Wrk. Comp. LEXIS 61 (writ denied), the WCAB affirmed an arbitrator's decision that an insurer provided coverage for an applicant's employer.

Complete discussion of these topics can be found in Sullivan On Comp available to subscribers at http://www.workcompcentral.com/sullivan.

Michael Sullivan is the founder of Michael Sullivan & Associates LLP, a workers' compensation defense firm with six offices in California, and author of "Sullivan on Comp," a treatise on California workers' compensation law.