What the panel ordered
Reconsideration denied; Findings and Award affirmed; contribution allowed for new and distinct benefits in Compromise and Release Agreement; Zurich responsible for 29% of Compromise and Release and Stipulated Award of temporary disabilityp. 31
Reconsideration granted to study factual and legal issues; decision after reconsideration issued affirming prior Findings and Award and Petition for Contribution rulings
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.
Zurich American Insurance Company was found responsible for 29% of the Compromise and Release Agreement and the Stipulated Award of temporary disability based on insurance coverage periods and injury periods.
From the decision · page 1324. The Arbitrator found, based on the medical report of the Agreed Medical Evaluator, the value of future medical treatment, the MSA and approval by CMS and the fact the AME found applicant's rheumatoid arthritis to various body parts was aggravated by his employment at California Pizza Kitchen and applicant's fibromyalgia was aggravated by his employment at California Pizza Kitchen, the Arbitrator finds the amount of the settlement is reasonable. 25. The Arbitrator found that American Home Assurance Company did not fail to file a timely Petition for Contribution against Hartford because Hartford had no liability for the second different continuous trauma injury. 26. The Arbitrator, based on the findings above, found that Zurich American Insurance Company is responsible for 29% of the amount of the Compromise and Release Agreement and 29% of the Stipulated Award of temporary disability. 27. The Arbitrator found that Zurich American Insurance Company is entitled to a credit for the sums they paid to the applicant in an amount to be adjusted between the parties with the Arbitrator retaining jurisdiction in case of a dispute. That credit is limited by the fact they are responsible for 29% of that amount paid and, therefore, the credit is 71% of the amount that they paid. 28.
The Petition for Contribution was timely as to the Compromise and Release Agreement approved in 2017, despite being untimely for the original 2007 Findings and Award, because the Compromise and Release was a new and distinct benefit.
From the decision · page 7We agree with the WCA that pursuant to the case of Rex Club v. Workers' Comp. Appeals Bd. (Oakley-Clyburn) (1997) 53 Cal.App.4th 1465 [62 Cal.Comp.Cases 441, the one-year statute of limitations outlined under section 5500.5(e) applies to any award of compensation benefits, not only final awards. Thus, even if American was untimely with respect to the original F&A issued on January 16, 2007, the existence of that F&A has no bearing on American’s reimbursement and/or contribution rights with respect to the Compromise and Release Agreement approved via OACR on May 31, 2017. As outlined above, American timely sought reimbursement and/or contribution for the Compromise and Release Agreement via their First Amended Petition for Contribution filed on the same date. Accordingly, we affirm the September 22, 2022 decision by the WCA.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
The Compromise and Release Agreement approved on May 23, 2017, was a new and distinct benefit different from the original 2007 Findings and Award.
Favours Applicant prevailed
This allowed the Petition for Contribution filed by American Home Assurance Company to be timely as to the Compromise and Release Agreement despite being untimely for the original award.
From the decision · page 7We agree with the WCA that pursuant to the case of Rex Club v. Workers' Comp. Appeals Bd. (Oakley-Clyburn) (1997) 53 Cal.App.4th 1465 [62 Cal.Comp.Cases 441, the one-year statute of limitations outlined under section 5500.5(e) applies to any award of compensation benefits, not only final awards. Thus, even if American was untimely with respect to the original F&A issued on January 16, 2007, the existence of that F&A has no bearing on American’s reimbursement and/or contribution rights with respect to the Compromise and Release Agreement approved via OACR on May 31, 2017. As outlined above, American timely sought reimbursement and/or contribution for the Compromise and Release Agreement via their First Amended Petition for Contribution filed on the same date. Accordingly, we affirm the September 22, 2022 decision by the WCA.
Zurich American Insurance Company had insurance coverage from May 24, 2001 through September 6, 2001, during which the applicant sustained cumulative trauma injury.
Favours Defendant prevailed
This established Zurich's liability for 29% of the Compromise and Release Agreement and Stipulated Award of temporary disability.
From the decision · page 14It was also stipulated that applicant's claim of injury to the psyche, internal, fingers, arms, shoulders, neck, spine, and legs had been dismissed. The applicant continued to be employed by California Pizza Kitchen from 1994 until September 6, 2001. the applicant Diaz, filed an Application for Adjudication of Claim alleging a cumulative trauma injury from June 1, 1992 through September 6, 2001, while applicant was employed as a cook for California Pizza Kitchen. Insurance coverage for California Pizza Kitchen was as follows: American Home Assurance Company, administered by AIG Claims, Inc., had insurance coverage for the period May 9, 2000 through May 24, 2001. Zurich American Insurance Company had insurance coverage for the period from May 24, 2001 through September 6, 2001. On January 12 2007 a Findings and Award issued against elected defendant American Home Assurance Company administered by AIG Claims, Inc. finding applicant sustained a cumulative trauma injury from approximately June 1, 1992 through September 6, 2001 to applicant's bilateral hands, bilateral knees, bilateral shoulders, back, internal system (rheumatoid arthritis and fibromyalgia) arising out of and occurring in the course of employment as a cook by
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.
Found that future medical treatment was required to cure or relieve the injured worker from the effects of the injury.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
LC 5500.5
Section 5500.5 of the California Labor Code regarding contribution and liability periods for cumulative injury claims
Applied to determine timeliness and allocation of contribution petitions.
From the decision · page 4Pursuant to section 5500.5(c) then, an “employee may obtain an award for the entire disability against any one or more of successive employers or successive insurance carriers if the disease and disability were contributed to by the employment furnished by the employer chosen or during the period covered by the insurance even though the particular employment is not the sole cause of the disability.” (Colonial Ins. Co. v. Industrial Acc. Com. (1946) 29 Cal.2d 79, 82 [11 Cal.Comp.Cases 226].) An applicant may also choose not to elect against a particular defendant and proceed against all insurers or employers. (Industrial Indemnity Co. v. Workers’ Comp. Appeals Bd. (1997) 60 Cal.App.4th 548, 554-556 [62 Cal.Comp.Cases 1661].) However, if an applicant elects to proceed against a single insurer, the insurer is entitled under section 5500.5 to seek contribution for awarded benefits from the remaining insurers in subsequent proceedings. (See Schrimpf v. Consolidated Film Industries, Inc. (1977) 42 Cal.Comp.Cases 602 (Appeals Bd. en banc).) With respect to contribution proceedings, in order to ascribe liability to the correct carriers, the liability period for a cumulative injury must be established pursuant to section 5500.5(a) which states, in relevant part, that “liability for occupational disease or cumulative injury claims … shall
Rex Club v. Workers' Comp. Appeals Bd. (1997) 53 Cal.App.4th 1465
One-year statute of limitations for contribution petitions applies to any award of compensation benefits, including supplemental awards
Applied to uphold timeliness of Petition for Contribution for the Compromise and Release Agreement.
From the decision · page 7We agree with the WCA that pursuant to the case of Rex Club v. Workers' Comp. Appeals Bd. (Oakley-Clyburn) (1997) 53 Cal.App.4th 1465 [62 Cal.Comp.Cases 441, the one-year statute of limitations outlined under section 5500.5(e) applies to any award of compensation benefits, not only final awards. Thus, even if American was untimely with respect to the original F&A issued on January 16, 2007, the existence of that F&A has no bearing on American’s reimbursement and/or contribution rights with respect to the Compromise and Release Agreement approved via OACR on May 31, 2017. As outlined above, American timely sought reimbursement and/or contribution for the Compromise and Release Agreement via their First Amended Petition for Contribution filed on the same date. Accordingly, we affirm the September 22, 2022 decision by the WCA.
What proof carried it
The evidence the panel weighed, by kind.
Medical report of Agreed Medical Evaluator Stuart Silverman supporting future medical treatment and aggravation of rheumatoid arthritis and fibromyalgia by employment
From the decision · page 1324. The Arbitrator found, based on the medical report of the Agreed Medical Evaluator, the value of future medical treatment, the MSA and approval by CMS and the fact the AME found applicant's rheumatoid arthritis to various body parts was aggravated by his employment at California Pizza Kitchen and applicant's fibromyalgia was aggravated by his employment at California Pizza Kitchen, the Arbitrator finds the amount of the settlement is reasonable. 25. The Arbitrator found that American Home Assurance Company did not fail to file a timely Petition for Contribution against Hartford because Hartford had no liability for the second different continuous trauma injury. 26. The Arbitrator, based on the findings above, found that Zurich American Insurance Company is responsible for 29% of the amount of the Compromise and Release Agreement and 29% of the Stipulated Award of temporary disability. 27. The Arbitrator found that Zurich American Insurance Company is entitled to a credit for the sums they paid to the applicant in an amount to be adjusted between the parties with the Arbitrator retaining jurisdiction in case of a dispute. That credit is limited by the fact they are responsible for 29% of that amount paid and, therefore, the credit is 71% of the amount that they paid. 28.
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