Gaspar: An Injury-Driven Retirement Undercut a Claim to Take Back Disability Benefits

A letter claiming you were overpaid can be especially unsettling after an injury has already forced you out of your job. Before accepting the insurer’s calculation, ask why it believes you stopped qualifying for benefits. A retirement form may establish that you left the employer, while the surrounding evidence explains that you still wanted to work.

That distinction shaped two decisions in Gaspar v. San Mateo County Transit District, No. ADJ11489504. The Board’s August 4, 2023 decision upheld the finding that an injury had compelled a bus operator to retire. Its August 5, 2024 decision then preserved an additional temporary-disability award and removed credit language concerning periods the employer had not put in dispute.

The retirement paperwork had a medical and employment history behind it

The 2023 Gaspar opinion describes roughly 25 years of work as a bus operator. His claim involved cumulative injury to his neck, lower back and left shoulder, with a separate psychiatric issue initially deferred. He underwent left-shoulder surgery in March 2019.

In the testimony recounted in Gaspar, he explained that he received a letter telling him to return to work or face termination. He was still recovering from surgery and in pain. He explained that he resigned because he did not want a termination on his record if he improved enough to pursue another job.

His account was specific. He said he had not planned to retire in May 2019, wanted to return when he recovered, and remained interested in working. He described difficulty steering a bus, sitting for extended periods and bending to tie his shoes. His resignation form also connected the decision to his shoulder surgery.

The 2023 panel in Gaspar affirmed the judge’s finding that the retirement was unplanned and compelled by the industrial injury. The later proceeding therefore began with an established finding about why he had left work.

Receiving a pension did not answer whether the injury caused lost earnings

The employer argued that Gaspar had voluntarily removed himself from the labor market. It sought a credit of about $29,000 in temporary-disability payments against his permanent-disability award.

In its first Gaspar decision, the panel applied the distinction between a person who chooses to stop all work and a person whose injury interrupts intended employment. It relied on Gonzales v. Workers’ Compensation Appeals Board, 68 Cal.App.4th 843 (1998), and Pham v. Workers’ Compensation Appeals Board, 78 Cal.App.4th 626 (2000). Gaspar’s credited account supported injury-related loss of earning capacity.

The 2023 Gaspar panel also examined the pension argument. The trial record contained no evidence of CalPERS plan language warranting the proposed reduction in workers’ compensation benefits. The existence of retirement payments, by itself, did not satisfy the employer’s compensation obligation.

Those were separate reasons to examine the actual documents. Why the worker retired concerned entitlement to wage replacement. Any claimed offset based on pension terms required support in the applicable arrangement.

The first decision required further findings before the credit could be resolved

The 2023 Gaspar ruling deferred the credit issue and sent the matter back. Although the orthopedic evaluator identified July 23, 2020 as the permanent-and-stationary date, the judge had made no corresponding finding. Questions concerning the psychiatric claim also remained unresolved.

The Board preserved 22 percent orthopedic permanent disability while directing further proceedings on the disability period and claimed overpayment. It explained that medical treatment alone does not establish temporary total disability. The medical status and the relevant period had to be determined.

The adopted report in the 2024 Gaspar decision records the parties’ stipulation to July 23, 2020 as the orthopedic permanent-and-stationary date and July 29, 2019 as the effective service-retirement date. The judge also resolved the psychiatric injury, finding no additional temporary or permanent disability from it. Those findings supplied the information missing from the first proceeding.

The later ruling preserved additional benefits and corrected the credit finding

The 2024 Gaspar opinion describes an award of temporary disability for July 29, 2019 through July 23, 2020, with the amounts due to be adjusted. The employer renewed its claim that payments after retirement were an overpayment and challenged liability for the later unpaid period.

The adopted judge’s report in Gaspar explained that the petition continued to describe the retirement as wholly voluntary, despite the earlier affirmed finding. The Board preserved the additional-benefit award.

It also corrected an important inconsistency. One finding appeared to give the employer credit for earlier payment periods that it had not raised as credit issues at either trial. The Board deleted that sentence. The amended finding recorded the periods of payments actually made and left the amounts due for adjustment.

The 2024 Gaspar decision thus requires careful reading of both the findings and the award. The final language identifies past payments without granting the deleted credit. The payment history supplies the basis for adjusting the amounts still due.

Test the proposed overpayment against the reason for retirement and the supported dates

If an insurer relies on retirement to demand a credit, compare the retirement papers with the contemporaneous medical restrictions and communications about returning to work. An accurate explanation of what you intended—and what the injury prevented—can be more useful than the label on a benefits form.

Next, match the claimed overpayment weeks to the findings establishing disability and medical stability. Keep the benefit ledger, termination notice, credit petition, pension terms and prior Board decisions together. The reason asserted in the credit petition should fit those records and any findings already made.

Gaspar is particularly useful when a proposed credit rests on treating an injury-driven departure as a voluntary end to all work. Its two decisions also show why resolving the disability period and correcting the operative credit language can protect benefits that a broad overpayment demand would otherwise consume.

Our Hillmon analysis examines a different post-retirement wage-loss record. For a separate dispute about the consequences of a proposed benefit offset, see temporary-disability overpayments and disputed credits. Our California workers’ compensation practice can help review the records in your claim.