WCPanelIQ
PanelQMELienGranted in Part

Cory Sather — ADJ12981125

CORY SATHER, Applicant vs. TRION SOLUTIONS, INC.; UNITED WISCONSIN INSURANCE COMPANY, ADMIN. BY NEXT LEVEL ADMINISTRATORS, Defendants

ADJ number
ADJ12981125
Decision date
Apr 11, 2022
District office
Sacramento
WCJ
—
Claim administrator
Next Level Administrators (administering for United Wisconsin Insurance Company)
Commissioners
MARGUERITE SWEENEY, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: right eye, hearing, psyche

LC §3208.3LC §4453LC §5702LC §5803LC §5900LC §5902LC §5903LC §5907

Summary

Applicant Cory Sather, a heavy equipment operator, sustained admitted industrial injury to his right eye and hearing, with a contested psychiatric injury, on October 13, 2019. At the MSC and trial, the parties stipulated to weekly earnings of $800.40 (TTD rate $533.60), but applicant later sought relief from the stipulation because he had received a scheduled 10% raise to $880.44 shortly after the injury that was not reflected. The WCJ initially declined to relieve applicant of the stipulation, finding only unilateral mistake, and deferred TTD pending an EDD lien resolution. On reconsideration, the Board found the petition timely (filed within 20 days of the first final award) and amended the award to reflect applicant's earning capacity under Labor Code section 4453(c)(4), set the TTD rate at $586.90, awarded further medical treatment, and admitted Exhibit 1. The Board relied on its authority under section 5702 to reject stipulations and found good cause under section 5803 because defendant knew or had reason to know the wage stipulation was incorrect.

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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