Presents Work Comp Litigation Basics
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Presents Work Comp Litigation Basics By: Chris Griffin Ofer Holzman and Matthew Fernstrom
Transcript of Presents Work Comp Litigation Basics
Presents
Work Comp Litigation Basics
By:
Chris Griffin Ofer Holzman
and Matthew Fernstrom
TableofContents• Applica3ons 2-3• Deposi3ons 4-6 • Pe33ons 7-14• D.O.R.s 15-16• Hearings 17-20• S3psandIssues 21-23• Suppor3ngyourSeHlement 24-25• PostTrialProcedure 26-32
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Applica3ons LC§5500Nopleadingsotherthantheapplica3onandanswershallberequired. Bothshallbeinwri3ngandshall conform to forms prescribed by the appealsboardinitsrulesofprac3ceandprocedure,simplybutclearlyandcompletelydelinea3ngallrelevantmaHersofagreementandallissuesofdisagreementwithinthejurisdic3onoftheappealsboard,andprovidingforthefurnishingofanyaddi3onalinforma3onastheappealsboardmay properly determine necessary to expediteitshearinganddetermina3onoftheclaim.
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Answers
LC§5505IfanydefendantdesirestodisclaimanyinterestinthesubjectmaHeroftheclaimincontroversy,orconsidersthattheapplica3onisinanyrespectinaccurateorincomplete,ordesiresto bring any fact, paper, or document to the aHen3on of theappealsboardasadefense to theclaimorotherwise,hemay,within10daysaTertheserviceoftheapplica3onuponhim,filewithormailtotheappealsboardhisanswerinsuchformastheappeals board may prescribe, seVng forth the par3culars inwhichtheapplica3onisinaccurateorincomplete,andthefactsuponwhichhe intends to rely. A copyof theanswer shall beforthwith served upon all adverse par3es. Evidence uponmaHersnotpleadedbyanswer shallbeallowedonlyupon thetermsandcondi3ons imposedby theappealsboardor refereeholdingthehearing.
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TheDeposi3on
LC § 5710 (a) provides “The appeals board, aworkers’ compensa3on judge, or any party to theac3on or proceeding,may, in any inves3ga3on orhearing before the appeals board, cause thedeposi3on ofwitnesses residingwithin orwithoutthestate tobe taken in themannerprescribedbylaw for like deposi3ons, in civil ac3ons in thesuperiorcourtsofthisstate."
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TheDeposi3on
LC § 5710 (b), when an employer or insurance carrierrequests a deposi3on of an injured employee theemployeeisen3tledtoreceivecoveragebytheemployeror insurance carrier for the expenses associated withaHending thedeposi3onandacopyof the transcriptofthe deposi3on paid for by the employer or insurancecompany. Further, if the injured employee does notspeakorunderstandtheEnglish language,theemployermust pay for a cer3fied language interpreter to be inaHendanceatthedeposi3on.
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TheDeposi3on• Pre-Deposi3onMaterial
– EmployerInves3ga3on– MedicalFile– EmployerRepresenta3ve(Yerav.J.C.Penney(2013)– WitnessStatements– Surveillance– ISO/Index– WageStatement– JobDescrip3on– SubpoenaedRecords
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Pe33ons
• CCR § 10450 (a) A request for ac3on by theWorkers'Compensa3onAppealsBoard,otherthan an Applica3on for Adjudica3on, anAnswer,oraDeclara3onofReadiness,shallbemade by pe33on. ... (b) Unless otherwiseprovidedbystatuteorrule,ananswermaybefiled within 10 days aTer the filing of ape33on.
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Pe33ons
• CCR§10450(e)Allpe33onsandanswersshallbe verified under penalty of perjury in themanner required for verified pleadings incourtsofrecord.Afailuretocomplywiththeverifica3on requirement cons3tutes a validgroundforsummarilydismissingordenyingape33onorsummarilyrejec3ngananswer.
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Pe33ons
• LC§5710(4)AreasonableallowanceforaHorneysfeesforthedeponent,ifrepresentedbyanaHorneylicensedbytheStateBarofthisstate.Thefeeshallbediscre3onarywith,and,ifallowed,shallbesetby,theappealsboard,butshallbepaidbytheemployerorhisorherinsurer.
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Pe33ons
• LC § 132a makes it a misdemeanor for anemployertodiscriminateinanyway,includingdischarge or threat of discharge, against anemployee who has filed or is thinking aboutfiling a workers' compensa3on claim or anemployee who has received a workers'compensa3onaward.
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Pe33ons• LC§4553(SeriousandWillfulMisconduct)
Theamountofcompensa3onotherwiserecoverableshallbeincreasedone-half,togetherwithcostsandexpensesnottoexceedtwohundredfiTydollars($250),wheretheemployeeisinjuredbyreasonoftheseriousandwillfulmisconductofanyofthefollowing:
(a) Theemployer,orhismanagingrepresenta3ve.(b) Iftheemployerisapartnership,onthepartofoneofthepartnersoramanagingrepresenta3veorgeneralsuperintendentthereof.(c) Iftheemployerisacorpora3on,onthepartofanexecu3ve,managingofficer,orgeneralsuperintendentthereof.
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Pe33ons
• VenueLC§5501.5iden3fies3possibleloca3onsforworkers’compensa3onvenues:– Thecountywheretheapplicantresidesatthe3meoffiling;
– Thecountywheretheinjuryallegedlyoccurred;– Thecountywheretheemployee’saHorneymaintainshisorherprincipalplaceofbusiness.
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Pe33ons
• LC§5501.5Venue(c)Ifthevenuesitewheretheapplica3onistobefiledisthecountywheretheemployeesaHorneymaintainshisorherprincipalplaceofbusiness,theaHorneyfortheemployeeshallindicatethatvenuesitewhenforwardingtheinforma3onrequestformrequiredbySec3on5401.5.Theemployershallhave30daysfromreceiptoftheinforma3onrequestformtoobjecttotheselectedvenuesite.Wherethereisanemployerobjec3ontoavenuesiteunderparagraph(3)ofsubdivision(a),thentheapplica3onshallbefiledpursuanttoeitherparagraph(1)or(2)ofsubdivision(a).
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Pe33ons
• LC§5501.6Pe33onforchangeofvenue(a)Anapplicantordefendantmaype33ontheappealsboardforachangeofvenueandachangeofvenueshallbegrantedforgoodcause.Thereasonsforthechangeofvenueshallbespecificallysetforthintherequestforchangeofvenue.(b)Ifachangeofvenueisrequestedfortheconvenienceofwitnesses,thenamesandaddressesofthesewitnessesandthesubstanceoftheirtes3monyshallbespecificallysetforthintherequestforchangeofvenue.
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Declara3onofReadinesstoProceed
• CCR§10414
(a)ExceptwhenahearingissetontheWorkers'Compensa3onAppealsBoard'sownmo3on,nomaHershallbeplacedoncalendarunlessoneofthepar3eshasfiledandservedadeclara3onofreadinesstoproceedintheformprescribedbytheAppealsBoard.Thedeclara3onofreadinessshallbeservedonallpar3esandlienclaimants.(d)Alldeclara3onsofreadinesstoproceedshallstateunderpenaltyofperjurythatthemovingpartyhasmadeagenuine,goodfaithefforttoresolvethedisputebeforefilingthedeclara3onofreadinesstoproceed,andshallstatewithspecificitythesameonthedeclara3onofreadinesstoproceed.Unlessastatusorpriorityconferenceisrequested,thedeclarantshallalsostateunderpenaltyofperjurythatthemovingpartyhascompleteddiscoveryandisreadytoproceedontheissuesspecifiedinthedeclara3onofreadiness.
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Objec3ontoDOR
• CCR§10416(a)Anyobjec3ontoadeclara3onofreadinesstoproceedshallbefiledandservedwithintencalendardaysaTerserviceofthedeclara3on.Theobjec3onshallsetforth,underpenaltyofperjury,specificreasonwhythecaseshouldnotbesetorwhytherequestedproceedingsareinappropriate.(b)Afalsedeclara3onorcer3fica3onfiledunderthissec3onbyanyparty,lienclaimant,aHorneyorrepresenta3vemaygiverisetoproceedingsunderLaborCodesec3on134forcontemptorLaborCodesec3on5813forsanc3ons.
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Hearings
• CCR§10301
(dd)"Statusconference"meansaproceedingsetforthepurposeofascertainingiftherearegenuinedisputesrequiringresolu3on,ofprovidingassistancetothepar3esinresolvingdisputes,ofnarrowingtheissues,andoffacilita3ngprepara3onfortrialifatrialisnecessary.
(v)"MandatoryseHlementconference"meansaproceedingtoassistthepar3esinresolvingtheirdisputeor,ifthedisputecannotberesolved,toframetheissuesands3pula3onsinprepara3onforatrial.
(z)"Priorityconference"meansaproceedinginwhichtheapplicantisrepresentedbyanaHorneyandtheissuesindisputeatthe3meoftheproceedingincludeemploymentand/orinjuryarisingoutofandinthecourseofemployment.
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Hearings
• CCR§10552ExpeditedHearing(a)Whereinjurytoanypartorpartsofthebodyisacceptedascompensablebytheemployer,apartyisen3tledtoanexpeditedhearinganddecisionuponthefilingofanapplica3onforadjudica3onofclaimandadeclara3onofreadinesstoproceedpursuanttosec3on10414establishingabonafide,goodfaithdisputeasto:(1)theemployee'sen3tlementtomedicaltreatmentpursuanttoLaborCodesec3on4600;(2)whethertheemployeeisrequiredtoobtaintreatmentwithinamedicalprovidernetwork;(3)amedicaltreatmentappointmentormedical-legalexamina3on;
(4)theemployee'sen3tlementto,ortheamountof,temporarydisabilityindemnitypayments; (5)theemployee'sen3tlementtocompensa3onfromoneormoreresponsibleemployerswhentwoormoreemployersdisputeliabilityasamongthemselves;or
(6)anyotherissueasprescribedintherulesandregula3onsoftheAdministra3veDirector.(b)Anexpeditedhearingmaybesetuponrequestwhereinjurytoanypartorpartsofthebodyisacceptedascompensablebytheemployerandtheissuesincludemedicaltreatmentortemporarydisabilityforadisputedbodypartorparts.
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Hearings
• CCR§10301(ff)"Trial"meansaproceedingsetforthepurposeofreceivingevidence.
(u)"Lienconference"meansaproceedingheldforthepurposeofassis3ngthepar3esinresolvingdisputedlienclaimspursuanttoLaborCodesec3on4903or4903.1or,ifthedisputecannotberesolved,toframetheissuesands3pula3onsinprepara3onforalientrial.
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Hearings
• ProperlypreparingyouraHorneyforaHearing– Someonewithauthority– BenefitPrintout– WageInforma3on– JobDescrip3on– WitnessesNames
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S3pula3ons
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Issues
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Exhibits
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Suppor3ngyourSeHlement
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FileandServe
• CCR§10301(r)To"file"adocumentmeanstodeliveradocumentorcauseittobedeliveredtothedistrictofficewithvenueortotheAppealsBoardforthepurposeofhavingitincludedintheadjudica3onfile.
(cc)To"serve"adocumentmeanstopersonallydeliveracopyofthedocument,ortosenditinamannerpermiHedbytheserulesortherulesoftheCourtAdministrator,toaparty,lienclaimant,oraHorneywhoisen3tledtoacopyofthedocument.
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PostTrialProcedure
• CCR§10566MinutesofHearingandSummaryofEvidenceMinutesofhearingandsummaryofevidenceshallbepreparedattheconclusionofeachhearingandfiledintherecordofproceedings.Theyshallinclude:(a)Thenamesofthecommissioners,deputycommissionerorworkers'compensa3onjudge,reporter,thepar3espresent,aHorneysorotheragentsappearingthereforandwitnessessworn;(b)Theplaceanddateofsaidhearing;(c)Allinterlocutoryorders,admissionsands3pula3ons,theissuesandmaHersincontroversy,adescrip3velis3ngofallexhibitsreceivedforiden3fica3onorinevidence(withtheiden3tyofthepartyofferingthesame)andthedisposi3on,whichshallincludethe3meandac3on,ifany,requiredforsubmission;(d)AsummaryoftheevidencerequiredbyLaborCodeSec3on5313thatshallincludeafairandunbiasedsummaryofthetes3monygivenbyeachwitness;(e)Ifmo3onpicturesareshown,abriefsummaryoftheircontents;(f)Afairstatementofanyoffersofproof.Ifthedisposi3onisanordertakingoffcalendaroracon3nuance,thereasonthereforshallbegiven.
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PostTrialProcedure
• CCR§10156FormalRaEngInstrucEonsAformalra3ngdetermina3onwillbepreparedbytheDisabilityEvalua3onUnitwhenrequestedbytheAppealsBoardoraWorkers'Compensa3onJudgeonaformspecifiedforthatpurposebytheAdministra3veDirector.Theformwillprovideforadescrip3onofthedisabilitytoberated,theoccupa3onoftheinjuredemployee,theemployee'sageatthe3meofinjury,thedateofinjury,theformulaused,andano3ceofsubmissioninaccordancewithAppealsBoardRulesofPrac3ceandProcedure.
WCJshallnotdiscusstheinstruc3onsoranyotheraspectofthecasewiththeassigneddisabilityevaluator,excepttoclarifyorcorrectclericalortechnicalerrorsoromissions.See:Blacklegevs.BankofAmerica,enbanc,(2010)75CCC613
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PostTrialProcedure
• LC§5800-5816FindingsandAward– FinalDeterminaEonbytheWCJoftheIssuesinDispute
– Decisionmustissuewithin90daysofsubmissionperLC§123.5(a)
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PostTrialProcedure
• LC§5903Pe33onforReconsidera3on
Atany3mewithin20daysaTertheserviceofanyfinalorder,decision,orawardmadeandfiledbytheappealsboardoraworkers’compensa3onjudgegran3ngordenyingcompensa3on,orarisingoutoforincidentalthereto,anypersonaggrievedtherebymaype33onforreconsidera3onupononeormoreofthefollowinggroundsandnoother:
(a)Thatbytheorder,decision,orawardmadeandfiledbytheappealsboardortheworkers’compensa3onjudge,theappealsboardactedwithoutorinexcessofitspowers.(b)Thattheorder,decision,orawardwasprocuredbyfraud.(c)Thattheevidencedoesnotjus3fythefindingsoffact.(d)Thatthepe33onerhasdiscoverednewevidencematerialtohimorher,whichheorshecouldnot,withreasonablediligence,havediscoveredandproducedatthehearing.(e)Thatthefindingsoffactdonotsupporttheorder,decision,oraward.
LC§5904
Thepe33onerforreconsidera3onshallbedeemedtohavefinallywaivedallobjec3ons,irregulari3es,andillegali3esconcerningthemaHeruponwhichthereconsidera3onissoughotherthanthosesetforthinthepe33onforreconsidera3on.
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PostTrialProcedure
• LC§5905AnswertoPe33onforReconsidera3onAcopyofthepe33onforreconsidera3onshallbeservedforthwithuponalladversepar3esbythepersonpe33oningforreconsidera3on.Anyadversepartymayfileananswertheretowithin10daysthereaTer.Suchanswershalllikewisebeverified.Theappealsboardmayrequirethepe33onforreconsidera3ontobeservedonotherpersonsdesignatedbyit.
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PostTrialProcedure
• LC§5950Pe33onforWritofReviewAnypersonaffectedbyanorder,decision,orawardoftheappealsboardmay,withinthe3melimitspecifiedinthissec3on,applytotheSupremeCourtortothecourtofappealfortheappellatedistrictinwhichheresides,forawritofreview,forthepurposeofinquiringintoanddeterminingthelawfulnessoftheoriginalorder,decision,orawardoroftheorder,decision,orawardfollowingreconsidera3on.
• Mustbemadewithin45daysaTerape33onforreconsidera3onisdenied
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PostTrialProcedure
• CRC8.500(e)(1)PeEEonforReviewtotheCASupremeCourtApe33onforreviewmustbeservedandfiledwithin10daysaTertheCourtofAppealdecisionisfinalinthatcourt.
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Q&A
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![index []...p 104—109 comp. 190 p 110—115 comp. 191 p 116—121 comp. 192 p 122—127 comp. 193 p 128—133 comp. 194 p 134—139 comp. 195 p 140—147 comp. 196 p 148—153 comp.](https://static.fdocuments.in/doc/165x107/5f95526362174b59db2f2d15/index-p-104a109-comp-190-p-110a115-comp-191-p-116a121-comp-192.jpg)
