Insurance of North America v. Workers' Compensation Appeals Board

122 Cal. App. 3d 905, 176 Cal. Rptr. 365, 46 Cal. Comp. Cases 913, 1981 Cal. App. LEXIS 2135
CourtCalifornia Court of Appeal
DecidedAugust 24, 1981
DocketCiv. No. 60977
StatusPublished
Cited by10 cases

This text of 122 Cal. App. 3d 905 (Insurance of North America 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
Insurance of North America v. Workers' Compensation Appeals Board, 122 Cal. App. 3d 905, 176 Cal. Rptr. 365, 46 Cal. Comp. Cases 913, 1981 Cal. App. LEXIS 2135 (Cal. Ct. App. 1981).

Opinion

Opinion

ROTH, P. J.

Petitioner Insurance Company of North America (hereinafter INA) contends that respondent Workers’ Compensation Appeals Board (WCAB) erred in denying INA’s petition for reconsideration of the decision of the workers’ compensation judge finding that (1) respondent Myrna R. Kemp (applicant) sustained injury to her psyche arising out of and occurring in the course of employment for Volt Technical Corporation (Volt), and (2) INA, the workers’ compensation insurance carrier for Volt, unreasonably refused to provide workers’ compensation benefits to applicant and therefore is liable for a 10 percent penalty pursuant to Labor Code section 5814. We agree with INA’s contention and accordingly we cannot accept the decision of the WCAB.

As stated in her original application for adjudication filed with the WCAB, the gravamen of applicant’s claim to industrial psychiatric injury is that she sustained emotional trauma as the result of employment [908]*908“harassment, pressures and tensions from November 28, 1978 to present and continuing .... ”

The application which initiates this proceeding is based upon a false representation. Paragraph 9 thereof reads: “This application is filed because of a disagreement regarding liability for [the psychic injury]: .. . . ” This is a false statement. Volt did not know applicant had suffered an injury. There had been no discussion between applicant and Volt with respect to an injury or to her claim. Volt did not know applicant was making a claim until the application as it shows on its face was served on Volt on or about December 22, 1978. Some weeks after that date, abortive efforts were made by applicant’s counsel to reach some agreement for payments on account of applicant’s claim. There is nothing in the record to show that Volt had any information with respect to said claim at the time of the aborted discussions except such as is contained in the served application. On August 1, 1979, Volt filed an answer denying it.

The application dated November 30, 1978, was prepared and typed in all respects except for applicant’s signature by attorneys for applicant and executed at Sherman Oaks. It bears the stamped seal of Schermer & Rand, Inc. The application does not describe applicant’s injury. After the printed words, “The injury occurred as follows:” are the words, “harassment, pressures and tensions.” Both documents were filed by Schermer & Rand, Inc. at WCAB offices in Panorama City on December 1, 1978. Concurrently, counsel prepared a declaration of readiness to proceed.

On November 29, 1978, applicant was tested and interviewed by Dr. Albert J. Rosenstein, a psychologist who maintains an office in Encino, California. We assume Schermer & Rand had a report from Dr. Rosenstein before they prepared and completed the application. If such report was in writing before the application was filed or since, it was not filed or made a part of the record at any time.

In a “Claim Statement of Employee” signed and filed by applicant on or about December 15, 1978, with the Employment. Development Department she fixed the commencement of her right to a claim as November 28, 1978, the date of her termination but stated the last day she worked before disability as November 24, 1978. In answer to the question in the claim statement of December 15, “Did you stop work because of sickness or injury? If ‘No,’ please give reason,” applicant an[909]*909swered “No” and wrote as her reasons “Terminated.” And in answer to question 2, “What was the first full day you were too sick to work ...?”, she replied, November 28, 1978. November 28, 1978, as the date of commencement of disability is again confirmed by a doctor’s certificate signed and filed on December 7, 1978, (discussed infra).

“[J]udicial review of decisions of the WCAB on factual matters is limited to determining whether the decision, based on the entire record, is supported by substantial evidence ([Lab. Code] § 5952, subd. (d); LeVesque v. Workmen’s Comp. App. Bd. (1970) 1 Cal.3d 627 [83 Cal.Rptr. 208, 463 P.2d 432]).” (Southern California Rapid Transit Dist., Inc. v. Workers’ Comp. Appeals Bd. (1979) 23 Cal.3d 158, 162 [151 Cal.Rptr. 666, 588 P.2d 806].) “‘The foregoing standard is not met “by simply isolating evidence which supports the board and ignoring other relevant facts of record which rebut or explain that evidence.”’ (Lamb v. Workmen’s Comp. Appeals Bd. [(1974) 11 Cal.3d 274,] at p. 281; Garza v. Workmen’s Comp. App. Bd., 3 Cal.3d 312, 317 [90 Cal.Rptr. 355, 475 P.2d 451]; Greenberg v. Workmen’s Comp. Appeals Bd., 37 Cal.App.3d 792 [112 Cal.Rptr. 626].)” (Universal City Studios, Inc. v. Workers’ Comp. Appeals Bd. (1979) 99 Cal.App.3d 647, 656 [160 Cal.Rptr. 597].)

In LeVesque v. Workmen’s Comp. App. Bd. (1970) 1 Cal.3d 627 [83 Cal.Rptr. 208, 463 P.2d 432], our Supreme Court stated: “In reviewing the evidence our legislative mandate and sole obligation ... is to review the entire record to determine whether the board’s conclusion was supported by substantial evidence.” (Id., at p. 637.)

“Le Vesque (1 Cal.3d, pp. 635-637) specifically rejected earlier judicial declarations that an award of the board must be sustained, if supported by ‘any evidence’ [citations], or ‘any substantial evidence’ [citations]. Although such a rule may continue in other fields of our law, in workmen’s compensation cases a reviewing court is no longer mandated to inquire only ‘whether there is substantial evidence in favor of the respondent’; and then if such is found, ‘no matter how slight it may appear in comparison with the contradictory evidence,’ be bound to affirm the decision under review. [Citations.]” (Hulbert v. Workmen’s Comp. Appeals Bd. (1975) 47 Cal.App.3d 634, 638 [121 Cal.Rptr. 239].)

“LeVesque gives effect to Labor Code section 5952, which provides that: ‘The review by the court shall not be extended further than to de[910]*910termine, based upon the entire record .. . whether: ... (d) The order, decision, or award was not supported by substantial evidence.... ’ (Italics added.)

“But in its review of the entire record, the reviewing court is further admonished by section 5952 that: ‘Nothing in this section shall permit the court ... to exercise its independent judgment on the evidence.’

“It will be seen that under LeVesque our function in workmen’s compensation cases is to consider the weight or persuasiveness of all of the evidence, as contrasted with that tending to support the board’s decision. For unless we do so we have not reviewed the ‘entire record to determine whether the board’s conclusion was supported by substantial evidence.’ But on the other hand, by mandate of Labor Code section 5952, we may not exercise our ‘independent judgment on the evidence.’” (Hulbert v. Workmen’s Comp. Appeals Bd., supra, 47 Cal.App.3d at pp. 638, 639.)

“. . .

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Ins. Co. of N. Am. v. WORKERS'COMP. APPEALS BD.
122 Cal. App. 3d 905 (California Court of Appeal, 1981)

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122 Cal. App. 3d 905, 176 Cal. Rptr. 365, 46 Cal. Comp. Cases 913, 1981 Cal. App. LEXIS 2135, Counsel Stack Legal Research, https://law.counselstack.com/opinion/insurance-of-north-america-v-workers-compensation-appeals-board-calctapp-1981.