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California WCABPanel decision

ADJ3444089 · November 12, 2021

The Workers' Compensation Appeals Board affirmed the September 19, 2019 Findings and Order denying the petitions for contribution/reimbursement filed by SCIF and Oak River Insurance Company, ordering that they take nothing.

Issues decided: 1
Medical opinions weighed: 0
Authorities named: 1
District office: Los Angeles

What the panel ordered

The Workers' Compensation Appeals Board affirmed the September 19, 2019 Findings and Order denying the petitions for contribution/reimbursement filed by SCIF and Oak River Insurance Company, ordering that they take nothing.

Petition for Reconsideration filed by State Compensation Insurance Fund (SCIF) seeking review of the September 19, 2019 Findings and Order after arbitration on petitions for contribution/reimbursement.

Read the official decision →

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.

Other disputed issueDefendant prevailed

The arbitrator and Appeals Board found no statutory or equitable basis for contribution or reimbursement between the defendants in separate workers' compensation cases, affirming the denial of the petitions.

From the decision · page 1Defendant State Compensation Insurance Fund (SCIF) seeks reconsideration of the September 19, 2019 Findings and Order issued after an arbitration proceeding on petitions for contribution/reimbursement filed by SCIF and Oak River Insurance Company. The arbitrator found that both defendants failed to prove entitlement to either statutory or equitable relief on their petitions and ordered that they take nothing.

The facts that decided it

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ADJ3444089 — California WCAB decision · SimilarCase

The petitions for contribution/reimbursement involved separate workers' compensation cases with different employers and insurance carriers, each defending their own case independently.

Favours Defendant prevailed

This fact showed that statutory or equitable relief for contribution or reimbursement was not applicable, leading to denial of the petitions.

From the decision · page 4Although both parties started their process by labeling their Petitions as a Petition for Contribution, the facts presented do not support such labeling. This is not continuing trauma with two employers having a portion of a one year injurious exposure. This is not one employer being elected against, and having to defend the entire case and afterward seeking reimbursement from other carriers not elected against. These are two continuing trauma cases against two different employers with different insurance carriers. Both defendant carriers provided their own defense. Both defendants secured med/legal opinions to bolster their case against applicant and each other. Both defendants hired different counsel, and both insurance companies had a different process in administering their claims. The result is that the relief for the carriers lies in equity through a Petition for Reimbursement, not statutory law (L.C 5500.5).

Neither defendant provided authority or logic to support why the other should pay any part of their administrative or medical/legal costs incurred in their own case.

Favours Defendant prevailed

Lack of justification for reimbursement supported the denial of the petitions.

From the decision · page 5carrier did administrative duties that would benefit the other. Both used their own bill review process, their own photocopy services, their own interpreters, and their own med/legal and AME doctors. All of which were aimed at defending their interest in their own case, and avoiding any liability for applicant's claim, or deflecting liability to the other carrier. Neither party has provided any authority or any logic as to why the co-defendant should be obligated to pay any part of these costs.