What the panel ordered
Defendant's Petition for Reconsideration denied; WCJ's Findings and Order of May 13, 2021 affirmed
Petition for Reconsideration filed by Defendant; WCJ decision dated May 13, 2021 affirmed after reconsideration
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.
Defendant did not meet burden of proof that applicant unreasonably refused medical care because no care was ever offered to applicant.
From the decision · page 6The burden of proof rests upon the party holding the affirmative of the issue. Labor Code Section 3202.5. Defendant alleges applicant unreasonably refused medical care. It is this Court's determination that no care was ever offered to applicant. The Defendant's own witness testified that no care was to be offered when Continuity Care initially went to applicant's home. Continuity Care seemed to have no knowledge of the evaluation provided by Sue Coleman, and no knowledge of her recommendations. Continuity Care did not even have knowledge as to whom had referred them to applicant in the first place. Pursuant
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
No home health care was ever offered to applicant by defendant or Continuity Care
Favours Applicant prevailed
Defendant failed to meet burden of proof for refusal of care claim because no care was offered
From the decision · page 6The burden of proof rests upon the party holding the affirmative of the issue. Labor Code Section 3202.5. Defendant alleges applicant unreasonably refused medical care. It is this Court's determination that no care was ever offered to applicant. The Defendant's own witness testified that no care was to be offered when Continuity Care initially went to applicant's home. Continuity Care seemed to have no knowledge of the evaluation provided by Sue Coleman, and no knowledge of her recommendations. Continuity Care did not even have knowledge as to whom had referred them to applicant in the first place. Pursuant
Continuity Care was not provided with Sue Coleman's report or instructions and did not know the level of care needed
Favours Applicant prevailed
Lack of information to Continuity Care meant no care was actually offered to applicant
From the decision · page 6Although neither party asked Linda Ginsburg if Continuity Care had been given a copy of Sue Coleman's report, it is clear that Continuity Care was not. Linda Ginsburg did not even know who made the initial referral. She thought it might have been Sue Coleman. A review of Sue Coleman's report would have indicated the level of care needed by Applicant, and what specifically she needed. If Continuity Care had been given a copy of the report, their only concerns should have been how to provide the care needed as set forth in Sue Coleman's report, and whether applicant's husband was an adequate care provider, and if not, how to accomplish a transfer of care pursuant to the requirements of WCAB Rule 9767.9
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code Section 3202.5
Burden of proof rests upon the party holding the affirmative of the issue
Defendant alleged applicant unreasonably refused medical care; burden on defendant to prove refusal
From the decision · page 6The burden of proof rests upon the party holding the affirmative of the issue. Labor Code Section 3202.5. Defendant alleges applicant unreasonably refused medical care. It is this Court's determination that no care was ever offered to applicant. The Defendant's own witness testified that no care was to be offered when Continuity Care initially went to applicant's home. Continuity Care seemed to have no knowledge of the evaluation provided by Sue Coleman, and no knowledge of her recommendations. Continuity Care did not even have knowledge as to whom had referred them to applicant in the first place. Pursuant
Labor Code Section 5702; County of Sacramento v. Workers' Comp. Appeals Bd. (Weatherall) (2000) 77 Cal.App.4th 1114; Labor Code Section 4600; California Code of Regulations, title 8, section 10742
Defendant remains obligated to provide home health care 24/7 pursuant to parties' stipulations
Defendant must provide home health care as stipulated; disputes over manner of care may be brought to Appeals Board
From the decision · page 1As outlined in the WCJ's report, the evidentiary record shows that home health care was not actually offered to applicant. We therefore do not address whether applicant's December 28, 2020 letter constituted a refusal of care. Our decision here should thus not be construed as an explicit or implicit endorsement of whether applicant's request regarding nurses' COVID-19 testing information is reasonable. Defendant remains obligated to provide home health care to applicant 24 hours per day, 7 days per week pursuant to the parties' December 10, 2020 stipulations. (See Lab. Code, § 5702; see also County of Sacramento v. Workers' Comp. Appeals Bd. (Weatherall) (2000) 77 Cal.App.4th 1114 [65 Cal.Comp.Cases 1]; Lab. Code, § 4600.) If there is a dispute over the manner in which this care is offered or provided in the future, either party may seek intervention from the Appeals Board as warranted following a genuine, good faith effort to resolve the dispute informally. (Cal. Code Regs., tit. 8, § 10742.)
What proof carried it
The evidence the panel weighed, by kind.
Testimony of Linda Ginsburg that no care was offered when Continuity Care initially went to applicant's home
From the decision · page 6The burden of proof rests upon the party holding the affirmative of the issue. Labor Code Section 3202.5. Defendant alleges applicant unreasonably refused medical care. It is this Court's determination that no care was ever offered to applicant. The Defendant's own witness testified that no care was to be offered when Continuity Care initially went to applicant's home. Continuity Care seemed to have no knowledge of the evaluation provided by Sue Coleman, and no knowledge of her recommendations. Continuity Care did not even have knowledge as to whom had referred them to applicant in the first place. Pursuant
Testimony that Continuity Care was not aware of Sue Coleman's report or recommendations
From the decision · page 6Although neither party asked Linda Ginsburg if Continuity Care had been given a copy of Sue Coleman's report, it is clear that Continuity Care was not. Linda Ginsburg did not even know who made the initial referral. She thought it might have been Sue Coleman. A review of Sue Coleman's report would have indicated the level of care needed by Applicant, and what specifically she needed. If Continuity Care had been given a copy of the report, their only concerns should have been how to provide the care needed as set forth in Sue Coleman's report, and whether applicant's husband was an adequate care provider, and if not, how to accomplish a transfer of care pursuant to the requirements of WCAB Rule 9767.9
The same issues, filtered across the whole corpus — or paste your own facts and let the search rank by factor match.
About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
- The injured worker is not named here, and the case caption is not printed. Physicians appear as the decision names them, because a medical opinion is an act in a public proceeding.
- Issues, outcomes and weights were extracted by AI and released only where the source passage checked. Read the official decision before relying on anything here. Not legal advice.
- If you are named in this decision and want this page removed, write to privacy@similarcase.com.