What the panel ordered
Petition for Reconsideration dismissed as premature; matter returned to WCJ for further proceedings treating the Petition as one to set aside the OACR and to hold a hearing to create a complete record.
Applicant filed a Petition for Reconsideration of the Order Approving Compromise and Release (OACR) signed by the WCJ on March 14, 2023, which was dismissed as untimely and unverified by the WCJ and the Appeals Board.
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 Petition for Reconsideration was dismissed as untimely and unverified, making it premature for consideration.
From the decision · page 1Applicant acting in pro per1seeks reconsideration of the Order Approving Compromise and Release (OACR) signed by the workers' compensation administrative law judge (WCJ) on March 14, 2023 and issued on March 16, 2023.2
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Applicant speaks only Spanish and did not understand the settlement document which was in English.
Favours Applicant prevailed
This fact supports the need for a hearing to determine if there was mutual agreement and understanding of the settlement terms, justifying setting aside the OACR.
From the decision · page 5Here, applicant contends that the C&R should be set aside. He alleges that he speaks only Spanish and could not read the C&R, which was in English and that his attorney did not tell him that his future medical treatment would be "closed out" after he signed the C&R. Since applicant contends that he did not understand what he was signing, an evidentiary record is necessary to evaluate whether there was mutual agreement as to all of the terms of the agreement. Here, the WCJ did not hold a hearing on the C&R and did not have the opportunity to assess whether the parties understood the meaning of the terms in the C&R. Therefore, the parties must have an opportunity to be heard and the WCJ must create a complete record.
What the panel did with the medical opinions
The role the physician served, and the weight the opinion carried. Physicians are named here as the decision names them; we do not score them.
Declared applicant MMI on 3/10/22 and rated permanent disability between 12-15%. Recommended future medical and psychological treatment.
From the decision · page 2In paragraph nine (9), the parties state in pertinent part as follows: DEFENDANT DISPUTES LIABILITY FOR THIS CLAIM IN ITS ENTIRETY BASED ON LC 3600(A)(l0), LACK OF SUBSTANTIAL MEDICAL EVIDENCE OF INJURY AOE/COE, AND DOES NOT WAIVE DEFENSES BY THIS SETTLEMENT. DEFENDANT CONTENDS IT WOULD OBTAIN A TAKE NOTHING IF THE MATTER PROCEEDED TO TRIAL.... APPLICANT WAS DECLARED MMI BY PTP DR. GUMBS ON 3/10/22. REPORT RATES AT BETWEEN 12 - 15% PD. DEFENDANT CONTENDS THE REPORT IS NOT SUBSTANTIAL MEDICAL EVIDENCE....
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Lab. Code, 5803
The appeals board has continuing jurisdiction to rescind, alter, or amend any order, decision, or award for good cause upon notice and hearing.
Applied to dismiss the untimely Petition for Reconsideration and to require a hearing for setting aside the OACR.
From the decision · page 3"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, § 5803.3)
What proof carried it
The evidence the panel weighed, by kind.
Applicant speaks only Spanish and alleges he was not properly informed by his former attorney that future medical would be closed out by the settlement, and he did not understand the settlement document in English.
From the decision · page 5Here, applicant contends that the C&R should be set aside. He alleges that he speaks only Spanish and could not read the C&R, which was in English and that his attorney did not tell him that his future medical treatment would be "closed out" after he signed the C&R. Since applicant contends that he did not understand what he was signing, an evidentiary record is necessary to evaluate whether there was mutual agreement as to all of the terms of the agreement. Here, the WCJ did not hold a hearing on the C&R and did not have the opportunity to assess whether the parties understood the meaning of the terms in the C&R. Therefore, the parties must have an opportunity to be heard and the WCJ must create a complete record.
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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.
- The injured worker is not named here, and the case caption is not printed. Physicians appear as the decision names them, because a medical opinion is an act in a public proceeding.
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