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ADJ17401990 — California WCAB decision · SimilarCase

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California WCABPanel decision

ADJ17401990 · June 9, 2023

Petition for Reconsideration dismissed as premature; matter returned to WCJ for further proceedings on applicant's petition to set aside the OACR.

Issues decided: 1
Medical opinions weighed: 1
Authorities named: 1
District office: Van Nuys

What the panel ordered

Petition for Reconsideration dismissed as premature; matter returned to WCJ for further proceedings on applicant's petition to set aside the OACR.

Applicant, in pro per, petitioned for reconsideration of an Order Approving Compromise and Release (OACR); the WCAB reviewed the petition and dismissed it as premature, returning the matter to the WCJ for further proceedings.

Read the official decision →

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.

Reconsideration / removalRemandedleft wrist

The record was insufficient to determine whether a contract was formed, whether applicant withdrew from the settlement, and whether the settlement was adequate; no hearing was held and the WCJ did not assess applicant's understanding of the agreement.

From the decision · page 5Accordingly, we dismiss the Petition as premature, and return the matter to the WCJ for further proceedings consistent with this opinion. Upon return of this matter to the trial level, we recommend that the WCJ treat the Petition as a petition to set aside and set a hearing so applicant can provide evidence in support of her arguments and create a record upon which a decision can be made by the WCJ.

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No hearing was held and the record was insufficient to determine contract formation, withdrawal, and adequacy of the settlement.

Favours neutral

The lack of evidence and hearing prevented a decision on the merits, resulting in dismissal of the petition as premature and remand to the WCJ.

From the decision · page 5While applicant alleges that she attempted to cancel acceptance of the settlement, as the WCJ notes, there is no evidence in the record on that issue. Consequently, the record is insufficient as to the issues of whether a contract was formed, whether applicant wished to withdraw from the settlement agreement, and whether the settlement was adequate.

Applicant alleged she attempted to withdraw from the settlement agreement prior to defendant's acceptance and claimed lack of understanding regarding the release of future medical care and QME rights.

Favours neutral

These allegations called into question whether a contract was formed and whether the settlement was adequate, leading to the remand for further proceedings.

From the decision · page 4Here, applicant contends that she contacted the adjuster to withdraw from the settlement. If applicant withdrew from the settlement agreement prior to defendant's acceptance, it calls into question whether a contract was created. Moreover, applicant contends that she was not aware that she was resolving future medical care and was not advised that she was entitled to an evaluation by a panel QME, which calls into question what applicant's understanding was at the time that the settlement was negotiated. We observe that generally, the determination of compensability, the existence or extent of permanent impairment, and limitations, if any, resulting from an injury all require a medical evaluation. As an unrepresented employee, an evaluation by a QME, as opposed to a treating physician, to determine compensability, if any, and the existence or extent of permanent impairment is the appropriate course. (Lab. Code, § 4060-4062.3.)