What the panel ordered
WCAB affirms WCJ's April 4, 2019 Findings of Fact denying UEBTF's request for credit against death benefits for civil settlement proceeds received by decedent's wife.
Petition for Reconsideration filed by Uninsured Employers Benefits Trust Fund (UEBTF) seeking credit against its liability for death benefits was granted for further study; WCJ denied credit in April 4, 2019 Findings of Fact; WCAB after reconsideration affirms WCJ's denial.
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.
UEBTF failed to prove entitlement to credit because the civil settlement proceeds received by the decedent's wife were for loss of companionship, a separate claim not compensable as workers' compensation benefits to the deceased employee or dependent.
From the decision · page 3In its Petition, UEBTF contends that pursuant to sections 3709, 3709.5, and 3732, it is entitled to a mandatory credit for the applicant's civil settlement recovery. UEBTF asserts that the WCJ erroneously placed the burden upon it to prove "double recovery" between the death benefits that it paid to the applicant and the third party settlement proceeds in order obtain the credit. (Petition, pp. 3-6, citing Lab. Code, § 3709, 3709.5, 3732.) UEBTF argues that, if anything, it was the applicant's burden to prove that the civil suit was unrelated to her husband's industrial injury/death, and that the settlement proceeds thus did not constitute overlapping workers' compensation benefits for which UEBTF could claim credit.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Favours Applicant prevailed
This settlement was a separate claim by the dependent spouse and not compensable as workers' compensation benefits to the deceased employee or dependent, thus not subject to credit.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Martinez v. Associated Engineering & Construction Co. (1979) 44 Cal.Comp.Cases 1012 (Appeals Board en banc)
Defendant bears the burden of proof to establish entitlement to credit for third party settlement proceeds against workers' compensation benefits.
The WCJ correctly placed the burden on UEBTF to prove entitlement to credit, which UEBTF failed to meet.
From the decision · page 3Upon review, we conclude that the WCJ correctly placed the burden of proof upon UEBTF. We have previously explained that the defendant bears the burden of proof to establish entitlement to credit. In Martinez v. Associated Engineering & Construction Co. (Martinez) (1979) 44 Cal.Comp.Cases 1012, 1021 (Appeals Board en banc),3 we explained:
Labor Code sections 3861, 4700 et seq.
Section 3861 allows credit to employer for recovery by employee for injury, but does not apply to dependent's separate recovery for loss of consortium.
The civil settlement proceeds received by the dependent spouse for loss of companionship are not compensable as workers' compensation benefits and thus not subject to credit under section 3861.
From the decision · page 3Section 3861 governs the allowance of credit in a Workers' Compensation Appeals Board proceeding, and states, in pertinent part:
What proof carried it
The evidence the panel weighed, by kind.
Testimony of Mohinder the applicant that the civil settlement included compensation for loss of companionship.
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About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
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