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Misaye Norikane — ADJ13355568

MISAYE NORIKANE, Applicant vs. SAFEWAY, INC.; permissibly self-insured, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., Defendant

ADJ number
ADJ13355568
Decision date
May 7, 2026
District office
Oakland
WCJ
—
Claim administrator
Sedgwick Claims Management Services, Inc. (administering for permissibly self-insured Safeway, Inc.); California Insurance Guarantee Association (for Western Employers Insurance Company, in liquidation)
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: low back, lumbar spine, right lower extremity (radiculopathy)

LC §5405LC §5412LC §3208.1LC §5500LC §5313LC §4600LC §4650CCR §10450CCR §10787

Summary

CIGA, standing in for the insolvent Western Employers Insurance Company (insuring Benihana for a 1982 low back injury), filed an Application on June 29, 2020, alleging a cumulative trauma to applicant's low back during subsequent employment with Safeway and seeking reimbursement under Insurance Code section 1063.1. The WCJ found CIGA's reimbursement claim time-barred under Labor Code section 5405, reasoning that a 2016 QME report from Dr. Mandell placed CIGA on notice more than one year before filing. The Appeals Board granted reconsideration and rescinded the F&O, holding the WCJ failed to properly determine the date of injury under section 5412 and failed to address tolling of the statute under section 5405(c) based on overlapping medical treatment paid on the companion 1982 claim. The Board returned the matter for development of a proper adjudicatory record, joinder of the concurrent dental employer/carrier, and determination of when applicant first suffered disability and when CIGA last paid benefits.

Issues

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Holding

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Analysis

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Defense takeaway

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Provider takeaway

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