DAISY REED, Applicant vs. ANGELES HOME HEALTH CARE, INC.; CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For TOWER SELECT INSURANCE NEW YORK/CASTLEPOINT NATIONAL INSURANCE GROUP, In Liquidation, Administered By SEDGWICK CMS, Defendants
ADJ number
ADJ9114534, ADJ9104277
Decision date
Jan 4, 2022
District office
Van Nuys
WCJ
—
Claim administrator
Sedgwick CMS (administering CIGA for Tower Select Insurance New York/CastlePoint National Insurance Group, in Liquidation)
Commissioners
—
Injury / body parts: tooth, mouth, face, neck, cervical spine, lumbar spine, thoracic spine, knees, wrists, shoulders, hips, right hip, right ankle, gastrointestinal system, headaches, hypertension, constipation
Defendant CIGA petitioned for reconsideration of a WCJ's Amended Joint Findings of Fact and Order imposing multiple Labor Code section 5814 penalties and section 5814.5 attorney's fees for unreasonable delay in paying compensation on an underlying permanent total disability award. The Board found the WCJ's decision was unclear (e.g., ambiguous as to whether a $10,000 penalty or 25% of $178.20 was imposed) and failed to properly analyze the relevant statutory framework. The Board rescinded the order and remanded for a complete reanalysis, instructing the WCJ to apply post-2004 section 5814 principles (penalties only on amounts actually delayed), evaluate the section 5814(b) self-imposed penalty defense, perform a Ramirez analysis on penalty amounts, and correctly determine when the award became 'due/final.' The Board took no position on the ultimate resolution.
Issues
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Holding
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Analysis
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Applicant takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Defense takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Provider takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Similar decisions
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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