Gallamore v. Workers' Compensation Appeals Board

591 P.2d 1242, 23 Cal. 3d 815, 153 Cal. Rptr. 590, 44 Cal. Comp. Cases 321, 1979 Cal. LEXIS 230
CourtCalifornia Supreme Court
DecidedMarch 26, 1979
DocketS.F. 23925
StatusPublished
Cited by64 cases

This text of 591 P.2d 1242 (Gallamore v. Workers' Compensation Appeals Board) is published on Counsel Stack Legal Research, covering California Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gallamore v. Workers' Compensation Appeals Board, 591 P.2d 1242, 23 Cal. 3d 815, 153 Cal. Rptr. 590, 44 Cal. Comp. Cases 321, 1979 Cal. LEXIS 230 (Cal. 1979).

Opinion

Opinion

RICHARDSON, J.

We consider the proper computation of penalties in workers’ compensation cases and, particularly, construe section 5814 of the Labor Code which provides for the assessment of a 10 percent penalty when payment of benefits has been unreasonably delayed or refused. In this case, petitioner (applicant) sought three separate penalties in the amount of $1,370 each, assessed against an award of permanent disability benefits in the total amount of $13,702.50. The Workers’ Compensation Appeals Board (board) allowed a single $1,370 penalty.'As we will explain, we have concluded that the penalty was properly imposed, that additional penalties may have been appropriate, and that the board should have the opportunity to reconsider the matter of the additional penalties in the light of the principles which we express herein.

Applicant was injured in an industrial accident on August 22, 1975. On August 27, 1975, respondent, employer’s insurance carrier (carrier), advised applicant that temporary disability benefits would commence as of August 23, and soon thereafter such benefits, at the rate of $117 per week, were paid to applicant. Carrier did not inform applicant of his right to reimbursement for any transportation expenses related to necessary medical examinations.

Thereafter, during 1975 and early 1976, applicant incurred travel expenses in submitting to medical examinations by two physicians, and on Januaiy 30, 1976, applicant’s attorney requested reimbursement to applicant of these expenses in the sum of $62.72. Carrier acknowledged the letter and requested itemization of the dates of the examinations. Applicant responded by filing a petition with the board on April 27, 1976, requesting assessment of the statutory 10 percent penalty against carrier for its failure to reimburse travel expenses “within a reasonable time after demand.” The petition requested imposition of the penalty in addition to other benefits for temporary disability and further medical treatment incurred subsequent to February 19, 1976.

In June 1976, applicant submitted an itemized statement of claimed travel expenses, and carrier voluntarily paid the $62.72 claim approxi *820 mately six weeks later prior to the hearing on applicant’s petition for a penalty.

In August 1976, carrier notified applicant that it was terminating further temporary disability payments because applicant’s condition had become permanent and stationary as of August 10. The notice further advised applicant that, by carrier’s calculations subsequently proven incorrect, the previous payments included a four-day overpayment, related to the fact that applicant had attempted to work on four different occasions.

Despite the termination of temporary disability benefits, carrier did not immediately commence permanent disability payments. Applicant’s attorney advised carrier in late August 1976 that such payments should be made “to avoid the possibility of a penalty.” On September 13, 1976, applicant filed his second formal petition with the board, seeking “separate and distinct 10% penalties” for the separate delays (1) in failing to advance permanent disability benefits, and (2) in claiming the four-day overpayment credit without prior board authorization. Thus, as of September 1976, applicant had sought three separate 10 percent penalties pursuant to the two petitions then pending before the board.

Carrier answered the second petition on September 22 and made its first advance permanent disability payment to applicant on September 29, no formal petition for an award of such benefits having yet been filed. The payment reflected the claimed four-day credit for overpayment of temporary disability benefits. Later, carrier paid to applicant the approximately $66 deducted for the credit, because it learned that applicant was never paid for the four days on which he attempted to work.

Applicant’s two petitions were consolidated and heard in March 1977. The parties stipulated to a permanent disability award rated at 42Vi percent. The compensation judge, observing that applicant was entitled to temporary disability benefits which were already “fully compensated,” awarded applicant permanent disability benefits in the amount of $13,702.50, and assessed a single 10 percent penalty on that sum, on the general ground that carrier “did unreasonably refuse to provide compensation benefits.” The penalty was based solely upon carrier’s six-week delay in advancing permanent disability payments.

Applicant sought reconsideration from the board, contending that two additional penalty assessments were appropriate. The board, in affirming *821 the judge’s award of a single penalty, stated that although the assessment of “multiple penalties for successive delays in the factual context of this case” was “discretionary” no abuse thereof occurred by reason of the award of a single 10 percent penalty.

The board and the parties have requested us to clarify the effect of section 5814 in situations involving asserted successive, preaward delays in different types of benefit payments. The specific issues presented are: (1) Whether in the assessment of the 10 percent penalty preaward and postaward delinquencies are to be treated similarly; (2) whether penalties may be assessed for an unreasonable delay in paying allegedly “de minimis” amounts of benefits; (3) whether multiple 10 percent penalties may be assessed for successive preaward delays in the payment of compensation benefits; and (4) whether the penalty for a preaward delinquency affecting only a particular class of benefits owing the applicant must be assessed against the entire amount of the ultimate aggregate award, including benefits of types which have been promptly paid.

As will appear, we have concluded that if a particular delinquency is found unreasonable by the board, the assessment of a 10 percent penalty is mandatoiy under section 5814, whether or not the delinquency occurs prior to the issuance of a formal award or involves amounts seemingly “de minimis.” We have further concluded that multiple penalties are mandatory for each separate delinquency, but that each penally must be assessed only against the class of benefits which was actually delayed or refused.

We preface our discussion of the foregoing issues by noting that 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. The question of delay and the reasonableness of the cause therefor shall be determined by the appeals board in accordance with the facts. Such delay or refusal shall constitute good cause under Section 5803 to rescind, alter or amend the order, decision or award for the purpose of making the increase provided for herein.”

1. Preaward Penalties

It is argued that the amount of the statutory penalty varies depending on whether the delinquency occurred before or after the

*822 award. Section 5814, however, expressly mandates the imposition of a penalty for delinquencies occurring “either prior to or subsequent to the issuance of an award . . .

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Bluebook (online)
591 P.2d 1242, 23 Cal. 3d 815, 153 Cal. Rptr. 590, 44 Cal. Comp. Cases 321, 1979 Cal. LEXIS 230, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gallamore-v-workers-compensation-appeals-board-cal-1979.