WCPanelIQ
PanelLienGranted

Amanda Quintanilla — ADJ8710457

AMANDA QUINTANILLA, Applicant vs. SUN HEALTHCARE GROUP dba PROCARE ONE; NATIONAL UNION INSURANCE, administered by BROADSPIRE, Defendants

ADJ number
ADJ8710457
Decision date
Mar 11, 2021
District office
Anaheim
WCJ
—
Claim administrator
Broadspire (administering National Union Insurance)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, DEIDRA E. LOWE, COMMISSIONER

Injury / body parts: left upper extremity

LC §5900

Summary

Applicant Amanda Quintanilla, a nurse, sustained an admitted left upper extremity injury on August 3, 2012 and pursued a civil action against third-party Mission Hospital Regional Medical Center, which settled for $350,000 (net $184,547.28). The dispute was whether defendant was entitled to a third-party credit against future workers' compensation benefits, or whether MICRA (Civil Code section 3333.1) barred such credit because the civil settlement was 'demonstrably reduced' to reflect collateral source contributions. The WCJ found the civil complaint stated a cause of action for professional negligence but concluded applicant failed to prove demonstrable reduction, awarding defendant the credit. On reconsideration, the WCAB panel rescinded the credit, finding substantial evidence — including the civil attorney's sworn declaration, trial testimony, and contemporaneous correspondence — that the settlement was demonstrably reduced by consideration of collateral source payments. The Board held defendant was barred from obtaining the third-party credit under section 3333.1 and Graham.

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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