What the panel treated as outcome-determinative, and which side it favoured.
Desert Sands Unified School District is the solvent insurer with joint and several liability for the injuries.
Favours Defendant prevailed
This fact relieved CIGA of liability for further medical treatment under Insurance Code section 1063.1(c)(9).
From the decision · page 7Here, as noted by the WCJ in his Report, given that Desert shares joint and several liability
with CIGA in all three cases, we agree that CIGA is not liable for further medical treatment and
amend the decisions accordingly.
Applicant did not present evidence of a petition to reopen for new and further disability.
Favours Defendant prevailed
Lack of evidence and waiver by CIGA led the Board to defer the issue of new and further disability.
From the decision · page 7Here, CIGA never raised the issue of whether a petition to reopen was filed or whether the
Appeals Board had jurisdiction to consider the January 12, 1998 injury at the time of trial in 2021.
In the March 11, 2021 letter to the WCJ, where CIGA requested that the WCJ amend the MOH of
March 3, 2021, they made no request for the WCJ to consider the issue of jurisdiction over
permanent disability in the January 12, 1998 injury. CIGA stipulated at the September 27, 2021
trial that applicant had entered into Stipulations on December 2, 1998 to 13%, and they proceeded
with submission on the matter, including on the issue of permanent disability, and despite
affirmative knowledge of the Stipulations. Moreover, litigation on the case continued beyond the
date of the end of the five year period in January 2003, and more than twenty years after the case
was resolved. Yet, CIGA raises the issue for the first time on reconsideration. There is no
explanation in their Petition as to why the issue was not raised previously, and thus, we conclude
that CIGA waived the issue of whether a petition to reopen was filed.
Medical evidence was unclear whether prior disability was considered in current disability rating.
Favours Applicant prevailed
This uncertainty required the Board to further develop the record and defer the new and further disability issue.
From the decision · page 8Here, the parties stipulated that the parties entered into Stipulations in December 1998 that
applicant had 13% permanent disability. Yet, in the decision, the WCJ found that applicant
sustained 40% permanent disability without stating either way whether this was new and further
disability or whether CIGA was entitled to a credit for the 13% benefits paid in 1998. Moreover,
the medical evidence is unclear as to whether Dr. Woods took into account applicant's prior level
of disability in opining on applicant's current level of disability. Therefore, the WCJ must develop