WCPanelIQ
PanelGranted

Rivas, Humberto

HUMBERTO RIVAS, Applicant vs. UNIVERSAL ALLOY CORPORATION; ACE USA, administered by ESIS; CALIFORNIA INSURANCE GUARANTEE ASSOCIATION by its servicing facility SEDGWICK CLAIMS MANAGEMENT SERVICES, for FREMONT COMPENSATION INSURANCE, in liquidation, Defendants

ADJ number
ADJ786706
Decision date
Date unavailable
District office
Anaheim
WCJ
—
Claim administrator
ESIS (administering for ACE USA); Sedgwick Claims Management Services (servicing facility for CIGA, for Fremont Compensation Insurance, in liquidation)
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, KATHERINE WILLIAMS DODD, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: bilateral upper extremities, arms, hands, wrists, shoulders, neck

LC §5909LC §5900LC §5950LC §5901LC §5907LC §5908LC §5908.5LC §5803LC §4909LC §5950

Summary

Applicant Humberto Rivas suffered an admitted specific injury to his bilateral upper extremities (11/13/1996) and a cumulative trauma injury (6/15/1998-9/20/2000) to his arms, hands, wrists, shoulders, and neck. A 2012 Findings and Award allocated liability for the cumulative trauma claim to ACE USA as 'other insurance' under Insurance Code section 1063.1, relieving CIGA. After CIGA's payments and a reimbursement stipulation, the WCJ found defendant entitled to a $46,351.25 credit against indemnity but disallowed a remaining $10,798.15 credit against future medical care and dismissed applicant's penalty petition. Applicant sought reconsideration arguing defendant never paid temporary disability and cannot profit from its failure to act. The Appeals Board granted reconsideration to further study whether there is any equitable or legal basis allowing defendant to unilaterally apply credit across injuries and species of benefits, deferring a final decision.

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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