Court Opinion

ID: 9537078
Source: CourtListenerOpinion
Date Created: 2023-08-07 07:12:15.636954+00
Date Added: 2024-06-11T14:55:56.206416
License: Public Domain

RICHARDSON, J., Concurring and Dissenting.
I concur with the majority’s conclusion that an injured worker must appeal an adverse decision of the Rehabilitation Bureau (Bureau) before seeking to reopen a permanent disability decision. I respectfully dissent from my colleagues’ unnecessary discussion of the merits of the potential motion for reopening which might be made should petitioner’s appeal from the Bureau’s decision prove unsuccessful.
The Workers’ Compensation Appeals Board (Board), in denying petitioner’s request to reopen, specifically stated that any claim of inequity arising *247from the disparity between the rehabilitation and disability determinations was “undercut” because petitioner failed to appeal the rehabilitation decision. In the Board’s words, “The time to have raised this point would have been in an appeal from the rehabilitation decision. The inconsistency between the Bureau’s decision and the rationale for the judge’s decision was clear. An appeal could have resolved the conflict. Thus applicant had his remedy but did not choose to avail himself of that remedy.” (Board’s Opinion and Order Denying Reconsideration, Sept. 14, 1981, p. 6.) As a result, the decision from which petitioner now appeals was based primarily on petitioner’s failure to seek appropriate relief. These circumstances render premature the majority’s discussion of what it describes as the “only issue” the Board considered, namely, whether a Bureau determination that an injured worker is not qualified for rehabilitation benefits constitutes good cause to reopen the compensation decision previously rendered by the compensation judge. (Ante, p. 241, fn. 8.) We, of course, do not know the outcome of the appeal from the Bureau’s determination nor the grounds upon which any decision in that appeal will be based.
The majority, while holding that an appeal of the Bureau’s order is a prerequisite to a motion to reopen (ante, pp. 244-245), fails to give sufficient weight to the fact that the Board itself primarily relied upon petitioner’s very failure to appeal as a basis for refusing to reopen its disability decision. In its conclusion, the Board specifically stated “Applicant’s remedy was to have appealed the decision of the Rehabilitation Bureau and to have asserted the inconsistency between the Rehabilitation Bureau’s rationale with the rationale of the judge’s earlier decision.” (Italics added, Board’s Opinion and Order Denying Reconsideration, supra, p. 7.) My colleagues nonetheless discuss the effect of the Bureau’s order, which they admit is not final, and which they have now held did not provide grounds for reopening because it was not appealed. It seems to me that in order to be consistent we should simply reaffirm the requirement that an appeal of an adverse Bureau decision must be taken and remand the case for that purpose. We should leave for a later day the full consideration of the effect of a final refusal to reopen based upon a Bureau decision that rehabilitation is not appropriate.
While believing that any discussion of the merits is dictum, nonetheless I feel it necessary to challenge several aspects of my colleagues’ analysis. In my view, the majority errs in its strong implication (ante, p. 243) that rehabilitation must be provided before a final decision has been made on the extent of a worker’s permanent disability. While citing Webb v. Workers’ Comp. Appeals Bd. (1980) 28 Cal.3d 621, 627 [170 Cal.Rptr. 32, 620 P.2d 618], quoting from Ponce De Leon v. Glaser Brothers (1977) 42 Cal.Comp.Cases 962, 968, to buttress their assertion, my colleagues fail to *248note the important qualifying language in that case: “ ‘However, the ideal situation above referred to will not always occur. For any number of reasons vocational rehabilitation procedures may not start before the applicant has been medically rehabilitated and has become stationary from a purely medical standpoint.’ ” (Webb, at p. 627, citing Ponce De Leon, at p. 968, italics added; see also, 1A Hanna, Cal. Law of Employee Injuries and Workmen’s Compensation (2d ed. 1981) § 19.05[l][a], pp. 19-24.) In fact, both the Board and the Court of Appeal have considered the question of entitlement to temporary rehabilitation benefits in cases where a permanent disability determination has been made before rehabilitation proceedings have commenced, demonstrating that such cases are not infrequent. (See Ponce De Leon, supra, 42 Cal.Comp.Cases at pp. 968-969; Shasta Convalescent Hospital v. Workers’ Comp. Appeals Bd. (1982) 132 Cal.App.3d 997, 1002 [183 Cal.Rptr. 602].) Similarly, the majority itself attempts to fashion a rule for application in instances where the “usual” progression has not occurred (see ante, p. 244), despite its apparent requirement that rehabilitation determinations precede disability decisions. The present case is illustrative. Here, before the case was submitted for decision on the degree of permanent disability, the Bureau issued an order deferring a determination of petitioner’s vocational rehabilitation needs “until clarification has been made by the WCAB as to the extent of disability.” No party objected. Petitioner does not, nor could he, assert that there was any error in the timing of the disability hearing.
Of more significance, the Board’s substantive rationale for denying any reopening of the disability phase in this case is persuasive for several reasons. First, as noted, petitioner failed to avail himself of an administrative opportunity to resolve any ambiguities. Second, there was conflicting evidence. While petitioner, at the hearing on permanent disability, presented evidence from Dr. Dansker, a rehabilitation counselor, who opined that few, if any, jobs would be available to petitioner because of his medical condition, the administrative law judge relied on competent contrary evidence that petitioner was not totally disabled. The judge noted that “The percentage of permanent disability is not the equivalent of a prediction as to whether an injured employee will, in fact, resume employment. Practically all individuals have inherent limitations with respect to such factors as education, intelligence, personality, stamina, or motivation which preclude certain employment areas from their consideration whether or not they have been injured .... The test concerns the ability to compete with other individuals, not the likelihood of finding and holding a job.” Following this original decision, petitioner sought reconsideration which was denied by the judge and by the Board; the Court of Appeal also denied his subsequent petition for writ of review.
*249The decision of the Bureau was based on information from Dr. Dansker which previously had been presented at the hearing on the degree of permanent disability. No new evidence was presented to the Bureau which concluded, based on Dr. Dansker’s opinion, that although petitioner was medically eligible for rehabilitation benefits, it was the Bureau’s “impression that [he] may be unable to be returned to suitable gainful employment via the assistance of the vocational rehabilitation services.” (Italics added.)
The majority reasons that despite the fact that Dr. Dansker’s material had already been presented to the administrative law judge, the rehabilitation decision itself independently created new grounds for reopening. The flaw in this analysis is that nothing in the original disability determination suggested that either the judge or the Board there relied upon any expectation that petitioner would qualify for rehabilitation benefits in reaching the determination of partial disability. An employee is not required to seek rehabilitation. Nor does the statutory provision for rehabilitation benefits require that unless such benefits are appropriate for a particular employee, permanent total disability must be found. While the rehabilitative potential of an employee may well be relevant in the determination of the degree of permanent disability, qualification for the Bureau’s services in no sense is a precondition to a finding of partial as opposed to total disability.
Labor Code section 4660, subdivision (a), provides that in determining the applicable percentage of permanent disability “account shall be taken of the nature of the physical injury or disfigurement, the occupation of the injured employee, and his age at the time of such injury, consideration being given to the diminished ability of such injured employee to compete in an open labor market.” The administrative law judge in the original proceedings made clear that he was relying on petitioner’s condition at the time of the hearing. At no point did the judge indicate that he anticipated petitioner would be able to undertake and complete rehabilitative training through the Bureau. Nor did the judge suggest that his decision that petitioner was partially rather than totally disabled was affected by any expectation that petitioner would undergo such training. (Compare Partenheimer v. Fontainebleau Hotel (Fla. 1974) 291 So.2d 1.)
In conclusion, because (1) the original determination of partial disability did not rely on any expectation that petitioner would successfully undertake rehabilitation, and (2) the Bureau’s determination that petitioner was ineligible for its services rests upon the same information which was considered by the judge who determined the degree of permanent disability, the Board’s order denying reconsideration may have been justified substantively.
*250However, we need not, and should not, consider the issue with the case in its present posture. The majority’s discussion of whether the Bureau’s order provides “good cause” for reopening is mere speculation in the absence of an appeal. More importantly, the Board has, as indicated, expressed its belief that any inconsistencies between the disability and rehabilitation determinations may best be resolved in an appeal of the Bureau’s decision here. I would leave the determination in the first instance to the administrative agency charged with responsibility for reconciling such differences, and defer judicial comment until an actual controversy has been presented.
Respondents’ petition for a rehearing was denied October 6, 1983, and the opinion was modified to read as printed above. Grodin, J., did not participate there. Richardson, J., was of the opinion that the petition should be granted.