Mark Richter v. Frontier Communications (2024 Cal. Wrk. Comp. P.D. LEXIS 20)
The WCAB held that defendant was required to pay applicant statutory maximum of 104 weeks of temporary disability benefits and affirmed the WCJ’s finding that defendant was not entitled to credit against temporary disability for one year of State Disability Insurance paid to applicant by EDD because there was no evidence defendant reimbursed EDD for SDI paid to the applicant.
The law provides that when a defendant reimburses EDD for SDI, it is as if EDD never paid those benefits, and instead, the payments were actually made to the applicant by defendant. The reimbursement effectively converts the SDI payments into workers compensation disability indemnity.
In this case, at the time of trial, there was no evidence presented that EDD had been reimbursed. Therefore, defendant cannot take credit for the payment that was never made. Furthermore, at the time of trial the parties were given an opportunity to file post arbitration briefs. Defendants filed such brief indicating that an agreement was reached to settle EDD on the day of trial, which settlement included interest. Although a settlement may have been reached, the defendant did not confirm the payment to EDD had been made in full and final satisfaction of the agreement.
The defendant failed to realize that the if they adhered to both Labor Code and Insurance Code, wherein, if an applicant is found temporarily totally disabled beyond the hundred and four weeks and EDD is properly reimbursed, applicant should be able to access such funds with state disability for the time frames beyond the statutory hundred four weeks. By failing to reimburse EDD, defendant inappropriately withheld applicant’s own funds normally available through EDD.
Defendant is not allowed to take any credit for any benefits administered by EDD. Despite any claim that this would be a windfall to the applicant, the facts clearly show that had the benefits been properly administered by defendant, applicant would have received TTD for 104 weeks and had the ability to access the additional 52 weeks of SDI.
