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■ Smith v. Workers' Comp. Appeals Board S150528

In these consolidated workers’ compensation cases, we consider the scope of Labor Code section 4607, which provides: “Where a party to a proceeding institutes proceedings to terminate an award made by the appeals board to an applicant for continuing medical treatment and is unsuccessful in such proceedings, the appeals board may determine the amount of attorney’s fees reasonably incurred by the applicant in resisting the proceeding to terminate the medical treatment, and may assess such reasonable attorney’s fees as a cost upon the party instituting the proceedings to terminate the award of the appeals board.”  (Lab. Code, § 4607.[1]) 

Petitioners obtained awards for future treatment of their industrial injuries.  Sometime thereafter, they submitted medical treatment requests, but their employers’ insurance carrier disputed their entitlement to the requested care.  Petitioners initiated proceedings to obtain the treatment and, ultimately, were determined to be entitled to the requested care.  The insurer thereafter authorized the treatment requests.  Petitioners subsequently sought attorney fees pursuant to section 4607.  Based on the statutory language, the Workers’ Compensation Appeals Board (Board) denied the fee requests, but the Court of Appeal reversed.  We granted review to resolve whether section 4607 permits an award under these circumstances.  In light of the statute’s unambiguous language, we conclude it does not.  An employer or insurer that disputes a specific treatment request cannot be said to have “institute[d] proceedings to terminate an award . . . for continuing medical treatment . . .” (§ 4607).  Accordingly, we reverse the contrary judgment of the Court of Appeal.

■ HELD:

In a dispute involving attorney's fees, Court of Appeals judgment is reversed where Labor Code sec. 4607 authorizes an award of attorney fees to employees who successfully resist efforts to terminate their award of continuing medical treatment, but does not permit an award of fees to employees who successfully challenge the denial of specific treatment requests.
Smith v. WCAB-S150528- 5/11/09 SC
Smith v. WCAB-S150528- 5/11/09 SC-pdf

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