Source: https://www.judgeobrien.com/index.php?option=com_content&view=article&id=2570&Itemid=138
Timestamp: 2019-04-25 23:43:23+00:00

Document:
20.1.10.2 What Does "Asserted" Mean?
20.1.15.1 What Constitutes Pre-Termination Psychiatric Treatment?
20.1.21 Disability Increased by Negligent Medical Provider, Consequence of?
20.12.2 When is Permanent Disability Payable?
20.16.7 Who Qualifies as a Dependent?
20.16.16 How are Death Benefits Paid?
20.18.6.1 An "Insurer" is not Included Within the Meaning of "Employer"
20.19.2 When do Fund Payments Commence?
20.19.8 Who Pays Cost of Fund Liability?
20.19.9 Who Defends the Fund?
20.5.9 When Does an Injury Arise out of an Employee's Employment (AOE)?
20.5.10 When is an Employee Acting in the Course of Employment (COE)?
20.5.11.10 What is "Heart Trouble"?
20.5.11.11 What do the Words "Develops or Manifests Itself" Mean?
20.7.18.1.1 How Often can an Injured Employee Change Treating Physicians if his or her Employer has not Established a Medical Provider Network or a Health Care Organization?
20.7.32.10 How an Injured Employee Enters the "Medical Provider Network"
20.7.32.13 If a Dispute Still Exists Over Treatment or Diagnosis, how is it Resolved?
20.7.32.15 How Does the Administrative Director Select the Independent Medical Reviewer?
40.20.1 When Does Statutory Time to File Commence to run?
40.2.14 Settlement of a Subrogation Claim in a Third-Party Suit for Less Than the Workers' Compensation Insurance Benefits Paid, Where the Settlement Will Result in a Loss to the Insured, may Constitute "Bad Faith"
40.3.7 When is an Appeals Board's Decision Binding?
50.3.12 Who is a Manufacturer?
70.4.0 Uninsured Employers, Consequences of?
The state of California has, over the years, enacted laws establishing programs designed to alleviate the hardships experienced by workers of this state in times of distress. These programs are structured in such a way as to render assistance expeditiously, inexpensively, and without encumbrance of any nature, with the goal of reducing to a minimum the suffering caused to workers in certain situations.
The distress toward which a certain body of these laws is directed is that which may be visited upon a worker and, in many cases, upon his or her family, when he or she becomes unable to work and needs an income and/or is in need of medical care due to an on-the-job injury. Assistance for such a worker or his or her family comes from the Workers’ Compensation Insurance Program.
This book is a concise and realistic explanation of the Workers’ Compensation Insurance Program and designed in such a way as to introduce the reader to the basic provisions of the program by use of extensive quotes from the Labor Code, Regulations and Case Law.
To more readily assist our readers, we have produced a separate book for the State Disability Insurance program, the Unemployment Insurance program, and the Paid Family Leave.
Case citations have been carefully selected and those that are given are not always intended to constitute authority for, or against, the conclusions drawn or the analysis given, but may be intended to refer the reader to an authority that discusses the general subject matter or the specific subject of analysis in more detail.
If the reader is using cases cited in this book to support a Petition for a Writ of Review, or Petition to the Supreme Court, it is important to check the official cases to be certain that they are still “published”. “Unpublished” California Court of Appeal cases cited in this book may not be cited in any action or proceeding before an Appellate Court, except where the opinion is relevant under the doctrines of "law of the case", "res judicata", or "collateral estoppel" or where the opinion is relevant to a criminal or disciplinary action because it states reasons for a decision affecting the same defendant or respondent in another such action. Cases cited as published, unpublished, or writ denied in this book may be changed by subsequent actions and therefore it is imperative that the reader shepardize before citing.
In 1964, the California Supreme Court ordered Courts of Appeal to designate which of its opinions were to be deemed "published" and which were to be deemed "unpublished". This rule was intended to relieve attorneys from the burden of researching thousands of Appellate Court decisions each year that neither interpreted new law nor involved legal issues of continuing public interest.
Then effective January 1, 1974, the California Supreme Court and the State Judicial Council ruled that "unpublished" opinions of the Courts of Appeal or opinions of a Department of a Superior Court could not be cited in Court proceedings, by a Court or a party in any other action or proceeding except when the opinion was relevant under the doctrine of the case, res judicata, or collateral estoppel, or in a criminal action or proceeding involving the same defendant or a disciplinary action or proceeding involving the same respondent.
Except as provided in (b), an opinion of a California Court of Appeal or superior court appellate division that is not certified for publication or ordered published must not be cited or relied on by a court or a party in any other action.
On request of the court or a party, a copy of an opinion citable under (b) must be promptly furnished to the court or the requesting party.
A published California opinion may be cited or relied on as soon as it is certified for publication or ordered published. See also 40.14.43 of this book for further discussion.
This prohibition applies even though the cases may be available in print in LexisNexis California Workers' Compensation Cases. See California Rules of Court, above. However, although cases denied Writ of Review, as well as Board En Banc, and Panel decisions, have no "stare decisis" effect at Appellate Courts, they are, in very limited circumstances, citable authority as to the holding of the Appeals Board. This is consistent with the well-established principle that "contemporaneous administrative construction" of a statute by the agency charged with its enforcement and interpretation, while not necessarily controlling, is of great weight, and Courts will not depart from such an Appeals Board construction unless it is clearly erroneous or unauthorized. (Smith v. W.C.A.B (2000) 65 Cal.Comp.Cases 277 (Published), First District; Ralph’s Grocery Co. v. W.C.A.B. (1995) 60 Cal.Comp.Cases 840 (Published); and Tenet/Centinela Hospital Center v. W.C.A.B. (Rushing) (2000) 65 Cal.Comp.Cases 477 (Published).) However, when cited to a Court, they are of limited value and the reader should advise the court as to the reason for the citation.
The above rules in no way limits the citing of any decision to a Workers' Compensation Judge or the Appeals Board.
However, in Woodward v. Tri Corp. Construction (2014) 2014 Cal.Wrk.Comp. P.D. LEXIS 104 (Panel Decision), the Board panel observed that although parties generally should not cite an unpublished Court of Appeal decision in a Petition for Reconsideration or Answer or other communications with the Judge or Board, counsel may cite such decisions if they indicate they are not citing the case as authority. Counsel may inform a Jude or Board panel that while counsel acknowledges that unpublished decisions are not binding on anyone, other than the parties in that case, counsel is offering the unpublished decision for consideration of the argument made by the successful counsel in the unpublished decision.
In Cubeudo v. Leemar Enterprises, Inc. et al,. 2011.Cal.Wrk.Comp.P.D. Lexis 356 (Panel Decision), the three Commissioners reprimanded the Workers Compensation Administrative Law Judge for supporting his decision by relying upon an unpublished Court of Appeal case.
California Rules of Court, Rule 8.1115 provides that a published California opinion may be cited or relied upon as soon as it is certified for publication or ordered published.
Almost all Appeals Board "En Banc" decisions are cited throughout this book. Once the Board, by majority vote, declares a decision "En Banc", that decision is binding on panels of the Appeals Board and Workers' Compensation Judges as legal precedent under "stare decisis." See Title 8 of the California Code of Regulations, section 10341 and Labor code sections 133 and 5307.
However, SPD decisions are not binding precedent as are Board "En Banc" decisions on panels of the Appeals Board and Workers' Compensation Judges.
Citations from the California Workers’ Compensation Reporter are now included inasmuch as the Reporter is a properly citable authority, especially as an indication of contemporaneous interpretation and application of workers’ compensation law by the Appeals Board and any of it's three panel Commissioners. See Griffith v. W.C.A.B. (1989) 54 Cal.Comp.Cases 145, Second District (Published).
Persons citing the above sources should be careful to check to make certain that a particular case being cited has not been reversed or amended on higher appeal.
Further, LexisNexis now publishes what it calls "Noteworthy Panel Decisions" which are other panel decisions it feels makes a contribution to the body of law available to attorneys, claims personnel, Judges and the Appeals Board, and others seeking to understand the Workers' Compensation laws of California. Many of these cases are cited throughout the book. Do not confuse these "Noteworthy Panel Decisions" with cases with "Significant Panel Decisions" or the cases reported in the "California Workers' Compensation Reporter."
The reader should be aware that ever since this program was enacted in 1917 the Legislator has time and again changed the law in various ways and attention must be paid as to whether a particular change applies to all claims regardless of date of injury or only to claims filed after the particular change was made by the Legislator.
For example, effective 1/1/2013 the Legislators made massive changes in this law when they enacted Senate Bill 863.
In Section 84 of SB 863 the Legislator stated, "This act shall apply to all pending matters, regardless of date of injury, unless otherwise specified in this act, but shall not be a basis to rescind, alter, amend, or reopen any final award of workers' compensation benefits."
I have continued my initial goal, in this thirteenth edition of setting forth sufficient facts and language used in leading cases from the California Supreme Court, Court of Appeals, and Workers’ Compensation Appeals Board, so that rarely will the reader have to seek out the case itself to fully understand the reasoning of the Court or Board.
Realizing that in certain instances the reader must have the precise language of a Labor Code Section or Regulation at hand, we have added throughout this book direct quotes from these sources. Further, we have added for the convenience of the reader, the complete Labor Code sections pertaining to Workers’ Compensation, the Regulations adopted by the Division of Workers’ Compensation, and the Workers’ Compensation Appeals Board in the Appendix.
Finally, I hope I have succeeded in my goal of sorting out and bringing to our readers’ attention those endless laws, regulations and cases of which we all must be aware in the field of Workers’ Compensation.
To sort out is not enough. I hope I have placed the cases, codes and regulations in those places you will logically look to see if there is law on the issue under study.

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