What the panel ordered
Applicant's Petition for Reconsideration is denied; Defendant's Petition for Reconsideration is granted; the August 7, 2023 Findings and Award is rescinded and the matter is returned to the WCJ for further proceedings.
Applicant and Defendant seek reconsideration of the Findings and Award issued by the WCJ on August 7, 2023.
This docket was decided more than once. Shown here is the latest released decision; we also hold September 24, 2021.
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
The Board found that the EDD was entitled to reimbursement from defendant for all benefits it paid to applicant during the period of temporary total disability, and that defendant is entitled to credit for those reimbursements against temporary disability indemnity benefits owed to applicant. The only issue left to litigate was the amount of UI benefits paid by EDD.
From the decision · page 3DISCUSSION Having reviewed our Decision in the context of the Petitions and the Report, it is clear that we found the EDD was entitled to reimbursement from defendant for all benefits it paid to applicant (whether SDI or UI) during the period that applicant was temporarily totally disabled as a result of his injury; and that defendant is entitled to credit for the reimbursement/payments made to the EDD, against the temporary disability indemnity benefits it owes to applicant. Neither the parties nor the lien claimant (EDD) sought reconsideration or review of our Decision. Thus, it became final, and binding, i.e., the amended Findings were not matters to be litigated after our September 24, 2021 Decision became final. (Lab. Code, § 5901 et seq.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Applicant was temporarily totally disabled from October 23, 2015, through November 17, 2016, due to injury to low back and both legs.
Favours neutral
This established the period for temporary disability indemnity and EDD benefit payments subject to reimbursement and credit.
From the decision · page 2BACKGROUND Applicant claimed injury to his low back and both legs while employed by defendant as a laborer on September 10, 2015. His last day of work for defendant was October 22, 2015. (Minutes of Hearing and Summary of Evidence (MOH/SOE), August 29, 2018, p. 5; Def. Exh. 5.) The EDD paid applicant UI benefits for the period from November 7, 2015, through February 6, 2016, and it paid SDI benefits from March 7, 2016, through October 3, 2016. (Def. Exh. 15; Lien Cl. EDD, Exh. 2.) The parties initially proceeded to trial on August 29, 2018. The subsequent Findings, Orders, and Award was rescinded for further development of the record and the parties again proceeded to trial on January 14, 2020. The March 4, 2020 Findings and Award was rescinded and the parties returned to trial on May 5, 2021. The issues submitted for decision included temporary disability, the permanent and stationary date, and the EDD lien. (MOH/SOE, May 5, 2021, p. 2.) On September 24, 2021, we issued our Decision whereby we affirmed the July 6, 2021 Findings and Award, except we amended it as follows:
EDD paid Unemployment Insurance benefits from November 7, 2015, through February 6, 2016, and State Disability Insurance benefits from March 7, 2016, through October 3, 2016.
Favours neutral
These payments formed the basis for EDD's reimbursement claim and defendant's credit against temporary disability indemnity benefits.
From the decision · page 2BACKGROUND Applicant claimed injury to his low back and both legs while employed by defendant as a laborer on September 10, 2015. His last day of work for defendant was October 22, 2015. (Minutes of Hearing and Summary of Evidence (MOH/SOE), August 29, 2018, p. 5; Def. Exh. 5.) The EDD paid applicant UI benefits for the period from November 7, 2015, through February 6, 2016, and it paid SDI benefits from March 7, 2016, through October 3, 2016. (Def. Exh. 15; Lien Cl. EDD, Exh. 2.) The parties initially proceeded to trial on August 29, 2018. The subsequent Findings, Orders, and Award was rescinded for further development of the record and the parties again proceeded to trial on January 14, 2020. The March 4, 2020 Findings and Award was rescinded and the parties returned to trial on May 5, 2021. The issues submitted for decision included temporary disability, the permanent and stationary date, and the EDD lien. (MOH/SOE, May 5, 2021, p. 2.) On September 24, 2021, we issued our Decision whereby we affirmed the July 6, 2021 Findings and Award, except we amended it as follows:
The Board found that defendant is entitled to credit for reimbursements made to EDD against temporary disability indemnity benefits owed to applicant.
Favours Defendant prevailed
This legal finding determined the offsetting of benefits in the award calculation.
From the decision · page 3DISCUSSION Having reviewed our Decision in the context of the Petitions and the Report, it is clear that we found the EDD was entitled to reimbursement from defendant for all benefits it paid to applicant (whether SDI or UI) during the period that applicant was temporarily totally disabled as a result of his injury; and that defendant is entitled to credit for the reimbursement/payments made to the EDD, against the temporary disability indemnity benefits it owes to applicant. Neither the parties nor the lien claimant (EDD) sought reconsideration or review of our Decision. Thus, it became final, and binding, i.e., the amended Findings were not matters to be litigated after our September 24, 2021 Decision became final. (Lab. Code, § 5901 et seq.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code §§ 5901 et seq. and 5950 et seq.
The EDD is entitled to recover benefits paid to applicant during temporary total disability and defendant is entitled to credit for reimbursements against temporary disability indemnity benefits owed to applicant.
The Board applied these statutes to confirm the reimbursement and credit rights.
From the decision · page 3DISCUSSION Having reviewed our Decision in the context of the Petitions and the Report, it is clear that we found the EDD was entitled to reimbursement from defendant for all benefits it paid to applicant (whether SDI or UI) during the period that applicant was temporarily totally disabled as a result of his injury; and that defendant is entitled to credit for the reimbursement/payments made to the EDD, against the temporary disability indemnity benefits it owes to applicant. Neither the parties nor the lien claimant (EDD) sought reconsideration or review of our Decision. Thus, it became final, and binding, i.e., the amended Findings were not matters to be litigated after our September 24, 2021 Decision became final. (Lab. Code, § 5901 et seq.
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About this page
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