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 WCAB found that the time to act on the petitions for reconsideration was tolled due to the Appeals Board's failure to act within 60 days through no fault of the parties, and thus granted reconsideration.
From the decision · page 1I. As a preliminary matter, we note that a petition for reconsideration is generally considered denied by operation of law if the Appeals Board does not grant the petition within 60 days after it is filed. (Lab. Code, § 5909.) However, we believe that "it is a fundamental principle of due process that a party may not be deprived of a substantial right without notice...." (Shipley v. Workers' Comp. Appeals Bd. (1992) 7 Cal.App.4th 1104, 1108 [57 Cal.Comp.Cases 493].) In Shipley, the Appeals Board denied the applicant's petition for reconsideration because it had not acted on the petition within the statutory time limits of Labor Code section 5909. This occurred because the Appeals Board had misplaced the file, through no fault of the parties. The Court of Appeal reversed the Appeals Board's decision, holding that the time to act on applicant's petition was tolled during the period that the file was misplaced. (Shipley, supra, 7 Cal.App.4th at p. 1108.) Like the Court in Shipley, "we are not convinced that the burden of the system's inadequacies should fall on [a party]." (Shipley, supra, 7 Cal.App.4th at p. 1108.) In this case, the Appeals Board failed to act on both lien claimant and defendant's Petitions for Reconsideration within 60 days of filing through no fault of the parties. Therefore, we find that our time to act on both petitions was tolled.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Appeals Board failed to act on petitions for reconsideration within 60 days through no fault of parties.
Favours Applicant prevailed
This failure tolled the time to act on the petitions, allowing reconsideration to proceed.
From the decision · page 1I. As a preliminary matter, we note that a petition for reconsideration is generally considered denied by operation of law if the Appeals Board does not grant the petition within 60 days after it is filed. (Lab. Code, § 5909.) However, we believe that "it is a fundamental principle of due process that a party may not be deprived of a substantial right without notice...." (Shipley v. Workers' Comp. Appeals Bd. (1992) 7 Cal.App.4th 1104, 1108 [57 Cal.Comp.Cases 493].) In Shipley, the Appeals Board denied the applicant's petition for reconsideration because it had not acted on the petition within the statutory time limits of Labor Code section 5909. This occurred because the Appeals Board had misplaced the file, through no fault of the parties. The Court of Appeal reversed the Appeals Board's decision, holding that the time to act on applicant's petition was tolled during the period that the file was misplaced. (Shipley, supra, 7 Cal.App.4th at p. 1108.) Like the Court in Shipley, "we are not convinced that the burden of the system's inadequacies should fall on [a party]." (Shipley, supra, 7 Cal.App.4th at p. 1108.) In this case, the Appeals Board failed to act on both lien claimant and defendant's Petitions for Reconsideration within 60 days of filing through no fault of the parties. Therefore, we find that our time to act on both petitions was tolled.
Favours Applicant prevailed
This stipulation resolved the matter and was approved by the WCAB, ending further litigation.
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.
Contended WCJ erred in failing to make findings on reasonableness and necessity of medication reimbursement and fee schedule value of treatment provided by lien claimant.
Petition for reconsideration by lien claimant Edwin Haronian, M.D., argued WCJ error on findings regarding medication reimbursement and fee schedule value.
From the decision · page 2II. Both lien claimant, Edwin Haronian, M.D., and defendant, Wesco Insurance Company, administered by Amtrust, timely petitioned for reconsideration of the Findings and Award issued by the workers' compensation administrative law judge (WCJ) in this matter on October 12, 2021. In that decision, the WCJ found that lien claimant properly provided medical treatment outside the [MPN] to applicant from July 12, 2017 through August 21, 2018, and ordered a review of the billing of Dr.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Lab. Code, 5909
Petition for reconsideration is generally denied by operation of law if not acted upon within 60 days (Lab. Code, 5909).
The Appeals Board's failure to act within 60 days tolled the time to act on petitions for reconsideration due to due process concerns.
From the decision · page 1I. As a preliminary matter, we note that a petition for reconsideration is generally considered denied by operation of law if the Appeals Board does not grant the petition within 60 days after it is filed. (Lab. Code, § 5909.) However, we believe that "it is a fundamental principle of due process that a party may not be deprived of a substantial right without notice...." (Shipley v. Workers' Comp. Appeals Bd. (1992) 7 Cal.App.4th 1104, 1108 [57 Cal.Comp.Cases 493].) In Shipley, the Appeals Board denied the applicant's petition for reconsideration because it had not acted on the petition within the statutory time limits of Labor Code section 5909. This occurred because the Appeals Board had misplaced the file, through no fault of the parties. The Court of Appeal reversed the Appeals Board's decision, holding that the time to act on applicant's petition was tolled during the period that the file was misplaced. (Shipley, supra, 7 Cal.App.4th at p. 1108.) Like the Court in Shipley, "we are not convinced that the burden of the system's inadequacies should fall on [a party]." (Shipley, supra, 7 Cal.App.4th at p. 1108.) In this case, the Appeals Board failed to act on both lien claimant and defendant's Petitions for Reconsideration within 60 days of filing through no fault of the parties. Therefore, we find that our time to act on both petitions was tolled.
Shipley v. Workers' Comp. Appeals Bd. (1992) 7 Cal.App.4th 1104
Due process requires notice before depriving a party of a substantial right (Shipley v. Workers' Comp. Appeals Bd. (1992) 7 Cal.App.4th 1104).
The Appeals Board's misplaced file tolled the time to act on petition for reconsideration; burden should not fall on party.
From the decision · page 1I. As a preliminary matter, we note that a petition for reconsideration is generally considered denied by operation of law if the Appeals Board does not grant the petition within 60 days after it is filed. (Lab. Code, § 5909.) However, we believe that "it is a fundamental principle of due process that a party may not be deprived of a substantial right without notice...." (Shipley v. Workers' Comp. Appeals Bd. (1992) 7 Cal.App.4th 1104, 1108 [57 Cal.Comp.Cases 493].) In Shipley, the Appeals Board denied the applicant's petition for reconsideration because it had not acted on the petition within the statutory time limits of Labor Code section 5909. This occurred because the Appeals Board had misplaced the file, through no fault of the parties. The Court of Appeal reversed the Appeals Board's decision, holding that the time to act on applicant's petition was tolled during the period that the file was misplaced. (Shipley, supra, 7 Cal.App.4th at p. 1108.) Like the Court in Shipley, "we are not convinced that the burden of the system's inadequacies should fall on [a party]." (Shipley, supra, 7 Cal.App.4th at p. 1108.) In this case, the Appeals Board failed to act on both lien claimant and defendant's Petitions for Reconsideration within 60 days of filing through no fault of the parties. Therefore, we find that our time to act on both petitions was tolled.
Lab. Code, 5313
Labor Code section 5313 penalty and interest may be waived by stipulation.
The parties waived penalty and interest provisions in their stipulation for lien payment.
What proof carried it
The evidence the panel weighed, by kind.
Appeals Board failed to act on petitions for reconsideration within 60 days through no fault of parties, tolling time to act.
From the decision · page 1I. As a preliminary matter, we note that a petition for reconsideration is generally considered denied by operation of law if the Appeals Board does not grant the petition within 60 days after it is filed. (Lab. Code, § 5909.) However, we believe that "it is a fundamental principle of due process that a party may not be deprived of a substantial right without notice...." (Shipley v. Workers' Comp. Appeals Bd. (1992) 7 Cal.App.4th 1104, 1108 [57 Cal.Comp.Cases 493].) In Shipley, the Appeals Board denied the applicant's petition for reconsideration because it had not acted on the petition within the statutory time limits of Labor Code section 5909. This occurred because the Appeals Board had misplaced the file, through no fault of the parties. The Court of Appeal reversed the Appeals Board's decision, holding that the time to act on applicant's petition was tolled during the period that the file was misplaced. (Shipley, supra, 7 Cal.App.4th at p. 1108.) Like the Court in Shipley, "we are not convinced that the burden of the system's inadequacies should fall on [a party]." (Shipley, supra, 7 Cal.App.4th at p. 1108.) In this case, the Appeals Board failed to act on both lien claimant and defendant's Petitions for Reconsideration within 60 days of filing through no fault of the parties. Therefore, we find that our time to act on both petitions was tolled.
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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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