In this unpublished case, the Fifth District Court of Appeal was asked to consider 10 findings by the WCJ, adopted on reconsideration by the WCAB.
Among them was a finding that the applicant's no contest plea to a misdemeanor count of workers' compensation fraud - for deposition testimony which conflicted with subrosa tapes - did not prevent her from receiving benefits in the same workers' compensation case.
The facts are long and grueling. The slightly abbreviated version:
After complaining of work-related pain, the applicant was initially treated by an employer-referred doctor. After several weeks of treatment, she requested a change of treaters and agreed to be seen by another employer-referred doctor who thereafter returned her to work with no further need for treatment.
After returning to work she suffered an apparent aggravation of the original injury after falling. The employer referred her back to the same original clinic which opined that the new problems were an aggravation of the first injury. Further physical therapy was prescribed.
The applicant thereafter sought treatment from new doctors but the carrier wouldn't authorize it, claiming that 30 days since the new injury had not yet passed.
Ultimately, the unrepresented applicant was evaluated by QME's, who gave her ratable disability. She continued treatment, unpaid by the carrier, and received EDD benefits.
Sometime during these proceedings, the applicant was charged with two felony fraud counts and ultimately pleaded no contest to one misdemeanor count of workers' comp. fraud based on statements made during her deposition which conflicted with subrosa tapes.
At her subsequent workers' compensation trial, the WCJ made various rulings which included past TD, an EDD lien, who the treater was and that the misdemeanor conviction didn't bar workers' compensation benefits. All findings were in favor of the applicant. The Judge also ruled that the medical record needed augmentation to determine a rating and need for treatment.
On reconsideration, the WCAB incorporated the WCJ's decision. The carrier appealed the 10 adverse findings.
Concluding the WCAB's decision was both reasonable and based on substantial evidence, the appellate court, in its unpublished opinion, denied the carrier's petition and granted the applicant's appellate counsel its request for attorney fees.
The case is Save Mart v. WCAB (Young).
To read the full decision,
PLEASE CLICK HERE.
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