WCPanelIQ
PanelGranted

Andrew Tom — ADJ21980525

ANDREW TOM, Applicant vs. CITY OF LOS ANGELES, permissibly self-insured, Defendant

ADJ number
ADJ21980525
Decision date
Jun 14, 2026
District office
Van Nuys
WCJ
—
Claim administrator
City of Los Angeles (permissibly self-insured); Sedgwick (third-party administrator)
Commissioners
JOSEPH V. CAPURRO, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER, PAUL F. KELLY, COMMISSIONER

Injury / body parts: skin

LC §5909LC §5900LC §5902LC §5903LC §3861LC §3856LC §3858LC §3860LC §3852LC §3852(b)CCR §10600CCR §10961CCR §10832CCR §10850CCR §10555

Summary

The City of Los Angeles, permissibly self-insured, filed an Application for Adjudication and a Petition for Credit under Labor Code section 3861 seeking credit against applicant Andrew Tom's net third-party recovery of $594,741.95 from an $800,000 settlement. The WCJ denied the Petition for Credit because no proposed order was included and the proof of service did not reflect service on all parties of record. Defendant sought reconsideration, and the WCJ conceded error, recommending rescission. The Board granted reconsideration, holding there is no requirement that a proposed order accompany a petition for credit and that the WCJ should have issued a notice of intention before denying the petition. The Board rescinded the Order and returned the matter for a hearing on the merits, noting the unrepresented applicant should be apprised of his rights and that firefighter credit limitations under section 3852(b) may apply.

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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