Estrada v. Workers' Comp. Appeals Bd.

58 Cal. App. 4th 1458, 69 Cal. Rptr. 2d 176, 97 Cal. Daily Op. Serv. 8510, 97 Daily Journal DAR 13725, 62 Cal. Comp. Cases 1384, 1997 Cal. App. LEXIS 903
CourtCalifornia Court of Appeal
DecidedNovember 5, 1997
DocketB107353
StatusPublished
Cited by2 cases

This text of 58 Cal. App. 4th 1458 (Estrada v. Workers' Comp. Appeals Bd.) 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
Estrada v. Workers' Comp. Appeals Bd., 58 Cal. App. 4th 1458, 69 Cal. Rptr. 2d 176, 97 Cal. Daily Op. Serv. 8510, 97 Daily Journal DAR 13725, 62 Cal. Comp. Cases 1384, 1997 Cal. App. LEXIS 903 (Cal. Ct. App. 1997).

Opinion

Opinion

CROSKEY, Acting P. J.

In this petition for writ of mandate challenging a decision of the Workers’ Compensation Appeals Board (the Board or WCAB), Miguel A. Estrada (Estrada), the injured worker, requests relief from the Board’s decision regarding his rights to vocational rehabilitation temporary disability (VRTD). We conclude the Board’s decision is in error because it relies on a provision of the written compromise and release *1462 (C&R) which Estrada and his employer signed, and under the terms of the C&R itself and the Labor Code, the provision is unenforceable. Moreover, the Board’s decision is based on a retroactive VRTD start-up date which is incorrect. We therefore annul the decision of the Board and direct the Board to issue a new and different order consistent with the views expressed herein.

Background of the Case

1. Estrada’s Application for Adjudication of Claim

Estrada was employed as a lithographer by Corporate Graphics. His application for adjudication of claim was filed with the Board in late 1989. In it he states he sustained injury to his head, neck, back, legs, stomach, and psyche from repetitive stress and strain for the period November 6, 1988, to November 6, 1989. The application states that Estrada’s right to vocational rehabilitation is at issue. Estrada forwarded his application to the Board with a November 13, 1989, cover letter. In the cover letter, Estrada states: “Demand is hereby made for Rehabilitation pursuant to Labor Code Section 139.5.” 1 The letter shows that a copy of it was sent to Nationwide Mutual Insurance Co. (Nationwide), one of Corporate Graphics’s workers’ compensation insurance carriers. 2

2. The Execution of the C&R

Trial was set for January 23, 1992. On that same day, a C&R was signed by Estrada, and by Corporate Graphics and its workers’ compensation insurance carriers, Nationwide and California Casualty. 3

The C&R is on a WCAB preprinted form with preprinted language and with blank spaces left for specifics of the parties’ compromise and release. Paragraph 10 of the C&R, which is entitled “Reason for Compromise, special provisions regarding rehabilitation and death benefit claims, and additional information,” contains the following handwritten provision: “This agreement settles any and all claims for T.D. and VRTD to date. The parties stipulate that the applicant is not a QIW per the report of Dr. Hunt dated 11-29-90. If applicant request [sic] rehab at a later date it is agreed that no *1463 benefits will be paid or owed until applicant is examined by Dr. Paul Endler as an AME." 4 Thus, the parties entered into an agreement regarding both accrued and future vocational rehabilitation benefits.

Paragraph 5 of the C&R contains the following preprinted provision regarding vocational rehabilitation; “Unless otherwise expressly ordered by a workers’ compensation judge, approval of this agreement Does Not Release Any Claim Applicant May Now or Hereafter Have for Rehabilitation or Benefits in Connection With Rehabilitation.” An “Order Approving Compromise & Release” (the approval order) was signed by Workers’ Compensation Judge Barbara Burke on January 23, 1992. The approval order does not contain an express indication by Judge Burke of her approval of the parties’ vocational rehabilitation provision.

3. Events Subsequent to the Execution of the C&R

On or about September 8, 1993, Estrada filed a request with the rehabilitation unit of the division of workers’ compensation for an order that Corporate Graphics provide him with vocational rehabilitation services. The *1464 request states Estrada had obtained “two P&S[ 5 ] reports, one from Dr. Capps and the other from Dr. Jones, indicating QIW status. " 6 Corporate Graphics objected to Estrada’s request for vocational rehabilitation services, arguing that the two doctors’ reports would not entitle Estrada to those services since the parties had stipulated in the vocational rehabilitation provision of the C&R that Estrada was not a QIW and had further stipulated that if Estrada were to request vocational rehabilitation, no benefits would be paid or owed to him until he was examined by Dr. Paul Endler as an AME. As of that point in time, Estrada had not been examined by Dr. Endler.

After review by the rehabilitation unit, the matter eventually came before Judge Burke, who rejected defendants’ contention that, under the terms of the vocational rehabilitation provision of the C&R, Estrada was not entitled to vocational rehabilitation benefits until he was examined by Dr. Endler. Judge Burke based her decision on the fact that her January 23, 1992, approval order did not specifically approve the vocational rehabilitation provision. She cited to paragraph 5 of the C&R. 7

The issue of whether the parties’ vocational rehabilitation provision could be enforced resurfaced in a disagreement between Estrada and defendants over whether Estrada was entitled to receive retroactive VRTD and retroactive “maintenance allowance.” 8 Defendants asserted they had properly delayed giving Estrada vocational rehabilitation benefits, including VRTD, until January 25,1994, because Estrada was examined by Dr. Endler on that *1465 day. 9 Defendants contended the parties’ vocational rehabilitation provision was effective to (1) release Estrada’s claim to VRTD benefits payable up to the date of the C&R (i.e., January 23, 1992), and (2) relieve Corporate Graphics from owing and paying prospective rehabilitation benefits until Estrada was examined by Dr. Endler. In contrast, Estrada asserted he was entitled to VRTD retroactive to a date prior to January 25, 1994. Judge Burke again rejected defendants’ position regarding the validity of the parties’ vocational rehabilitation provision, citing section 5100.6, as well as section 10870 of title 8 of the California Code of Regulations (both of which are discussed post). She determined that as a QIW, Estrada was owed VRTD for the period April 17, 1990, through January 24, 1994. Regarding the April 17, 1990, date, Judge Burke referenced the April 16, 1990, report of Dr. Capps (see fn. 6, ante). 10

The Board made a different determination of when Estrada first became entitled to VRTD.

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Related

Martinez v. Workers' Compensation Appeals Board
101 Cal. Rptr. 2d 406 (California Court of Appeal, 2000)
Johnson v. Workers' Compensation Appeals Board
76 Cal. Rptr. 2d 422 (California Court of Appeal, 1998)

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58 Cal. App. 4th 1458, 69 Cal. Rptr. 2d 176, 97 Cal. Daily Op. Serv. 8510, 97 Daily Journal DAR 13725, 62 Cal. Comp. Cases 1384, 1997 Cal. App. LEXIS 903, Counsel Stack Legal Research, https://law.counselstack.com/opinion/estrada-v-workers-comp-appeals-bd-calctapp-1997.