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Michael Bell — ADJ12083629

MICHAEL BELL, Applicant vs. COUNTY OF VENTURA, Permissibly Self-Insured; NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PENNSYLVANIA, Defendant

ADJ number
ADJ12083629
Decision date
Mar 10, 2022
District office
Oxnard
WCJ
—
Claim administrator
County of Ventura (Permissibly Self-Insured); National Union Fire Insurance Company of Pittsburgh, Pennsylvania
Commissioners
—

Injury / body parts: heart, valvular heart disease, coronary artery disease, hypertensive heart disease, hypertension, left ventricular hypertrophy

LC §3212.5LC §4663LC §4664LC §5005LC §5412LC §5500.5LC §5904

Summary

Applicant Michael Bell, a deputy sheriff, was found to have sustained a cumulative industrial injury in the form of valvular heart disease, coronary artery disease, and hypertensive heart disease during a period ending March 18, 2016, resulting in 80% permanent disability. The County of Ventura, the self-insured employer, sought reconsideration arguing it was entitled to apportionment or credit based on a 2015 Compromise and Release between applicant and prior carrier National Union Fire Insurance Company that settled 25 claims, including a hypertension claim, for $18,900. The WCAB denied reconsideration, holding that Labor Code section 4663 apportionment is precluded by the law enforcement heart presumption under section 3212.5 and section 4663(e), section 4664 does not apply absent any prior award of permanent disability, and section 5005 credit is unavailable because it applies only when multiple carriers are on the risk during the same section 5500.5 liability period. The PQME found a single cumulative injury spanning the entire employment period, and the County waived any argument about the proper section 5500.5 liability period falling in National Union's coverage.

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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