“As explained in our opinion in Mendoza v. Huntington Hosp. et al. (2010) 75 Cal.Comp.Cases 634 (Appeals Board en banc) (writ den.), “[t]he WCAB has exclusive original jurisdiction to determine the validity of regulations adopted by the A[dministrative] D[irector]. [Citations.]””
(Dennis, supra, citing Mendoza v. Huntington Hosp. (2010) 75 Cal.Comp.Cases 634, 640 (Appeals Bd. en banc) (writ den.), at p. 8.)
“In making this determination, a court must consider the following: (1) whether the regulation is consistent and not in conflict with the statute, and (2) whether the regulation is within the scope of the authority conferred. (Mendoza, at p. 640.) A regulation that is inconsistent with the statute is invalid. (Ibid.) Likewise, a regulation that exceeds the scope of the enabling statute is invalid.”
(Dennis, supra, citing Mendoza, supra, 75 Cal.Comp.Cases at pp. 640–641 (Appeals Bd. en banc), at p. 9.)
““Accordingly, ‘any . . . regulation promulgated by the [Administrative] Director of the Division of Workers’ Compensation in contradiction to the Workers’ Compensation Act is invalid. . . . [A]dministrative regulations may not contravene [the] terms of statutes under which they are adopted. [Citations.]’” (Ibid.) Courts “not only may, but it is their obligation to strike down such regulations. [Citations.]””
(Dennis, supra, quoting Mendoza, supra, at p. 9.)
“We do not dispute that an “administrative regulation is presumptively valid” and that “if there is a reasonable basis for it, a reviewing court [shall] not substitute its judgment for that of the administrative body.” (Tomlinson v. Qualcomm, Inc. (2002) 97 Cal.App.4th 934, 940; Boughner v. Comp USA, Inc. (2008) 73 Cal.Comp.Cases 854, 860 (Appeals Board en banc); see AD’s Response, p. 3:12-16.) But this presumptive validity is rebuttable and the law sets forth clear standards as discussed above for rebutting it. (Boughner, supra.)”
(Dennis, supra, citing Tomlinson v. Qualcomm, Inc. (2002) 97 Cal.App.4th 934, 940; Boughner v. Comp USA, Inc. (2008) 73 Cal.Comp.Cases 854, 860 (Appeals Bd. en banc), at p. 9.)
“A statute[16] is a law enacted by the Legislature. A regulation is a rule issued by a governmental agency and must be authorized by statute.”
(Dennis, supra, fns. 16–17 [dictionary definitions omitted], at p. 15.)
“The Workers’ Compensation Act is found in Divisions 4 and 4.5 of the Labor Code, as administered and enforced by the Division of Workers’ Compensation under the control of the Administrative Director, “except as to those duties, powers, jurisdiction, responsibilities, and purposes as are specifically vested in” the Appeals Board.”
(Dennis, supra, as quoted in Vazquez, supra, at p. 8, quoting Lab. Code, § 111 — the line between the Division and the Appeals Board; also printed at § 1.3.) · same rule printed at § 1.3
“Neither statute authorizes the Administrative Director to adjudicate SJDB disputes. As discussed above, the power to adjudicate workers’ compensation claims is reserved exclusively to the WCAB. (§§ 5300, 5307;”
(Dennis, supra — administration is not adjudication; applied at § 15.3, at p. 13.) · same rule printed at § 15.3
“[R]equiring a party to file an appeal within a specified timeframe is not within the Administrative Director’s administrative authority because, as discussed above, this requirement restricts a party from accessing the jurisdiction of the WCAB.”
(Dennis, supra — a regulatory deadline may not restrict access to the Board; applied at § 15.3, at p. 15.) · same rule printed at § 15.3
“For instance, we observe that the Administrative Director’s initial determination regarding disputed medical bills is distinct from an initial determination regarding SJDB disputes because the former is based on statute (§ 4603.6(f)) and the latter is based on a regulation (Cal. Code Regs., tit. 8, § 10133.54). . . . Thus, while the Administrative Director may properly make an initial determination regarding disputed medical bills, this is not the case with SJDB disputes.”
(Dennis, supra — the statute/regulation distinction that decides which initial determinations stand; applied at § 15.3, at p. 14.) · same rule printed at § 15.3
“Thus, while the rules are valid, AD Rules 31.3 and 31.5 cannot be interpreted as finally determining whether a replacement panel is appropriate because such an interpretation would usurp the adjudicative power of the Appeals Board to determine whether a QME should be replaced.”
(Vazquez, supra, at p. 13 — a valid rule may still not adjudicate; applied at § 9.6.) · same rule printed at § 9.6
“WCAB Rule 10390 does not supersede the Coldiron decisions. Defendants must comply with WCAB Rule 10390 and the disclosure requirements in Coldiron I and II, regardless of whether there is a third-party administrator.”
(DiFusco, supra, at p. 2 [Holding No. 3] — a renumbered Board rule does not displace en banc precedent; applied at § 16.2.)
Cross-references: § 1.2 (a regulation cannot supersede en banc precedent); § 1.3 (the Board’s own rulemaking power); § 2.1 (the statutory carve-outs from exclusive jurisdiction); § 9.6 (AD Rules 31.3, 31.5 applied); § 15.3 (AD Rule 10133.54 held invalid).
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