WCPanelIQ
PanelGranted

Sanchez, Melanie

MELANIE SANCHEZ, Applicant vs. MIANO’S FOOD CORPORATION dba IHOP; HARTFORD INSURANCE COMPANY OF THE MIDWEST, administered by HARTFORD; Defendants

ADJ number
ADJ25485
Decision date
Nov 24, 2024
District office
Van Nuys
WCJ
Mark Polan (Arbitrator)
Claim administrator
Hartford (Hartford Insurance Company of the Midwest); Travelers Casualty & Surety Co.
Commissioners
JOSE A. RAZO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: orthopedic (unspecified)

LC §5500.5LC §5412LC §112LC §115LC §5301LC §5901LC §5908.5LC §5950LC §5906LC §5908LC §5315LC §5701LC §5911LC §5951LC §5909LC §5270LC §5275LC §5501.5LC §4709LC §5903LC §5272LC §5952LC §4622CCR §10320CCR §10330CCR §10995CCR §10605CCR §10390CCR §10914CCR §10205.12

Summary

Defendant Travelers sought reconsideration of an arbitrator's September 21, 2023 Findings of Fact, which determined that the section 5500.5 liability period (date of injury) was May 13, 2009 through May 13, 2010 in accordance with orthopedic AME Dr. Angerman, in a contribution dispute over a cumulative trauma injury. The case file was not transmitted to the Appeals Board until September 26, 2024, well beyond the former 60-day period of section 5909. The Board applied equitable tolling under Shipley, finding the delay was due to administrative error outside the parties' control, and concluded its time to act was tolled until November 25, 2024. The Board also found that service of the WCA's decision was defective on Travelers' out-of-state address, making the petition timely. However, the arbitration record lacked the transcripts of the April 24, 2023 and August 22, 2023 proceedings, preventing meaningful review. The Board granted reconsideration and issued a Notice of Intention to rescind the arbitrator's decision unless a complete record per WCAB Rule 10995(c)(3) is filed within 30 days.

Issues

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Holding

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Analysis

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Applicant takeaway

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Defense takeaway

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Provider takeaway

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