CASE LAW - CT/SOLE CARRIER REFUSES TO ADMIN CLAIM (Californi

The filing and enforcement of liens (different states refer to these with different terms) to secure payment for services or goods against a workers' compensation award is complex and filled with special rules - this category is for questions and discussion of this special area of work comp law.

CASE LAW - CT/SOLE CARRIER REFUSES TO ADMIN CLAIM (Californi

Postby gaiassoul1@yahoo.com on Sat Jun 19, 2010 10:40 am

I know there is case law that say that just because you don't have the bulk of a CT, you cannot refuse to administer a claim while the other carrier is joined and/or identified.

I lost it with the crash and burn of my last computer, any help with this? Can't find it now that I need it.

Thanks in advance.
gaiassoul1@yahoo.com
 
Posts: 658
Joined: Mon Mar 09, 2009 10:06 am

Re: CASE LAW - CT/SOLE CARRIER REFUSES TO ADMIN CLAIM (Californi

Postby stewshe on Mon Jun 21, 2010 8:00 am

Ginger,

I just read your post about C.T. elections and joinder. I'm not sure this is what you had in mind, from pages 216 and 218 under Cumulative Trauma:

...• Election where there is more than one defendant: L.C. §5500.5(c); also MARKS 49
......CCC 486; election permissive per WCJ.............material omitted................

................................material omitted.........................................

...▫ Employer not elected against not allowed to proceed with med-legal exam and depo
......of EE when EE’s attorney objected: Set for hearing vs elected against defendant only,
......KELM 9 CWCR 42, 46 CCC 113

.....................page 218..............................

• Joining more parties, only 1 continuance allowed: L.C. §5500.5(b)

...▫ Joinder needed within one year of filing (not allowed thereafter) or statute may run
...... against un-named defendant: McCLEARY 23 CWCR 68, 59 CCC 841

...▫ Participate in hearing: Party joined after election or first hearing “shall not be entitled
......to” participate, L.C. §5500.5(c)

Stew
James T. Stewart (stewshe@comcast.net)
User avatar
stewshe
 
Posts: 412
Joined: Mon Mar 02, 2009 12:27 pm

Re: CASE LAW - CT/SOLE CARRIER REFUSES TO ADMIN CLAIM (Californi

Postby gaiassoul1@yahoo.com on Tue Jun 22, 2010 10:13 pm

actually Stew, I found it on page 633...under Old Penalties, now I have to find the case to see if it is still applicable...

Defendants, Multiple, each "pointing the finger" at the other, Peanlties allowed against both, I.T.E. Imperial (DORMAN) 43 CCC 302

(The WCJs opinion, not reporetd stated the carrier might have been corrected if it did not owe treatmetn and perhaps only the self-insured employer should pay, but the carrier's remedy, since the treatment was agreed to be industrial, was to provide the treatment and file a lien.......

So, my friend, where do I get copy of that opinion for argument that says all that???? assuming it still applies
gaiassoul1@yahoo.com
 
Posts: 658
Joined: Mon Mar 09, 2009 10:06 am

Re: CASE LAW - CT/SOLE CARRIER REFUSES TO ADMIN CLAIM (Californi

Postby stewshe on Wed Jun 23, 2010 11:35 am

Ginger,
I was the claims examiner on this case around 30 years ago. The opinion was fairly long as I recall and failed to quote the WCJ about finger pointing. There were 3 specifics and a CT. The CT went back many years and at the time (1975) you were not limited to a 1 year period of liability under L.C. 5500.5. The court noted the AA had chosen to proceed only vs. The Hartford and the employer, leaving contribution for prior defendants a matter for further litigation.

There were 3 specifics and a CT. Hartford had 2 specifics after which EE returned to work, no PD. A couple of years later, after working for a year or so as I recall, he had another specific, a bad back injury and also filed a new CT. Arguably a demand for psyche treatment was made to both Hartford and the ER. My thinking was psyche treatment wasn't owed, but if it was, the self-insured ER owed it. I was wrong! Anyhow, I don't think the case will help your fact situation.

My full entry on page 633, if anyone is interested is:

...• Defendants, Multiple, each “pointing the finger” at the other: Penalties allowed
......against both, I.T.E. Imperial (DORMAN) 43 CCC 302 {The WCJ’s opinion, not
......reported, stated the carrier might have been correct it did not owe treatment and perhaps
......only the self-insured employer should pay, but the carrier’s remedy, since the treatment
......was agreed to be industrial, was to provide the treatment and file a lien! Why, reasoned
......the WCJ, should an employee suffer while defendants fight over which one should pay?
......At the time I did not see the wisdom of the decision. I do now.} See discussion of
......contribution between specific injuries as to TD, despite the anti-merger legislation,
......CWCLP §§4:161, 8:161{end} discussing Schutz Instrument (RAVESSOUD) 39
......CCC 161; Thomas J. Lipton Co. (VRANJES) 62 CCC 1325

Stew
James T. Stewart (stewshe@comcast.net)
User avatar
stewshe
 
Posts: 412
Joined: Mon Mar 02, 2009 12:27 pm


Return to Liens

Who is online

Users browsing this forum: No registered users and 1 guest

cron