Martino v. Workers' Compensation Appeals Board

YEGAN, J.,

Dissenting.—I agree that we should (1) construe limitations provisions in workers’ compensation law liberally in favor of an injured worker (maj. opn., ante, at p. 489), (2) not elevate form over substance or insist on a strict chronological sequence in the filing of documents by an applicant (maj. opn., ante, at p. 490), and (3) liberally view the workers’ compensation laws in favor of affording substantial justice to injured workers (maj. opn., ante, at p. 491). Constitutional, statutory, and decisional law dictates that these laudatory goals be furthered. However, there must, of necessity, come a time when the rules dictate that the employer and its insurance carrier no longer have liability. The rules, whether they favor the employee or the employer in any given instance, allow the parties some assurance and repose in their respective rights and liabilities. Here, the workers’ compensation judge (WCJ) and the workers’ compensation appeals board (WCAB) have determined that applicant is not entitled to vocational rehabilitation benefits because she did not timely or appropriately perfect her request therefor. This case is not one where the employer, its carrier, the WCJ, and the WCAB insisted upon a hypertechnical rule to deny benefits. Insurance carriers have rights too.

Initially, the carrier did everything it could to provide vocational rehabilitation to applicant. When it became reasonably apparent that applicant did not want those services, it secured an order from the vocational rehabilitation *493unit (hereafter RU) terminating liability therefor. At that point in time, carrier could reasonably rely on the order and was not required to financially plan on the costs of such services in the future. This allowed the carrier to financially plan for the costs of services to other injured workers. (See Kaiser Foundation Hospitals v. Workers’ Comp. Appeals Bd. (1985) 39 Cal.3d 57, 62 [216 Cal.Rptr. 115, 702 P.2d 197].) All of that is changed by the majority opinion. A carrier may not rely on a final order from the RU which the majority impliedly determine is of no consequence whatsoever.

Applicant sustained an industrial injury on April 10, 1995, was provided vocational rehabilitation (VR) services, and requested that the services be interrupted.1 On February 26, 1998, she was awarded a 59.5 percent permanent disability. The award was silent on VR services.

On April 9, 1998, the employer’s insurer, Superior National Insurance Company (carrier), requested that liability for VR be terminated. (See Lab. Code, § 4644, subd. (b); Martinez v. Workers’ Comp. Appeals Bd. (2000) 84 Cal.App.4th 1079, 1086 [101 Cal.Rptr.2d 406].) Before the RU even heard the matter, appellant filed an April 24, 1998 petition to reopen with the WCAB, not the RU.2

On May 11, 1998, the RU granted carrier’s request to terminate VR services. The order advised appellant that she had the right to reopen pursuant to Labor Code section 5410 and that a request to reopen “MUST BE MADE PRIOR TO 4-10-2000, OR WITHIN 5 YEARS FROM THE DATE OF INJURY.” The order stated: “THIS DETERMINATION IS FINAL. ANY AGGRIEVED PARTY MUST FILE AN APPEAL WITH THE WORKERS’ COMPENSATION APPEALS BOARD WITHIN TWENTY (20) DAYS FROM THE DATE OF SERVICE OF THIS DETERMINATION.” The petition to reopen was not discussed at the RU hearing.

Applicant did not object, move for reconsideration, or appeal the May 11, 1998 order. Nor did she request that the WCAB reserve jurisdiction to *494adjudicate further VR services. (See Roberts v. Workers’ Comp. Appeals Bd. (1992) 3 Cal.App.4th 631, 636, fn. 8 [4 Cal.Rptr.2d 576].) The only inference that flows from these occurrences is that applicant waived VR services.

On May 30, 2000, applicant’s permanent disability rating was increased to 8592 percent on her petition to reopen. She did not then ask for vocational rehabilitation benefits. On May 29, 2001, she did so. The WCAB found that the request was barred by the May 11, 1998 order and Labor Code section 5410.

The majority hold that an applicant may ignore a final RU order if a petition to reopen is filed with the WCAB before VR services were closed. By filing this stealth petition to reopen with a different hearing board (the WCAB), applicant is allowed to attend the RU hearing, say nothing, and later successfully claim that the order closing VR services was of no force or effect. This is akin to filing a motion for new trial before the jury has returned a verdict. In the words of the WCJ, “one cannot reopen what has not been closed, ffl] If this were acceptable practice, . . . [t]here would never be any finality to anything . . . ,”3

An injured worker cannot suspend VR services by filing a generic petition to reopen before VR services are closed. Where VR services are adjudicated and closed, the WCAB and RU lack jurisdiction to consider a new request for VR services filed more than five years from the date of the industrial injury. (Lab. Code, §§ 5410, 5804; Youngblood v. Workers’ Comp. Appeals Bd. (1989) 216 Cal.App.3d 764, 774 [265 Cal.Rptr. 211]; Sacramento County Off. of Education v. Workers’ Comp. Appeals Bd. (2000) 82 Cal.App.4th 107, 115 [97 Cal.Rptr.2d 699].)

The majority assume that applicant was not medically able to use VR services before May 30, 2000, when the WCAB increased the permanent disability award. If that was the case, all she had to do was timely inform the RU and ask for an interruption of services. There is nothing in the record to support that she was medically unable to use VR services. Unlike Pool v. Workers’ Comp. Appeals Bd. (1989) 211 Cal.App.3d 694 [259 Cal.Rptr. 564], rehabilitation services were not suspended so applicant could seek additional medical evaluation and treatment.

Labor Code section 5410 is designed “to foster both certainty and finality in the law. For example, an applicant may believe a newly manifested *495disability is caused by a previous industrial injury for which compensation had been awarded. Nevertheless, the applicant’s ability to reopen the claim ceases five years from the date of the injury (§ 5410). In symmetrical fashion, section 5804 generates some repose for the injured employee by terminating the employer’s .ability to reopen a previously adjudicated claim once five years from the date of the original injury have passed.” (Barnes v. Workers’ Comp. Appeals Bd. (2000) 23 Cal.4th 679, 686-687 [97 Cal.Rptr.2d 638, 2 P.3d 1180], fn. omitted.)

The majority’s opinion goes beyond a liberal construction of the WCAB rules. It eviscerates the concept of finality of orders. Now, every applicant can file a “Martino” petition to reopen before the WCAB just before rehabilitation services are closed by the RU. The applicant can keep the petition dormant, and years later, claim that rehabilitation services were suspended. Such a procedure renders Labor Code section 5410 a nullity.

On November 25, 2002, the opinion was modified to read as printed above.

California Code of Regulations, title 8, section 10129.1, subdivision (b) states in pertinent part: “An employee may interrupt rehabilitation services subsequent to accepting services. . . .” (Italics added.)

The majority say that the request was “appropriate.” (Maj. opn., ante, at p. 489.) It was not appropriate. Quite apart from the obvious untimeliness of this motion, requests to reopen VR “should be filed with the [rehabilitation] Unit. . . .” (2 Hanna, Cal. Law of Employee Injuries and Workers’ Compensation (rev. 2d ed., Tancor edit., 2001) Vocational Rehabilitation, § 35.73, p. 35-89, relying upon an en banc opinion of the WCAB; Fraile v. Dzurilla & Dymond Construction Co. (1982) 47 Cal.Comp.Cases 523.)

The Court of Appeal should not micromanage the application of WCAB rules designed for the orderly adjudication of compensation benefits. The rule requiring that a request to reopen VR benefits be filed in the first instance with the RU not only seems reasonable, but is a practical delegation to the appointed experts who are in the best position to make VR evaluations.

At all times, applicant was represented by experienced and capable counsel. The record does not show why applicant and her attorney waited from April 24, 1998, to May 27, 2001, to press for a ruling on the earlier stealth motion to reopen VR.