E & J Gallo Winery v. the Worker's Compensation Appeals Board

37 Cal. Rptr. 3d 208, 134 Cal. App. 4th 1536, 2005 Cal. Daily Op. Serv. 10725, 70 Cal. Comp. Cases 1644, 2005 Daily Journal DAR 14674, 2005 Cal. App. LEXIS 1945
CourtCalifornia Court of Appeal
DecidedDecember 20, 2005
DocketF047246
StatusPublished
Cited by9 cases

This text of 37 Cal. Rptr. 3d 208 (E & J Gallo Winery v. the Worker's 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
E & J Gallo Winery v. the Worker's Compensation Appeals Board, 37 Cal. Rptr. 3d 208, 134 Cal. App. 4th 1536, 2005 Cal. Daily Op. Serv. 10725, 70 Cal. Comp. Cases 1644, 2005 Daily Journal DAR 14674, 2005 Cal. App. LEXIS 1945 (Cal. Ct. App. 2005).

Opinion

Opinion

WISEMAN, J.

In this opinion we must determine the appropriate method of apportioning liability between two workers’ compensation injuries as conjured by the Legislature in reforming the workers’ compensation laws by enacting Senate Bill No. 899 (2003-2004 Reg. Sess.). We conclude that where an employee sustains multiple disabling injuries while working for the same self-insured employer, the employee is entitled to compensation for the total disability above any percentage of permanent disability previously awarded. In this narrow context, we see no reason to treat an employee who has been injured twice differently from a similarly situated employee who is injured once with the same level of disability. Our conclusion benefits employers by ensuring there can be no double recovery for the same disability; it benefits the employee by providing equitable compensation under the exponentially progressive nature of the workers’ compensation system. This approach best meets the legislative goal of bringing stability to what had become an unworkable statutory scheme.

*1541 FACTUAL HISTORY

David Dykes injured his back while working as a winery worker for E & J Gallo Winery (Gallo) in September 1996. As a result of the injury, a workers’ compensation administrative law judge (WCJ) approved a stipulated agreement on March 26, 1999, to provide Dykes with future medical care and a 20.5 percent permanent disability award worth $11,680 in compensation. Dykes returned to work with Gallo with a lighter duty and a medical restriction of lifting up to 50 pounds. By January 2002, his condition improved and his work restrictions were lifted.

On October 28, 2002, Dykes again injured his back while working for Gallo. Following a November 2004 workers’ compensation hearing, a WCJ determined that Dykes was temporarily totally disabled between November 12, 2002 through March 25, 2004, when he became 73 percent permanently disabled. Adjusting for Dykes’s age and occupation, a 73 percent disability award translated to a weekly $230 payment over 453.50 weeks for a total sum of $104,305. From the award, the WCJ subtracted the $11,680 in compensation previously paid to settle Dykes’s 1996 back injury, as well as 12 percent in attorney fees. The WCJ also awarded Dykes future medical treatment as reasonably necessary to cure or relieve the injury. Gallo was permissibly self-insured for purposes of workers’ compensation at the time of both injuries. (See Lab. Code, 1 § 3700; Denny’s Inc. v. Workers’ Comp. Appeals Bd. (2003) 104 Cal.App.4th 1433, 1439 [129 Cal.Rptr.2d 53].)

Gallo timely petitioned the Workers’ Compensation Appeals Board (WCAB) for reconsideration, contending that the Labor Code mandated subtracting the percentage, not dollar amount, of the prior award from Dykes’s disability award. The WCJ advised the WCAB in a report and recommendation by repeating her original analysis without addressing the calculation issue. On January 5, 2005, WCAB Commissioners Frank M. Brass, William K. O’Brien, and Janice Jamison Murray summarily denied reconsideration by adopting and incorporating the reasoning from the WCJ’s report.

DISCUSSION

The Legislature enacted Senate Bill No. 899 (2003-2004 Reg. Sess.) (Sen. Bill 899), effective April 19, 2004, as a comprehensive plan to reform the workers’ compensation system. Among the reforms, the legislation amended *1542 the standards of “apportionment,” the process of segregating “ ‘ “the residuals of an industrial injury from those attributable to other industrial injuries, or to nonindustrial factors, in order to fairly allocate the legal responsibility.” ’ ” (Marsh v. Workers’ Comp. Appeals Bd. (2005) 130 Cal.App.4th 906, 911 [30 Cal.Rptr.3d 598].)

“Before the enactment of Sen. Bill 899, apportionment was ‘concerned with the disability, not its cause or pathology.’ ” (Marsh v. Workers’ Comp. Appeals Bd., supra, 130 Cal.App.4th at p. 912.) “Because the statutes focused on disability, an employer could be liable to the full extent an industrial injury accelerates, aggravates, or ‘lights up’ a nondisabling preexisting disease, condition, or physical impairment.” (Ibid.)

Establishing new apportionment provisions for specific injuries, Sen. Bill 899 repealed sections 4663, 4750, and 4750.5 and enacted new sections 4663 and 4664. (Stats. 2004, ch. 34, §§ 33-35, 37-38.) Sections 4663 and 4750 applied to antecedent injuries, while section 4750.5 applied to subsequent injuries. (Fresno Unified School Dist. v. Workers’ Comp. Appeals Bd. (2000) 84 Cal.App.4th 1295, 1305 [101 Cal.Rptr.2d 569].) Under the earlier section 4663, the aggravation of a preexisting disease or compensable injury was “allowed only for the proportion of the disability due to the aggravation of such prior disease which is reasonably attributed to the injury.” Former section 4750 prevented an industrially injured employee suffering from a previous permanent disability or physical impairment from receiving a workers’ compensation award greater than he or she would otherwise receive for the later injury alone and limited the employer’s liability to only “that portion due to the later injury as though no prior disability or impairment had existed.”

Now, apportionment is “based on causation” and the “employer shall only be liable for the percentage of permanent disability directly caused by the injury arising out of and occurring in the course of employment.” (§§ 4663, subd. (a) & 4664, subd. (a).) “The plain reading of ‘causation’ in this context is causation of the permanent disability.” (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 611 (en banc), review den. Nov. 16, 2005, S137275.) Examining physicians therefore must “make an apportionment determination by finding what approximate percentage of the permanent disability was caused by the direct result of injury arising out of and occurring in the course of employment and what approximate percentage of the permanent disability was caused by other factors both before and subsequent to the industrial injury, including prior industrial injuries.” (§ 4663, subd. (c).) The Legislature also added a new conclusive presumption *1543 affecting the burden of proof that a prior permanent disability exists whenever an employee has received a prior permanent disability award. (§ 4664, subd. (b).) In short, Sen. Bill 899 provides for apportionment based on either nonindustrial factors sufficiently described by the medical evidence (§ 4663, subd. (c)) or as previously awarded to the employee under a prior workers’ compensation claim (§ 4664, subd. (b)).

After a rocky transition period, it is now well settled that, consistent with the Legislature’s intent, “the apportionment provisions of Sen. Bill 899 must be applied to all cases . . . not yet final at the time of the legislative enactment on April 19, 2004, regardless of the earlier dates of injury and any interim decisions.” (Marsh v. Workers’ Comp. Appeals Bd., supra, 130 Cal.App.4th at p. 910; see also Rio Linda Union School Dist. v. Workers’ Comp. Appeals Bd.

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37 Cal. Rptr. 3d 208, 134 Cal. App. 4th 1536, 2005 Cal. Daily Op. Serv. 10725, 70 Cal. Comp. Cases 1644, 2005 Daily Journal DAR 14674, 2005 Cal. App. LEXIS 1945, Counsel Stack Legal Research, https://law.counselstack.com/opinion/e-j-gallo-winery-v-the-workers-compensation-appeals-board-calctapp-2005.