Frito-Lay, Permissibly Self Insured, Sedgwick Management Claims Services Daniel Ramos WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIADANIEL RAMOS, Applicant,vs. FRITO-LAY, Permissibly Self Insured, SEDGWICK MANAGEMENT CLAIMS SERVICES, DefendantsCase No. OAK 326483OPINION AND ORDER GRANTING RECONSIDERATION AND DECISION AFTER RECONSIDERATION Defendant seeks reconsideration of the October 13, 2007 Findings and Award wherein the workers’ compensation administrative law judge (WCJ) found that applicant, while employed on July 26, 2005, sustained industrial injury to his left knee, and that applicant was paid temporary disability indemnity (TDI) for 104-weeks from July 27, 2005 through August 7, 2007, The WCJ also found that defendant was estopped from asserting the 104-week cap on TDI from March 13, 2006, when authorization for surgery was requested, to October 13, 2006, the date surgery was performed; from December 11, 2006 through February S, 2007, subject to proof of agreement to use an agreed medical examiner (AME); and from June 12, 2007 through October 3, 2007, due to its delay in authorizing medical treatment. Defendant contends the WCJ erred in finding that it was estopped from asserting the 104-week cap on TDI, arguing that the doctrine of estoppel does not apply because there is no evidence that it supplied erroneous information upon which applicant relied to his detriment. Defendant also contends that by applying estoppel to the 104-week limitation of TDI pursuant Labor Code section 4656, subdivision (c)(1)1, the WCJ has created a new species of penalty unauthorized by statute. Defendant further contends that the WCJ erred by failing to make findings [size=1]1 . [/size][size=1]Unless otherwise stated, all further statutory references are to the Labor Code.[/size] , on all material facts pursuant to section 5313, arguing that the WCJ’s Findings of Fact Numbers 4, 5 and 6 are actually legal conclusions, and, therefore, her deci
Daniel Ramos vs. Frito-Lay: Workers' Comp Case Overview
In this case, Daniel Ramos, an employee of Frito-Lay, was injured on July 26, 2005, and was paid temporary disability indemnity (TDI) for 104-weeks from July 27, 2005 through August 7, 2007. The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration and rescinded the decision of the WCJ, finding that the defendant was not estopped from asserting the 104-week limitation of Labor Code section 4656, subdivision (c)(1). The Board found that the facts of the case did not support application of the doctrine of equitable estoppel, as the injured worker was not ignorant of the true state of the facts and the defendant had not taken any action on which
- Filed On:
- Court: California, Oakland
- Case No. ['OAK326483']
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