Consani v. Workers' Compensation Appeals Board & Safeway Stores, Inc.

227 Cal. App. 3d 12, 277 Cal. Rptr. 619, 56 Cal. Comp. Cases 45, 91 Cal. Daily Op. Serv. 817, 91 Daily Journal DAR 1324, 1991 Cal. App. LEXIS 102
CourtCalifornia Court of Appeal
DecidedJanuary 29, 1991
DocketA049648
StatusPublished
Cited by12 cases

This text of 227 Cal. App. 3d 12 (Consani v. Workers' Compensation Appeals Board & Safeway Stores, Inc.) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Consani v. Workers' Compensation Appeals Board & Safeway Stores, Inc., 227 Cal. App. 3d 12, 277 Cal. Rptr. 619, 56 Cal. Comp. Cases 45, 91 Cal. Daily Op. Serv. 817, 91 Daily Journal DAR 1324, 1991 Cal. App. LEXIS 102 (Cal. Ct. App. 1991).

Opinion

Opinion

PETERSON, J.

This case presents a question on which courts of appeal have divided in interpreting the penalty provisions of Labor Code 1 section 5814 after the Supreme Court’s decision in Gallamore v. Workers’ Comp. Appeals Bd. (1979) 23 Cal.3d 815 [153 Cal.Rptr. 590, 591 P.2d 1242].

We will hold, in annulling and remanding the decision of the Workers’ Compensation Appeals Board (Board), that the “entire amount” of a particular class of workers’ compensation benefits, on which the 10 percent penalty provided by section 5814 is calculated, includes all nondelayed voluntary payments of such class of benefits which are made by an employer before issuance of an award.

I. Facts and Procedural History

Between October 23, 1985, and October 12, 1987, Armando Consani filed five workers’ compensation claims for back injuries sustained while em *15 ployed as an investigator for Safeway Stores. In February 1987, he underwent lumbar surgery which consisted of a two-level fusion at L4-5 and L5-Sl. In November 1987, Consani’s treating physician, Charles Barnes, M.D., reported that X-rays showed a solid fusion at L4-5 but not at L5-S1. Dr. Barnes’s report stated: “The low back remains a problem. He is large, having gained weight, now at 240 [pounds]. [Nutri-System] would benefit this patient if authorized by the carrier.”

Consani immediately went to Nutri-System, obtained a contract for a weight-loss program that cost $1,244, and hand delivered it to the claims department of Safeway with a note asking for approval. Safeway did not respond. In December 1987 and in January 1988, Consani’s counsel wrote letters to Safeway demanding that it approve the weight-loss program. Safeway did not respond. In March 1988, Consani’s counsel filed a petition for a 10 percent penalty for unreasonable delay in paying for the weight-loss program. The petition asked that the penalty be computed by multiplying 10 percent times the cost of “all medical treatment, past, present and future.... "

A hearing on the petition was scheduled for June 15, 1988, and then continued to July 19. In late June, Safeway was served with a prescription prepared by Dr. Barnes on June 20. It stated: “Nutri-System—for Weight Loss []f] Diagnosis: Solid fusion at L4-5; delayed fusion at L5-S1 [11] (Weight interfering with fusion)” Safeway responded by agreeing to pay for the weight-loss program.

At the hearing on the petition for a penalty assessment, Safeway argued that it had not unreasonably delayed payment for the weight-loss program. Safeway pointed out that Consani had enrolled in the Nutri-System program on a voluntary basis on previous occasions. In addition, for three years, Safeway had provided Consani with membership in a physical fitness club, namely the Diablo Athletic Club. Safeway had declined to pay for the weight-loss program because there was no evidence that such treatment was reasonable or necessary to cure or relieve the effects of this injury.

In her decision filed on August 22, 1988, the workers’ compensation judge (WCJ) found that Safeway had unreasonably delayed payment for the weight-loss program. The WCJ also found that Consani was entitled to a 10 percent penalty assessed against the “full dollar value of all medical treatment provided to date . . . .” less an attorney fee of 12 percent. The next day, August 23, the WCJ amended her decision by extending the 10 percent penalty against the value of all future medical treatment.

Safeway filed a petition for reconsideration, which the Board granted. The Board found that Safeway “failed to seasonably and/or reasonably *16 provide a weight loss program for [Consani].” It modified the WCJ’s decision by limiting the penalty to which Consani was entitled to 10 percent of the full dollar value of (a) his weight-reduction program, and (b) all medical expenses of any type reasonably, actually, and necessarily incurred after August 23, 1988 (the date of the WCJ’s decision). A majority of the Board, thus, ruled that the penalty could not be assessed against the value of medical treatment Safeway had theretofore voluntarily paid without delay ($44,537.81) and without compulsion of an award. One Board member, in a concurring and dissenting opinion, urged that the 10 percent penalty should be limited to the cost of the weight-loss program alone. No review is sought of that portion of the Board’s decision finding the employer unreasonably delayed the provision of that portion of Consani’s medical treatment consisting of a weight-loss program and its assessment of penalty against future medical benefits.

Consani petitions this court for a writ of review of the Board’s decision, The sole issue presented is whether the 10 percent penalty authorized by section 5814 must be assessed against the entire cost of the class of Consani’s workers’ compensation benefits comprising medical expenses, including that portion thereof the employer voluntarily paid without delay before any award was made.

II. Discussion

Section 5814 provides: “When payment of compensation has been unreasonably delayed or refused, either prior to or subsequent to the issuance of an award, the full amount of the order, decision or award shall be increased by 10 percent. . . .”

A weight-reduction program is a covered medical expense under section 4600 if it is prescribed to “ ‘cure or relieve from the effects of the injury ....’” (Braewood Convalescent Hospital v. Workers’ Comp. Appeals Bd. (1983) 34 Cal.3d 159, 169 [193 Cal.Rptr. 157, 666 P.2d 14].) Thus, the penalty prescribed by section 5814 may be imposed if there is unreasonable delay in providing the injured worker with a weight-reduction program. We must decide how, in these circumstances, that penalty should be computed.

The Supreme Court, prior to its decision in Gallamore, considered the issue of whether a section 5814 penalty could be assessed against a subsequent award of permanent disability where no permanent disability payment had been delayed, where the only delay in payments to the injured employee was that of temporary disability pursuant to a separate and earlier award therefor, and where untimely preaward payments of temporary disability had been made by the employer. (Garcia v. Workmen’s Comp. Appeals Bd. (1972) 6 Cal.3d 687 [100 Cal.Rptr. 149, 493 P.2d 877].) Garcia *17

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Bluebook (online)
227 Cal. App. 3d 12, 277 Cal. Rptr. 619, 56 Cal. Comp. Cases 45, 91 Cal. Daily Op. Serv. 817, 91 Daily Journal DAR 1324, 1991 Cal. App. LEXIS 102, Counsel Stack Legal Research, https://law.counselstack.com/opinion/consani-v-workers-compensation-appeals-board-safeway-stores-inc-calctapp-1991.