Facundo-Guerrero v. Workers' Compensation Appeals Board

163 Cal. App. 4th 640, 77 Cal. Rptr. 3d 731, 2008 Cal. App. LEXIS 820, 2 Cal. WCC 597
CourtCalifornia Court of Appeal
DecidedJune 2, 2008
DocketA119814
StatusPublished
Cited by11 cases

This text of 163 Cal. App. 4th 640 (Facundo-Guerrero 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
Facundo-Guerrero v. Workers' Compensation Appeals Board, 163 Cal. App. 4th 640, 77 Cal. Rptr. 3d 731, 2008 Cal. App. LEXIS 820, 2 Cal. WCC 597 (Cal. Ct. App. 2008).

Opinion

*644 Opinion

RUVOLO, P. J.—

I. INTRODUCTION

Labor Code 1 section 4604.5, subdivision (d) (section 4604.5(d)) was enacted in 2003 as Senate Bill No. 228 (2003-2004 Reg. Sess.) (Stats. 2003, ch. 639, § 27) (Senate Bill 228), and provided that, unless approved by an injured employee’s employer, benefits for chiropractic treatments and physical therapy sessions were limited to no more than 24 visits per industrial injury, if the injury occurred after January 1, 2004. The statute was amended the following year as part of Senate Bill No. 899 (2003-2004 Reg. Sess.) (Stats. 2004, ch. 34, § 25) (Senate Bill 899), a comprehensive reform of this state’s workers’ compensation system. As pertinent to section 4604.5(d), Senate Bill 899 left in place the cap on chiropractic and physical therapy visits, but added a limit of 24 occupational therapy visits per industrial injury as well.

Petitioner Jose Facundo-Guerrero (petitioner) received 76 chiropractic treatments following an industrial injury he sustained while working for respondent Nurserymen’s Exchange (Nurserymen’s), whose insurer was respondent Argonaut Insurance Company. He filed a writ of review with this court after a Workers’ Compensation Appeals Board (WCAB) decision determined that he was entitled to benefits covering only 24 chiropractic treatments, as specified by section 4604.5(d).

Petitioner contends that section 4604.5(d) violates the California Constitution’s mandate to the state Legislature, that it implement a “complete system of workers’ compensation,” including “full provision for such medical, surgical, hospital and other remedial treatment as is requisite to cure and relieve from the effects of such injury.” (Cal. Const., art. XIV, § 4 (article XIV, section 4).) Similarly, he contends that vesting sole authority in employers to approve benefits for more than 24 treatments without affording workers a right of judicial review of that decision is an unconstitutional delegation of legislative power that denies him due process.

Lastly, he also argues that the limitation on the number of chiropractic treatments in section 4604.5(d) violates his right to equal protection under the law, as compared to (1) the class of injured workers who undergo modalities of treatment not statutorily limited, or (2) the class of workers injured prior to January 1, 2004, the effective date of the statute, who were not limited to 24 chiropractic treatments.

*645 We reject all of these constitutional challenges to section 4604.5(d), and affirm the decision of the WCAB.

n. FACTUAL AND PROCEDURAL BACKGROUND

On December 28, 2006, petitioner filed a request for a determination that he was entitled to medical treatment under section 4600, and requested an expedited hearing pursuant to section 5502, subdivision (b). He claimed Nurserymen’s had refused to authorize more than 24 chiropractor visits to treat his industrial injury, including those treatments occurring before Nurserymen’s accepted his initial claim for benefits.

A hearing was held before a WCAB judge (WCJ) on February 16, 2007, 2 and an initial decision was issued on March 9. That decision was rescinded by the WCJ upon petitioner’s application, and a further hearing was held on July 23. A new decision was filed on July 30, and petitioner filed a motion to reconsider that decision on several grounds, including that (1) petitioner’s treating chiropractor was entitled to manage his further treatment and remain as petitioner’s treating health care provider, and (2) the 24 chiropractic visit limitation in section 4604.5(d) was unconstitutional under both the California and federal Constitutions.

The WCJ determined that petitioner’s first ground for reconsideration had merit. Therefore, a new decision was issued on September 5, in which the WCJ rescinded her July 30 decision, and made new findings and conclusions. These new findings included that (1) petitioner was entitled to no more than 24 chiropractic treatments per industrial injury under section 4604.5(d), and this section was applicable because petitioner’s injury occurred after January 1, 2004; (2) because petitioner’s treating chiropractor, Dr. Pevec, was a member of Nurserymen’s medical provider network, Dr. Pevec could serve as petitioner’s duly selected treating health care provider; and (3) therefore, petitioner was entitled to additional visits with Dr. Pevec “for the purpose of enabling Dr. Pevec to manage his care and render opinions on all medical issues necessary to determine his eligibility for compensation.” As to petitioner’s constitutional challenges, the WCJ concluded that she lacked the legal authority to decide them.

Petitioner sought reconsideration with the WCAB. The WCAB granted reconsideration and adopted the September 5 decision of the WCJ as its own. Once again, it reaffirmed that it lacked the authority to decide appellant’s constitutional challenged to section 4604.5(d). The WCAB’s decision was filed on October 11.

*646 Petitioner filed a petition for writ of review with this court on November 26, which was answered by Nurserymen’s on December 19. This court granted the writ on January 17, 2008.

III. LEGAL DISCUSSION

A. Petitioner’s Constitutional Challenge Under Article XIV, Section 4

Section 4604.5(d) was enacted in 2003 as Senate Bill 228. The statute was amended the following year as part of Senate Bill 899, a comprehensive reform of this state’s workers’ compensation system. (Rio Linda Union School Dist. v. Workers’ Comp. Appeals Bd. (2005) 131 Cal.App.4th 517, 521 [31 Cal.Rptr.3d 789] (Rio Linda).) Section 4604.5(d) reads as follows:

“(d)(1) Notwithstanding the medical treatment utilization schedule or the guidelines set forth in the American College of Occupational and Environmental Medicine’s Occupational Medicine Practice Guidelines, for injuries occurring on and after January 1, 2004, an employee shall be entitled to no more than 24 chiropractic, 24 occupational therapy, and 24 physical therapy visits per industrial injury.

“(2) Paragraph (1) shall not apply when an employer authorizes, in writing, additional visits to a health care practitioner for physical medicine services.

“(3) Paragraph (1) shall not apply to visits for postsurgical physical medicine and postsurgical rehabilitation services provided in compliance with a postsurgical treatment utilization schedule established by the administrative director pursuant to Section 5307.27.”

Because Nurserymen’s would not approve more than 24 chiropractic treatments for petitioner, he contends that section 4604.5, both facially and as applied to him, violates article XIV, section 4. In deciding this issue we are guided by general principles applicable to statutory construction, including that “ 1 “[a]ll presumptions and intendments favor the validity of a statute .... Statutes must be upheld unless their unconstitutionality clearly, positively, and unmistakably appears.” ’ [Citation.]” (Voters for Responsible Retirement v.

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163 Cal. App. 4th 640, 77 Cal. Rptr. 3d 731, 2008 Cal. App. LEXIS 820, 2 Cal. WCC 597, Counsel Stack Legal Research, https://law.counselstack.com/opinion/facundo-guerrero-v-workers-compensation-appeals-board-calctapp-2008.