What the panel ordered
The Appeals Board denies defendant's petition for reconsideration and affirms the finding that a contested claim existed when subpoenas were issued in March 2019.
Defendant Berkshire Hathaway Homestate Insurance Company seeks reconsideration of the Appeals Board's March 17, 2025 Opinion granting reconsideration and finding a contested claim existed at the time cost petitioner provided subpoena services.
This docket was decided more than once. Shown here is the latest released decision; we also hold March 17, 2025.
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
The Appeals Board found that a contested claim existed when subpoenas were issued in March 2019 because the employer had issued a delay notice and the claim was on delay status, which constitutes a contested claim under the law and relevant en banc precedent.
From the decision · page 4Section 4620(b)(2) states that: "A contested claim exists when the employer knows or reasonably should know that the employee is claiming entitlement to any benefit arising out of a claimed industrial injury and one of the following conditions exists:... (2) The employer fails to accept liability for benefits after the expiration of a reasonable period of time within which to decide if it will contest the claim." (Emphasis added.)
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Subpoenas were issued on March 13, 2019 and March 20, 2019, during the delay period.
Favours Applicant prevailed
The issuance of subpoenas during the delay period supports the finding that a contested claim existed at that time.
From the decision · page 7Therefore, we continue to conclude that cost petitioner met its burden that a contested claim existed pursuant to section 4620(b) when cost petitioner issued the first subpoena duces tecum on March 13, 2019 (Exhibit 7, 3/13/2019) and the second subpoena duces tecum on March 20, 2019, (Exhibit 9, 3/20/19.) Hence, we make no changes to our Opinion.
Defendant issued a delay notice on February 15, 2019, indicating a dispute regarding the claim.
Favours Applicant prevailed
This delay notice constitutes evidence of a contested claim under Labor Code section 4620(b).
From the decision · page 7application is filed because of a disagreement regarding liability for: Temporary disability, Permanent disability indemnity, Reimbursement for medical care, Rehabilitation, Medical treatment, Supplemental Job Displacement." (Application for Adjudication of Claim, 2/1/2019.) On February 15, 2019, defendant issued a "Notice Regarding Delay of Workers' Compensation Benefit." (Exhibit D, 2/15/2019.) At that point, when defendant issued the delay notice, a contested claim existed under section 4620(b) because the Delay Notice is evidence of a dispute since a claim is contested unless all benefits owing are paid forthwith. Moreover, the Application indicating a disagreement had been filed, thus the claim was contested when the subpoenas issued on March 13, 2019 and March 20, 2019.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code section 4620(b)
A contested claim exists when the employer knows or reasonably should know that the employee is claiming entitlement to any benefit arising out of a claimed industrial injury and either denies the claim outright or fails to act within a reasonable time regarding the claim.
Applied to determine existence of contested claim at time subpoenas were issued.
From the decision · page 4Section 4620(b)(2) states that: "A contested claim exists when the employer knows or reasonably should know that the employee is claiming entitlement to any benefit arising out of a claimed industrial injury and one of the following conditions exists:... (2) The employer fails to accept liability for benefits after the expiration of a reasonable period of time within which to decide if it will contest the claim." (Emphasis added.)
Colamonico v. Secure Transport (2019) 84 Cal. Comp. Cases 1059 (Appeals Board En Banc)
Appeals Board en banc decisions are binding on panels of the Appeals Board and workers' compensation judges as legal precedent under the principle of stare decisis.
Cited to support the binding nature of en banc decisions in determining contested claim existence.
From the decision · page 6However, in 2019, we issued the en banc decision in Colamonico, supra, 84 Cal. Comp.
What proof carried it
The evidence the panel weighed, by kind.
Delay notice issued by defendant and the claim being on delay status at the time subpoenas were issued
From the decision · page 7application is filed because of a disagreement regarding liability for: Temporary disability, Permanent disability indemnity, Reimbursement for medical care, Rehabilitation, Medical treatment, Supplemental Job Displacement." (Application for Adjudication of Claim, 2/1/2019.) On February 15, 2019, defendant issued a "Notice Regarding Delay of Workers' Compensation Benefit." (Exhibit D, 2/15/2019.) At that point, when defendant issued the delay notice, a contested claim existed under section 4620(b) because the Delay Notice is evidence of a dispute since a claim is contested unless all benefits owing are paid forthwith. Moreover, the Application indicating a disagreement had been filed, thus the claim was contested when the subpoenas issued on March 13, 2019 and March 20, 2019.
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About this page
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