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PanelLienGranted

Avola, Maria

MARIA AVOLA, Applicant vs. SOUTHERN CALIFORNIA EDISON, permissibly self-insured, Defendant

ADJ number
ADJ9313967
Decision date
May 13, 2024
District office
Los Angeles
WCJ
—
Claim administrator
Southern California Edison (permissibly self-insured)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, PATRICIA A. GARCIA, DEPUTY COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: psyche, internal systems

LC §4661.5LC §4903.1LC §4903LC §4903.05LC §4909LC §5705CCR §10964

Summary

Maria Avola, an IT specialist for self-insured Southern California Edison, sustained industrial injury to her psyche and internal systems during the period February 10, 2009 to February 10, 2010, causing temporary disability from February 10, 2010 through October 3, 2017. The WCJ found her entitled to 104 weeks of temporary disability indemnity but allowed the defendant credit for long-term disability (LTD) payments based on the Employee Benefit Handbook. On reconsideration, the Board held that defendant failed to meet its burden of proving entitlement to credit because it never produced the actual LTD policy and could not establish the parties intended the LTD payments to be an advance on workers' compensation. The Board rescinded the WCJ's decision, denied credit, and increased the temporary disability rate to $1,314.35 per week under Labor Code section 4661.5 since benefits were paid more than two years after the injury. The matter was remanded for further proceedings on attorney's fees and outstanding issues.

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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