Draper v. Workers' Compensation Appeals Board

147 Cal. App. 3d 502, 195 Cal. Rptr. 248, 48 Cal. Comp. Cases 748, 1983 Cal. App. LEXIS 2211
CourtCalifornia Court of Appeal
DecidedSeptember 28, 1983
DocketCiv. No. 67187
StatusPublished
Cited by4 cases

This text of 147 Cal. App. 3d 502 (Draper v. Workers' Compensation Appeals Board) 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
Draper v. Workers' Compensation Appeals Board, 147 Cal. App. 3d 502, 195 Cal. Rptr. 248, 48 Cal. Comp. Cases 748, 1983 Cal. App. LEXIS 2211 (Cal. Ct. App. 1983).

Opinion

Opinion

WOODS, P. J.

Petitioner, Jerry Draper, seeks review and annulment of the Workers’ Compensation Appeals Board’s decision after reconsideration finding that petitioner did not sustain new and further permanent disability subsequent to a stipulated award.1

Petitioner and applicant, Jerry Draper, sustained an admitted industrial injury to his heart due to his employment with respondent, Department of Corrections, over the period December 9, 1963, to July 10, 1975.

The report of Dr. Travis Winsor dated November 4, 1975, stated that subsequent to applicant’s two heart attacks of June 27, 1974, and July 10, 1975, the applicant “has become permanently disabled from working.” On December 15, 1975, an informal disability rating issued giving applicant a 100 percent permanent disability rating based on Dr. Winsor’s report. On January 27, 1976, Dr. Winsor stated: “It is possible that this patient will naturally regain some strength and then possibly perform some sedentary activity. He would fall into category 8 [disability resulting in limitation to sedentary work].’’

At the hearing on March 24, 1976, the parties entered into stipulated facts, including that the applicant’s condition became permanent and stationary on September 23, 1975, and “[t]he injury caused permanent disability of 90 percent, ...”

[505]*505The applicant filed a petition to reopen the matter on July 20, 1979, on the ground that he had sustained new and further disability since the issuance of the original award. The issue of reopening the case was submitted based on applicant’s testimony of June 8, 1982, and medical reports of Kaiser Hospital, Dr. Julien H. Isaacs, and Dr. Travis Winsor.

Dr. Travis Winsor reported on February 15, 1980, that the applicant had increased pain in his chest since 1975, more shortness of breath on exercise, and numbness of the feet and legs below the knee. Dr. Winsor concluded that the applicant “has become completely disabled for any type of job

Dr. Julien Isaacs stated in his reports of February 20, 1980 and April 15, 1980, that the applicant was precluded from gainful employment due to his cardiac condition but did not comment on the applicant’s condition in 1976.

The applicant testified at trial that he believed his condition had worsened since 1976 because he experiences symptoms of shortness of breath, dizzy spells, chest pains, and numbness in his legs more often than he did in 1976. He underwent a coronary by-pass on March 11, 1977, because his angina was constant at that time, and he required nitroglycerine every half hour.

The workers’ compensation judge denied the petition to reopen on the ground that medical evidence of applicant’s total disability existed prior to the stipulation to 90 percent permanent disability and therefore applicant had failed to sustain his burden of proof of increased disability. The board affirmed the judge’s decision as to the permanent disability issue.2

Labor Code section 54103 allows the reopening of a prior findings and award of the Workers’ Compensation Appeals Board for “new and further disability” upon the filing of a petition of the injured employee within five years of the date of injury. (Aliano v. Workers’ Comp. Appeals Bd. (1979) 100 Cal.App.3d 341, 365 [161 Cal.Rptr. 190].)

The court in Nicky Blair’s Restaurant v. Workers’ Comp. Appeals Bd. (1980) 109 Cal.App.3d 941, 955 [167 Cal.Rptr. 516], adopted the definition that “‘[t]he term “new and further disability” has been defined to mean disability which results from some demonstrable change in an employee’s condition.’” (Quoting 1 Herlick, Cal. Workers’ Compensation Law Hand[506]*506book (2 ed. 1978) § 14.5.) The court concluded that “if [applicant’s] condition is unchanged from the time of the original decision . . . there is no ‘new and further disability’ within the meaning of section 5410 to permit reopening of the case.” (Nicky Blair’s Restaurant v. Workers’ Comp. Appeals Bd., supra, at p. 955.)

The court in Nicky Blair’s Restaurant also pointed out that “good cause” is a separate and distinct ground for reopening.

“The principle of reopening for ‘good cause’ does not permit an attempt to simply relitigate the original award. . . .

“ ‘Through many court decisions it has become well settled that, in order to constitute “good cause” for reopening, new evidence (a) must present some good ground, not previously known to the Appeals Board, which renders the original award inequitable, (b) must be more than merely cumulative or a restatement of the original evidence or contentions, and (c) must be accompanied by a showing that such evidence could not with reasonable diligence have been discovered and produced at the original hearing.’ (1 Hanna, [Cal. Law of Employee injuries and Workmen’s Compensation (2d rev.ed. 1980)] § 9.02[2][d]; see Merritt-Chapman & Scott Corp. v. Indus. A. C. (1936) 6 Cal.2d 314 . . .; Clendaniel v. Ind. Acc. Com. (1941) 17 Cal.2d 659 .. . .)

“[T]he concepts of ‘good cause’ and ‘new and further disability,’ in application to a request to reopen these concepts may intertwine. ‘Good cause’ includes ‘new and further disability. ’ (Cal. Workmen’s Compensation Practice (Cont.Ed.Bar 1973), supra, § 12.12.) ‘New and further disability’ may help establish ‘good cause.’ (See Aliano, supra, 100 Cal.App.3d at p. 366.) For example, the change or lack thereof in the injured’s condition may demonstrate his condition was originally misdiagnosed and therefore] warrant a total reevaluation of the injured’s status. (Ibid.)” (Nicky Blair’s Restaurant v. Workers’ Comp. Appeals Bd., supra, 109 Cal.App.3d at pp. 956-957.)

Section 5000 allows the parties to compromise “any liability which is claimed to exist [under Div. Four of the Lab. Code] on account of [industrial] injury . . . .” Such a settlement is not valid until approved by the workers’ compensation judge or board. (Raischell & Cottrell, Inc. v. Workmen’s Comp. App. Bd. (1967) 249 Cal.App.2d 991 [58 Cal.Rptr. 159].)

[507]*507Section 5001 provides: “Compensation is the measure of the responsibility which the employer has assumed for injuries or deaths which occur to employees in his employment when subject to this division. No release of liability or compromise agreement is valid unless it is approved by the appeals board or referee.”

Once the settlement is approved, however, it can only be set aside for good cause upon a petition to reopen demonstrating that the agreement was the result of fraud, mistake, duress, or undue influence. (Silva v. Industrial Acc. Com. (1924) 68 Cal.App. 510, 515 [229 P. 870].) As noted by Hanna: “The mere fact of [a permanent disability] increase or that post-settlement disability has exceeded expectations is not a ground for setting aside an approval order. . . . [f] True mistake of fact has not been shown where the agreement was entered into knowingly and as a calculated risk, i.e., the parties knew or should have known that there was a possibility of improvement or deterioration of the condition resulting from injury.” (1 Hanna, Cal. Law of Employee Injuries and Workmen’s Compensation (2d rev. ed. 1980) § 8.05[4][e], pp. 8-33—8-34, citing Carmichael v. Industrial Acc. Com.

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Cite This Page — Counsel Stack

Bluebook (online)
147 Cal. App. 3d 502, 195 Cal. Rptr. 248, 48 Cal. Comp. Cases 748, 1983 Cal. App. LEXIS 2211, Counsel Stack Legal Research, https://law.counselstack.com/opinion/draper-v-workers-compensation-appeals-board-calctapp-1983.