ADJ12089372 — California WCAB decision

What the panel ordered

The WCAB affirmed the Joint Findings and Award issued May 11, 2021, except for an amendment correcting Everest's coverage dates to December 31, 2017 through December 21, 2019.

Petition for Reconsideration filed by defendant Everest National Insurance Company challenging the Joint Findings and Award issued by the WCJ on May 11, 2021.

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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.

Other disputed issueApplicant prevailedfingers · upper extremities · back · shoulders · knee · head · lower extremities · circulatory system · nervous system

The C&R agreement in case ADJ10870218 did not include Everest National Insurance Company and did not cover the injuries or time period of case ADJ12089372; applicant's credible testimony supported that she intended to settle only the first case and not the second; no meeting of the minds existed to settle the second case; therefore, the C&R does not bar the second claim.

From the decision · page 1Defendant Everest National Insurance Company (Everest) seeks reconsideration of the Joint Findings and Award (F&A) issued by a workers' compensation administrative law judge (WCJ) on May 11, 2021, wherein the WCJ found in pertinent part that: applicant claimed cumulative injury from May 17, 2016 to May 17, 2017 to various body parts, while employed as a housekeeper for defendant (case number ADJ10870218); applicant claimed cumulative injury from February 15, 2018 through February 15, 2019 to various body parts, while employed as a housekeeper for defendant (case number ADJ12089372); Everest was the employer's workers' compensation insurance carrier from "December 31, 2017 to December 31, 2017"; there was no evidence that the settlement entered into in case number ADJ10870218 was intended to settle case number ADJ12089372; defendant Everest "lacks standing to litigate the terms of the agreement entered into and the Compromise and Release documents filed in case number ADJ10870218"; and applicant is not barred from pursing the claim in case number ADJ12089372.

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

Everest National Insurance Company was not a party to the C&R agreement in case ADJ10870218.

Favours Applicant prevailed

Because Everest was not a party to the C&R, it has no effect on applicant's right to pursue a claim against Everest in case ADJ12089372.

From the decision · page 6Based on the record before us, there is no evidence that the parties settled applicant's second case (ADJ12089372), in which Everest is the defendant. Pursuant to the plain language of paragraph No. 7 of the C&R, the C&R here was entered into by the "parties": applicant, the employer L.A. Koreana, Inc., also known as YHB Long Beach, DBA Holiday Inn Long Beach Airport and the two named insurance companies, Sompo International Insurance and Cypress Insurance Company, as listed in the C&R. (C&R, pp. 1-4.) These defendants reached an agreement with applicant, in which they agreed to pay consideration to applicant to settle case number ADJ10870218. (C&R, § 1, p. 4, and § 7, p. 8.) Everest was not a party to the C&R, and there is no evidence that Everest entered into any agreement with applicant or agreed to pay any consideration to applicant. (Id.) Thus, the C&R is binding upon the parties that entered into the agreement, while it has no effect on applicant's right to pursue a claim against Everest, which was not a party to that agreement. (Camacho, supra, 4 Cal.App.5th at 306; Yount, supra, 134 Cal.App.3d at 935.)

The C&R agreement in case ADJ10870218 did not include the case number, time period, or body parts of the second case ADJ12089372.

Favours Applicant prevailed

This shows the C&R was limited to the first case and did not settle the second case.

From the decision · page 8We conclude, further, that even if the C&R had not been amended, Everest's contention that the terms of the C&R, as originally written, bar applicant from pursuing her claim in case number ADJ12089372 would be without merit. (Camacho, supra, 24 Cal.App.5th 291.) Applying the legal requirements above to the facts of this case demonstrates that applicant's second case is outside the scope of the C&R agreement in this case: as Everest conceded in its Petition, Everest was not a party to the C&R (Petition, at p. 3); the C&R did not include the case number for applicant's second case (ADJ12089372); and the C&R did not include the later time period, nor the body parts, that were listed in applicant's second case. For each of these reasons, the C&R does not preclude applicant from pursuing her claim in case number ADJ12089372.

Applicant's credible testimony at trial that she intended to settle only the first case and keep the second case open.

Favours Applicant prevailed

The WCJ found this testimony credible and it supported the conclusion that the C&R did not bar the second claim.

From the decision · page 7[She] testified that at the time she signed a settlement document at the WCAB she had two open workers' compensation cases against her employer. It was her intention to settle and close out just one case. When she signed the paperwork she understood she was only trying to close out the one case which she described as the orthopedic case. The other case referred to as a stroke case she wanted to keep open.

The rules the panel named

Authorities as the decision cited them, with how this panel applied each one.

Civil Code sections 1636, 1638, 1639, 1641

A contract must be interpreted to give effect to the mutual intention of the parties as it existed at the time of contracting, ascertained from the writing alone if possible.

The WCJ and WCAB interpreted the C&R agreement language to determine the scope of the settlement and found it limited to the first case only.

From the decision · page 5A contract must be interpreted as to give effect to the mutual intention of the parties as it existed at the time of contracting, so far as the same is ascertainable and lawful. (Civ. Code, § 1636; Camacho v. Target Co. (2018) 24 Cal.App.5th 291, 310 [83 Cal.Comp.Cases 1014]; TRB Investments, Inc. v. Fireman's Fund Ins. Co. (2006) 40 Cal.4th 19, 27; County of San Joaquin v.

Burbank Studios v. Workers' Comp. Appeals Bd. (Yount) (1982) 134 Cal.App.3d 929

Compromise and release agreements require the necessary elements of a contract, including offer, acceptance, and meeting of the minds, to be effective.

The WCJ and WCAB applied this standard to determine that the C&R in case ADJ10870218 did not include the second case ADJ12089372 because there was no meeting of the minds to settle the second case.

From the decision · page 5Compromise and release agreements in workers' compensation matters are governed by the same legal principles as those governing other contracts. (Burbank Studios v. Workers' Co. Appeals Bd. (Yount) (1982) 134 Cal.App.3d 929, 935 [47 Cal.Comp.Cases 832].) For a compromise and release agreement to be effective, the necessary elements of a contract must exist, including an offer of settlement of a disputed claim by one of the parties, and an acceptance by the other. (Id.) There can be no contract unless there is a meeting of the minds, and the parties mutually agree upon the same thing. (Civ. Code, § 1550, 1565, 1580; Sackett v. Starr (1949) 95 Cal.App.2d 128, 133; Sieck v. Hall (1934) 139 Cal.App. 279, 291.) The essential elements of contract also include consideration. (Civ. Code, § 1550, 1584, 1595, 1605, et seq., 1659.) "For a compromise and release agreement to be effective, the necessary elements of a contract must exist, including an offer of settlement of a disputed claim by one of the parties, and an acceptance by the other. [citation] A court has no authority to fashion a compromise and release agreement to which the parties have not themselves agreed." (Yount, supra, 134 Cal.App.3d at 935, citing Burgess v. California Mut. Bldg. & Loan Assoc. (1930) 210 Cal. 180.)

ADJ12089372 · December 18, 2024

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