ADJ9145976 — California WCAB decision

What the panel ordered

Petition for Reconsideration granted; January 16, 2025 Supplemental Findings and Order rescinded; matter returned to Arbitrator

Petition for Reconsideration granted; Arbitrator's decision rescinded and matter returned for further proceedings

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This docket was decided more than once. Shown here is the latest released decision; we also hold October 25, 2022.

What was disputed, and how it came out

Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.

Other disputed issueApplicant prevailed

The Arbitrator found that the United States Fidelity and Guarantee Insurance policy covered the Applicant in California because the employment contract was made in California, activating the policy's coverage, and the policy did not require the Applicant to begin employment in California.

From the decision · page 5I now rely upon Board Rules and Regulations most commonly entitled "Orders After Filing a Petition for Reconsideration." I am persuaded by the Petition for Reconsideration argument by the Guardians that my " Supplemental Findings and Order" is erroneous. I recommend that the Supplemental Order be amended and modified. I confess that in recognizing the word "You" in the United States Fidelity and Guaranty Insurance Company policy, I misapplied a condition in the policy as applicable to the Applicant rather than the Schaumberg Flyers. The language found in Part 3, A2 of the policy can be interpreted only in a fashion to reflect the mutual intention of the parties and those parties would be the Schaumberg Flyers and the insurance company. The "You" in the policy can be read, by the plain meaning of the contract, to apply to the Schaumberg Flyers beginning employment in the State of California and they were signatory and a party to the policy and insurance contract.

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

The employment contract was made in California, activating the United States Fidelity and Guarantee Insurance policy coverage for the Applicant in California.

Favours Applicant prevailed

This established the insurer's obligation to provide benefits under the policy despite the location of employment activities.

From the decision · page 5The Schaumberg Flyers, by providing an employment contract to Applicant, who was in California, living in California, and signing the contract in the State of California, created the California employment contract, thus, beginning employment in the state and the United States Fidelity and Guarantee Insurance policy activates. The plain meaning of the contract reflects that the "You" applies to the employer and the carrier but certainly not to the applicant. Nowhere in the

The Arbitrator's Supplemental Findings and Order did not comply with Labor Code section 5313's requirement to provide a summary of evidence and reasons for the decision.

Favours Applicant prevailed

This failure led to the Appeals Board granting the petition for reconsideration and rescinding the decision.

From the decision · page 1We have considered the allegations of the Petition for Reconsideration and the contents of the Report of the Arbitrator with respect thereto.1 Based on our review of the record, and for the reasons stated in the Arbitrator's report, which we adopt and incorporate except as noted below, we will grant reconsideration, rescind the Arbitrator's decision, and return this matter to the Arbitrator for further proceedings and decision. This is not a final decision on the merits of any issues raised in the petition and any aggrieved person may timely seek reconsideration of the Arbitrator's new decision.

The parties were not provided with accurate notice of transmission to the Appeals Board as required by Labor Code section 5909.

Favours Applicant prevailed

This lack of notice affected the parties' awareness of the 60-day period for the Appeals Board to act on the petition.

From the decision · page 3No other notice to the parties of the transmission of the case to the Appeals Board was provided by the district office. Thus, we conclude that the parties were not provided with accurate notice of transmission as required by section 5909(b)(1). While this failure to provide notice does not alter the time for the Appeals Board to act on the petition, we note that as a result the parties did not have notice of the commencement of the 60-day period on February 27, 2025.

The rules the panel named

Authorities as the decision cited them, with how this panel applied each one.

Labor Code section 5909

Labor Code section 5909 requires the Appeals Board to act on a petition for reconsideration within 60 days of transmission of the case to the Appeals Board.

The Appeals Board acted timely on the petition as the decision was issued on the 60th day after transmission.

From the decision · page 2Under section 5909(a), the Appeals Board must act on a petition for reconsideration within 60 days of transmission of the case to the Appeals Board. Transmission is reflected in Events in the Electronic Adjudication Management System (EAMS). Specifically, in Case Events, under Event Description is the phrase "Sent to Recon" and under Additional Information is the phrase "The case is sent to the Recon board."

Labor Code section 5313

Labor Code section 5313 requires that a decision include a summary of the evidence and reasons for the determination.

The Arbitrator's decision was rescinded for failure to comply with this requirement.

From the decision · page 1We do not adopt and incorporate the Report to the extent that it recommends that we amend and modify Arbitrator's decision. Instead, we will rescind the January 16, 2025 Supplemental Findings and Order and return this matter to the Arbitrator for further proceedings as he determines appropriate and for the issuance of a new decision that complies with Labor Code2 section 5313's requirement that "[t]ogether with the findings, decision, order or award there shall be served upon

Hamilton v. Lockheed Corporation (2001) 66 Cal.Comp.Cases 473

The trier of fact must refer to the evidence in the opinion on decision and clearly designate the evidence forming the basis of the decision.

The Arbitrator was directed to explain the basis for his decision with specific references to the evidence.

From the decision · page 2all the parties to the proceedings a summary of the evidence received and relied upon and the reasons or grounds upon which the determination was made." (Lab. Code, § 5313.) The trier of fact "is charged with the responsibility of referring to the evidence in the opinion on decision, and of clearly designating the evidence that forms the basis of the decision." (Hamilton v. Lockheed Corporation (Hamilton) (2001) 66 Cal.Comp.Cases 473, 475 (Appeals Board en banc).) In this case it would be appropriate for the Arbitrator to explain the basis for his decision, including his change of opinion, with specific references to the evidence in the record.

Labor Code section 3600.5(a)

Labor Code section 3600.5(a) provides coverage requirements for workers' compensation insurance policies.

The Arbitrator found that the insurance policy covered the Applicant in California under this statute.

From the decision · page 6United States Fidelity and Guarantee Insurance policy does it indicate that the applicant employment must begin in the State of California. (See Labor Code § 3600.5(a)).

ADJ9145976 · April 28, 2025

What the panel ordered

What was disputed, and how it came out

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The facts that decided it

The rules the panel named

What proof carried it

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