CHERYL COLDIRON, Applicant,
v.
COMPUWARE; Permissibly Self-Insured, by And through GALLAGHER BASSETT SERVICES, INC., Adjusting Agent, Defendants.
No. SRO 0088351
California Workers Compensation Decisions
Workers Compensation Appeals Board State of California
July 30, 2018
NOTICE OF INTENTION TO IMPOSE SANCTIONS AND NOTICE OF
INTENTION TO HOLD COMMISSIONER'S CONFERENCE (EN
BANC)
MERLE
C. RABINE, Chairman.
On
November 26, 2001, the Workers' Compensation Appeals
Board (Board) granted the petition for reconsideration filed
by Compuware Corporation (Compuware or petitioner) in which
defendant Compuware challenged the Findings and Award that
issued by the workers' compensation administrative law
judge (WCJ) on August 31, 2001. In that decision, the WCJ
followed and adopted the stipulations of parties as true in
finding, among other things, that Cheryl Coldiron
(applicant), born October 6, 1955, sustained an admitted
industrial injury to her neck and back on January 13, 1995
while employed by Compuware, permissibly
self-insured. The WCJ awarded in applicant's favor
and against Compuware various benefits including temporary
disability, permanent disability indemnity of $28,203, less
specified credit to defendant for applicant's third-party
recovery, and further medical treatment.
The
sole issue raised by defendant in its petition for
reconsideration is the entity against whom the benefits
should have been awarded by the WCJ. Petitioner's
attorney asserts that he first learned on September 5, 2001
that at the time of the industrial injury herein, Compuware
was insured for workers' compensation benefits by
Reliance National Insurance Company (Reliance).[1] Petitioner
characterizes the relationship of Reliance to Compuware as a
carrier with "a high self-insured retention."
Petitioner requests that the Award be amended nunc pro
tunc to reflect the I proper defendant entity, Reliance.
Petitioner asserts that the error was due to "excusable
error" which was brought to the WCJ's attention upon
discovery. Petitioner states that the amendment would not
prejudice applicant.
After
granting reconsideration, because of the important legal
issue presented, and in order to secure uniformity of
decision in the future, the Chairman of the Board, upon a
majority vote of its members, has reassigned this case to the
board as a whole for an en banc decision. (Lab. Code,
§H5.)2
In this
case we hold that where an employer's liability for
workers' compensation benefits is adjusted by a
third-party administrator, the administrator must disclose to
the Workers' Compensation Appeals Board, to the other
parties in any proceeding in which it is a party, and to its
own counsel the identity of its client, whether a
self-insured employer or insurance carrier.[3] If the client is
an insurance carrier, the administrator must disclose whether
the policy includes a "high self-insured
retention," a large deductible, or any other provision
that affects the identity of the entity actually liable for
the payment of compensation. Failure of the administrator to
disclose the identity of its client may subject it to
sanctions pursuant to Labor Code section 5813.
In this
case the third-party administrator failed to disclose the
true identity of its client until more than six years after
the date of the injury. On our own motion, we will issue
notice that sanctions may be ordered against the third-party
administrator. We will schedule a Commissioner's
Conference for clarification of the relationship between
Compuware and Reliance, and whether sanctions should be
imposed. The merits of defendant's petition for
reconsideration will be dealt with in our decision after
reconsideration.
I.
BACKGROUND
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