WCPanelIQ
PanelQMELienAffirmed

Milagros Paul — ADJ10360307

MILAGROS PAUL, Applicant vs. ICON, INC.; TECHNOLOGY INSURANCE COMPANY, Defendants

ADJ number
ADJ10360307
Decision date
May 30, 2022
District office
Van Nuys
WCJ
—
Claim administrator
AmTrust North America (Technology Insurance Company)
Commissioners
CRAIG SNELLINGS, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER

Injury / body parts: neck, upper extremities, back, shoulders, nervous system, psyche

LC §3752LC §4656LC §4903LC §4904LC §5705LC §5902LC §5904CCR §10617

Summary

Applicant, a hair stylist, claimed a cumulative trauma injury and received temporary disability from both the defendant and EDD during overlapping periods. EDD filed a lien seeking reimbursement of $20,436 for disability payments it made from May 9, 2016, to May 7, 2017. The WCJ found EDD entitled to full reimbursement plus interest, reasoning that an employer on notice of an EDD lien who continues making payments does so at its own peril, and that the two-year temporary disability cap under section 4656(c)(2) is calculated only on payments the defendant actually made. Defendant sought reconsideration arguing EDD should be estopped because reimbursement would result in unjust enrichment. The Appeals Board affirmed, holding defendant waived any notice or lien defect issues and that section 4656(c)(2) does not obviate EDD's entitlement to reimbursement under sections 4903 and 4904.

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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