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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. ADJ7432904
Regular
Sep 24, 2012

NEDA MOTAVAKEL vs. FANTASTIC SAM'S, TOWER SELECT INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, STAR INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, ENDURANCE WORKERS' COMPENSATION, SOUTHERN INSURANCE CO., FIRSTCOMP OMAHA

This case involves an appeal by Star and Tower Insurance Companies regarding a workers' compensation award. The primary issue is the applicant's average weekly earnings, specifically the inclusion of tip income, which was not adequately substantiated by documentary evidence. The Appeals Board found the initial decision lacked substantial evidence regarding earnings and rescinded the award. The matter is remanded for further proceedings to properly develop the evidentiary record on earnings and insurance coverage dates before a new decision is issued.

Workers' Compensation Appeals BoardNeda MotavakelFantastic Sam'sTower Select Insurance CompanyStar Insurance CompanyIllinois Midwest Insurance AgencyLLEndurance Workers' CompensationSouthern Insurance CompanyFirstComp Omaha
References
Case No. ADJ9782943
Regular
Jan 20, 2016

Felix Contreras vs. County of Fresno

The Workers' Compensation Appeals Board denied Felix Contreras' petition for reconsideration. The Board adopted the judge's report, which found that Contreras' injury did not arise out of and in the course of employment due to the "Going and Coming Rule." The judge found Contreras' testimony regarding his actions at the time of the accident lacked credibility, citing conflicting accounts and evidence that the stated work purpose was already completed. The Board gave great weight to the judge's credibility determinations due to observing the witness demeanor.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJGarza v. Workmen's Comp. Appeals Bd.Going and Coming RuleCourse and Scope of EmploymentCredibility DeterminationsApplicant TestimonyEmployer TestimonyPrior Findings of Fact
References
Case No. ADJ10797237
Regular
Sep 27, 2019

JOHN JENKINS vs. APPLEONE, ACE AMERICAN, GALLAGHER BASSETT

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration, adopting the Administrative Law Judge's (WCJ) report. The Board gave significant weight to the WCJ's credibility determinations based on observing witnesses. The applicant failed to meet the burden of proving industrial causation by a preponderance of the evidence. Therefore, the WCJ's original decision, denying the claim, stands.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ reportcredibility determinationsburden of proofindustrial causationpreponderance of the evidenceapplicantdefendantVan Nuys District Office
References
Case No. ADJ10612569
Regular
Mar 12, 2018

Patrick Wilder vs. The Ryan Company, Old Republic Insurance Company

This case concerns a defendant's petition for reconsideration of an award of temporary total disability (TTD) benefits to the applicant, Patrick Wilder. The Workers' Compensation Appeals Board (WCAB) denied the petition, upholding the finding that Wilder sustained an injury to his left ankle and was temporarily totally disabled. The defendant failed to prove that Wilder was terminated for cause, which would have potentially ended his TTD benefits, and the WCAB found no credible evidence to support their allegations of misconduct or availability of modified duty. The WCAB also admonished the defendant and their counsel for making unsubstantiated factual claims in their petition, warning of potential sanctions.

Workers Compensation Appeals BoardPatrick WilderThe Ryan CompanyOld Republic Insurance CompanyGallagher Bassett ServicesInc.ADJ10612569Bakersfield District OfficePetition for ReconsiderationFindings Orders and Award
References
Case No. ADJ9350015
Regular
Feb 24, 2017

LAURA SIERRA vs. RUIZ CONTRACTING, STAR INSURANCE COMPANY, Administered by MEADOWBROOKS INSURANCE GROUP, ICW

The Workers' Compensation Appeals Board denied Star Insurance Company's petition for reconsideration. The Board found that Star Insurance failed to meet its burden of proof by a preponderance of the evidence to establish entitlement to contribution. Furthermore, the petition did not adequately explain why new medical evidence was unavailable prior to the close of discovery. Therefore, the petition was denied.

Petition for ReconsiderationArbitrator's ReportBurden of ProofAffirmative of the IssuePreponderance of the EvidenceSubstantial EvidenceMedical OpinionReasonable Medical ProbabilityInadequate Medical HistoriesCumulative Trauma
References
Case No. ADJ10934545
Regular
Aug 23, 2019

Richard Rodriguez vs. CPG FOODS, LLC/GALA FOOD, Cannon Cochran Management Services Inc.

The Appeals Board granted reconsideration and modified the original award, finding that the Qualified Medical Examiner's (QME) apportionment opinion lacked substantial evidence. The Board reversed the original 12% permanent disability finding, awarding 16% based on the QME's impairment rating after reviewing surveillance video evidence. The Board also clarified that treating physician reports from Dr. Mahboubian and Dr. Ahmed are admitted into evidence and may be relied upon. Finally, the Board affirmed the original findings regarding the injured body parts and the permanent and stationary date.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardApplicantDefendantsInjury AOE/COEUpper BackHipsKneesTemporary Total Disability
References
Case No. ADJ3277733; (LAO 855716) ADJ1451780; (LAO 873046)
Regular
Sep 08, 2008

NEFERTITI HAYNES vs. RALPHS GROCERY COMPANY

The WCAB denied applicant's petition for reconsideration of the WCJ's June 19, 2008 findings that applicant did not sustain industrial injury. The WCAB found the WCJ properly relied on Dr. Minton's report, which considered a prior robbery but found it irrelevant to the applicant's current psychological diagnosis.

Petition for ReconsiderationIndustrial InjuryPsycheQualified Medical EvaluatorRemote RobberySubstantial EvidenceConflicting Medical ReportsWCJ FindingsData Entry ClerkCumulative Injury
References
Case No. ADJ7224294; ADJ6597177
Regular
Dec 31, 2012

GIOVANNI MENDOZA vs. COBY ELECTRONICS CORP., CHUBB INSURANCE

The Workers' Compensation Appeals Board denied Dr. Nachman Brautbar's petition for reconsideration regarding the disallowance of his lien. The Board affirmed the finding that Dr. Brautbar failed to meet his evidentiary burden to prove the reasonableness and necessity of his services, and that he was not the applicant's treating physician. The Board clarified that lien claimants, like defendants, must prove their case by a preponderance of the evidence, and reliance on outdated case law like *Keifer* is misplaced due to legislative amendments. Furthermore, Dr. Brautbar's failure to appear at conferences and present evidence on raised issues, coupled with procedural errors in his petition, supported the denial.

Lien claimantPetition for ReconsiderationJoint Findings and OrdersWCJindustrial injurypsychelower extremityinternalherniacervical spine
References
Case No. ADJ10950502
Regular
Mar 10, 2020

ROBERT HANSEN (Deceased), DIANA HANSEN, MAYA HANSEN, CALLIE HANSEN, ROBERT GENE REINHARDT, Guardian Ad Litem For MATTHEW HANSEN and TAYLOR HANSEN vs. FREIGHT HANDLERS, LLC., LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding that the deceased sustained a compensable industrial injury causing death. The Board agreed with the WCJ that the defendant failed to prove the decedent's intoxication proximately caused the injury, despite acknowledging the decedent was intoxicated. Furthermore, the Board found substantial evidence supported the WCJ's conclusion that the death was not a suicide and that the decedent remained within the course of employment under the commercial traveler rule, even with his intoxication and the employer's zero-tolerance policy.

Compensable Industrial InjurySuicide DefenseIntoxication DefenseCourse of EmploymentCommercial Traveler RuleProximate CauseBurden of ProofSubstantial Evidence RuleCredibility DeterminationsZero Tolerance Policy
References
Case No. ADJ12239828 (MF); ADJ12514900
Regular
Apr 17, 2023

LETICIA RIVERA GUTIERREZ vs. LABORNOW INC, GALLAGHER BASSETT GOLD RIVER

The Workers' Compensation Appeals Board granted reconsideration and amended the original Findings and Award concerning attorney fees for both adjudication numbers. The Board adopted and incorporated the WCJ's report, affirming the findings and award with the specified amendments. Specifically, Finding of Fact 8 was modified for ADJ12239828 to reflect an attorney fee of $5,698.50 plus 15% of temporary disability, and for ADJ125149008, to reflect an attorney fee of $913.50. The Board denied the defendant's petition on the issue of apportionment, finding they failed to meet their burden of proof.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactAwardAttorney FeeTemporary DisabilityPermanent DisabilityApportionmentLabor Code § 5705Labor Code § 4663
References
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