State Compensation Insurance Fund v. Workers' Compensation Appeals Board

*1221MOSK, J.

I dissent.

The workers’ compensation judge (WCJ) found, as a fact, that the delay in payment of workers’ compensation benefits in this matter was unreasonable.

The Workers’ Compensation Appeals Board found, as a fact, that the delay was unreasonable.

The Court of Appeal found, as a fact, that the delay was unreasonable.

I would affirm.

Although I agree, in principle, that inadvertent error in processing workers’ compensation payments is not per se “unreasonable” under Labor Code section 5814, I disagree that we should second-guess the determination that the delay at issue here was unreasonable. In my view, it-is supported by substantial evidence.

The facts herein are simple and clear. Jo Jo Arago, the claims examiner for the State Compensation Insurance Fund (SCIF), who was assigned to injured employee Adrienne Stuart’s case, went on vacation during the last week of April 1995. During that period, another SCIF employee, Grace Chu, covered his desk. Chu reviewed a two-sentence letter, dated April 15, from Stuart’s employer notifying SCIF of his change of address. The letter, headed with the employer’s name, said: “Kindly change your records to reflect a change of my mailing address from 15300 Ventura Boulevard, Suite 415, Sherman Oaks, CA to: fi[] Post Office Box 2608 fll] Beverly Hills, CA 90213-2608. flQ Thank you.” Chu incorrectly entered the change of address into the computer as a change of Stuart’s address, with the result that Stuart’s May 15 benefits were sent to the wrong address.

At the hearing before the WCJ, Arago testified that he would not have made the mistake Chu made. The WCJ found Arago credible, observing that he “gave the impression of being a hardworking and conscientious claims adjuster.” Taking into consideration Arago’s testimony and the fact that the text of the letter from Stuart’s employer was straightforward and unambiguous, the WCJ concluded that Chu’s error resulted from a lack of ordinary diligence: “Mr. [Arago] would not have made that error and neither would anyone else who took the time to read the document in question before acting on it.” Arago, in effect, testified concerning the applicable standard of *1222professional care at SCIF; his testimony supports a conclusion that Chu’s handling of this matter did not meet that standard.1

I also agree with the Court of Appeal that Kampner v. Workers’ Comp. Appeals Bd. (1978) 86 Cal.App.3d 376 [150 Cal.Rptr. 222] offers little guidance on the factual issue before us. It involved a different question: i.e., “ ‘the legitimate needs of administering workers’ compensation insurance’ ” (id. at p. 380), and turned on the appropriate standard of conduct for the diligent processing of a settlement. Although the holiday closures and work disruptions in Kampner may have been examples of such “legitimate needs,” lack of ordinary diligence in handling a simple request for a change of address emphatically does not qualify. Thus, unlike the majority, I do not believe that the “realities of the business of processing claims for benefits” (maj. opn., ante, at p. 1219) require us to condone the type of carelessness the WCJ found here. That the mistake at issue involved “clerical error” does not excuse it or negate its real-life impact on the employee who failed to receive her disability benefits in a timely manner. Nor is the relative shortness of the delay a reason to excuse or overlook SCIF’s error. True, a one-week delay may seem to be of little consequence. It can be of significance, however, if the employee has rent to pay on time or if she has medical or food bills to pay in order to properly survive. She should not have to bear the burden of SCIF’s lack of ordinary diligence.

Because, after reviewing the record, I see no grounds for reversal, I would affirm the finding that the delay was unreasonable, and, accordingly, the imposition of a mandatory penalty under Labor Code section 5814.

Kennard, J., concurred.

The majority point to a comment by the WCJ to the effect that “[i]t may well be that Ms. Chu was so overwhelmed from having to do both her and Mr. [Arago’s] work that she didn’t have enough time to exercise proper care,” and observe that there was no evidence to support the suggestion that Chu was “overwhelmed” or about whether SCIF ensured its adjusters manageable loads. I agree that the comment did not amount to substantial evidence. Nor did the WCJ purport to rely on it for that purpose. Rather, it found that the error itself was inexcusable: No one who actually read the document would have made it. No history of improperly processing benefits payments was required in order to account the “solitary” error here unreasonable. (See maj. opn., ante, at pp. 1216-1217.) ■