ADJ11813243 · June 27, 2024

The WCAB found the Petition for Reconsideration premature because the WCJ had not yet held a hearing on the Petition to Set Aside the C&R, and thus returned the matter to the WCJ for a substantive hearing to develop the record and make findings.

From the decision · page 7Reconsideration is premature and this matter should be returned to the WCJ for a substantive hearing on the Petition to Set aside the C&R.

The WCJ did not hold a hearing on the Compromise and Release (C&R) before issuing the Order Approving Compromise and Release (OACR).

Favours Defendant prevailed

This lack of hearing meant the WCJ could not assess whether the parties understood the terms of the C&R, making reconsideration premature.

Defendant discovered newly discovered evidence of an Employment Development Department (EDD) lien for benefits paid overlapping with defendant's temporary disability payments.

Favours Defendant prevailed

This newly discovered evidence is the basis for the Petition to Set Aside the C&R, supporting defendant's request for reconsideration.

From the decision · page 6Defendant contends that it learned in a later conversation with EDD that EDD had paid out benefits to applicant from March 5, 2019 through January 19, 2020, thus there are both TTD and EDD payments from March 5, 2019 through January 19, 2020. (Petition For Reconsideration, February 5, 2024, 2:9-2:11.) Further, defendant contends that the OACR should be set aside due to newly discovered evidence of EDD's payment for benefits paid from March 5, 2019 to January 19, 2020 while defendant paid temporary disability benefits. Defendant contends it learned about the EDD Lien for SDI benefits after it filed the C&R on February 5, 2024, and that it notified applicant of EDD's claim in a letter dated March 5, 2024. A DOR was filed and served by defendant on April 11, 2024, requesting a May 8, 2024 hearing for the WCAB to assist the parties with the outstanding EDD lien. On April 24, 2024, defendant filed a Motion to Set Aside Compromise and Release approved on April 8, 20244 or in the alternative, Petition for Reconsideration of the Order Approving Compromise and Release on the grounds of the newly discovered EDD lien. Due to applicant's attorney's scheduling conflicts, the hearing date was moved to June 5, 2024. On April 29, 2024, defendant filed a Petition For Reconsideration, before the WCJ could hold a hearing on their Motion to set aside the Compromise and Release. Thus,

Lab. Code, 5313

The appeals board or the workers' compensation judge shall make and file findings upon all facts involved in the controversy and an award, order, or decision stating the determination as to the rights of the parties.

Applied to emphasize the need for findings and a record to support the decision on the Petition to Set Aside the C&R.

From the decision · page 5The appeals board or the workers' compensation judge shall, within 30 days after the case is submitted, make and file findings upon all facts involved in the controversy and an award, order, or decision stating the determination as to the rights of the parties. Together with the findings, decision, order or award there shall be served upon all the parties to the proceedings a summary of the evidence received and relied upon and the reasons or grounds upon which the determination was made. (Lab. Code, § 5313.)

Lab. Code, 5803.42

The appeals board has continuing jurisdiction over all its orders, decisions, and awards and may rescind, alter, or amend any order, decision, or award for good cause.

Applied to determine the WCAB's authority to reconsider and set aside the OACR.

From the decision · page 2"The appeals board has continuing jurisdiction over all its orders, decisions, and awards made and entered under the provisions of [Division 4]... At any time, upon notice and after the opportunity to be heard is given to the parties in interest, the appeals board may rescind, alter, or amend any order, decision, or award, good cause appearing therefor." (Lab. Code, § 5803.42)

Cal. Code Regs., tit. 8, 10700(b)

The Workers' Compensation Appeals Board shall inquire into the adequacy of all Compromise and Release agreements and may set the matter for hearing to take evidence when necessary.

Applied to support the need for a hearing to determine whether the C&R should be approved or set aside.

From the decision · page 3"The Workers' Compensation Appeals Board shall inquire into the adequacy of all Compromise and Release agreements and Stipulations with Request for Award, and may set the matter for hearing to take evidence when necessary to determine whether the agreement should be approved or disapproved, or issue findings and awards." (Cal. Code Regs., tit. 8, § 10700(b).) The Appeals Board's record of proceedings is maintained in the adjudication file and consists of: the pleadings, minutes of hearing and summary of evidence, transcripts, if prepared and filed, proofs of service, evidence received in the course of a hearing, exhibits marked but not received in evidence, notices, petitions, briefs, findings, orders, decisions, and awards, and the arbitrator's file, if any... Documents that are in the adjudication file but have not been received or offered in evidence are not part of the record of proceedings. (Cal. Code Regs., tit 8, § 10803.)