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

Case No. ADJ4411072
Regular
Nov 07, 2008

FRANCISCO MARTINEZ vs. UNITED RENTALS, INC., ESIS

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding a prior decision that the defendant has no further liability for temporary disability payments. The applicant argued for continued temporary disability based on his treating physician's opinion, but the Board found that the five-year statute of limitations, as per Labor Code sections 5804 and 5410, barred further claims for temporary disability beyond the established award. The applicant's permanent and stationary status was determined by a defense QME on December 17, 2007, which ended the defendant's obligation to pay temporary disability indemnity.

Temporary disability indemnityReconsiderationPermanent and stationaryPrimary treating physicianStipulated awardLabor Code sections 54105804New and further disabilityPetition to reopenJurisdiction
References
Case No. ADJ1991870
Regular
Sep 07, 2010

TOM DRENNAN vs. SUPERIOR INSPECTION SERVICES, FIREMAN'S FUND INSURANCE COMPANY

This case involves an employer's petition for reconsideration of a WCJ's award finding industrial injury to the applicant's left knee, both hips, and gastrointestinal system as consequential to an admitted right knee injury. The defendant argues that a prior 2005 WCJ decision denying consequential injury to the left knee and hips is res judicata. The Appeals Board granted reconsideration, amending the award to remove the left knee and hip injuries, holding that the 2005 decision was final and the five-year time limit to reopen under Labor Code sections 5410 and 5804 had passed. The finding of consequential injury to the gastrointestinal system and 29% permanent disability remain affirmed.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardCompensable ConsequencesRes JudicataIndustrial InjuryLeft KneeHipsGastrointestinal SystemPermanent Disability
References
Case No. ADJ4446673 (AHM 0130995)
Regular
Oct 13, 2020

OCTAVIO ARTURO ANAYA vs. CARLOS SANDOVAL DBA SANDS TRANSPORT, STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the applicant sought an increased hourly rate for attendant care services provided since January 1, 2020. The defendant argued the Administrative Law Judge erred by modifying a 2013 stipulation award outside the five-year statutory period under Labor Code section 5804. The Appeals Board granted reconsideration, affirming the increased rate by distinguishing enforcement of awards under section 5803 from modification under section 5804. The Board clarified that the 2013 award's provision for ongoing attendant care allowed for adjustments based on reasonable costs, without violating the five-year limitation.

Workers' Compensation Appeals Boardattendant care serviceshourly rateStipulation Award OrderLabor Code section 5803Labor Code section 5804petition for reconsiderationadministrative law judgehome health carewage analysis report
References
Case No. SBA 0083894; SBA 0099253
Regular
Jul 29, 2008

RAFAEL LOPEZ vs. SAN YSIDRO RANCH, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For HIH AMERICA, In Liquidation

This case concerns an applicant's petition to amend a prior workers' compensation award to include the right shoulder as an injured body part. The Appeals Board denied reconsideration, holding that the omission of the right shoulder was not a clerical error and that Labor Code section 5804, which limits amendments to awards after five years from the date of injury, barred the requested modification. Since the applicant sought to add a new injury rather than enforce an existing award and the five-year jurisdictional limit had passed, the Board lacked the authority to grant the relief sought.

Workers' Compensation Appeals BoardPetition for ReconsiderationStipulated Awardclerical errorLabor Code § 5804continuing jurisdictiondate of injuryAgreed Medical Examiner (AME)permanent disabilitymedical treatment
References
Case No. ADJ1327186 (VNO 0352611)
Regular
Jun 02, 2010

MARTHA JONES vs. LOS ANGELES COUNTY METROPOLITAN TRANSPORTATION AUTHORITY; TRAVELERS

The Workers' Compensation Appeals Board (WCAB) affirmed a prior decision denying a defendant's request to set aside a stipulated award. The defendant argued mutual mistake of fact, claiming their counsel was unaware of a prior compromise and release agreement. However, the WCAB found the petition to set aside was untimely under Labor Code § 5804, as all injuries predated the five-year statute of limitations. Furthermore, the defendant failed to present sufficient evidence of mutual mistake regarding the actual parties' awareness of the prior agreement, and the stipulated award covered some distinct injuries.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderCompromise and ReleaseStipulated AwardSet AsideMutual Mistake of FactLabor Code § 5804Statute of LimitationsJurisdictional
References
Case No. ADJ3767421 (SFO 0438615)
Regular
Aug 02, 2010

MICHELLE ROUTSON vs. JOHN EVANS, D.D.S., ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision that found it lacked jurisdiction over a petition to transfer structured settlement payment rights. The WCAB rescinded the prior decision, holding that the five-year limitation under Labor Code section 5804 does not apply to commutations of compensation payments. Instead, such matters are governed by Labor Code section 5100, which allows the WCAB to commute payments at any time if certain conditions are met. The case is returned to the trial level for the WCJ to determine if the proposed transfer satisfies section 5100 and related Insurance Code provisions.

Structured settlement transferPetition for ApprovalInsurance Code §10134Labor Code §5804commutationWorkers' Compensation Appeals Boardjurisdictionrescindedfive-year limitationLabor Code §5100
References
Case No. ADJ578550
Regular
Nov 19, 2010

JOSE ALBERTO MARTINEZ vs. AMY'S KITCHEN and CIGA, Intercare, Paula Insurance

This case involves a clerical error in a prior Workers' Compensation Appeals Board (WCAB) order. The Board issued an order correcting its November 17, 2010 Opinion and Order Denying Petition for Reconsideration. Specifically, the word "not" was omitted on page 2, line 21, affecting the interpretation of Labor Code section 5804. The correction clarifies that the cited section does not bar the Board from amending a WCJ's decision.

Workers' Compensation Appeals BoardOrder Correcting Clerical ErrorPetition for ReconsiderationOpinion and Order Dismissing PetitionDecision After ReconsiderationLabor Code Section 5804InterlineationsCIGAPaula InsuranceMajestic Insurance Company
References
Case No. ADJ1887143 (SJO 0240404)
Regular
Feb 01, 2010

SHEILA GOKEY vs. ASSOCIATION MANAGEMENT SERVICE, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

This case concerns an admitted industrial neck injury from 2000. The defendant seeks relief from a prior stipulation agreeing to further medical treatment for the applicant's neck. The Appeals Board rescinded the prior award because the judge improperly applied Labor Code section 5804 to a stipulation, not an award. The matter is returned for a determination on whether good cause exists to set aside the stipulation and for further proceedings on the merits of medical treatment if the stipulation is vacated.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardStipulationFurther medical treatmentLabor Code section 5804Good causeRescindReturn to trial levelWaiver
References
Case No. AHM 81069 AHM 81103 AHM 81104
Regular
Jan 14, 2008

SHEILA RAY vs. RALPHS GROCERY COMPANY, SEDGWICK DMS, INC.

The Workers' Compensation Appeals Board granted reconsideration, reversing a prior order that had set aside a 2001 stipulated award. The Board found the judge lacked jurisdiction under Labor Code section 5804 to grant the applicant's petition to set aside the award due to a supposed mutual mistake regarding permanent disability rating. Consequently, the applicant's petitions to set aside the award and to reopen for new and further disability were denied.

WCABRalphs Grocery CompanySedgwick DMSSheila RayReconsiderationStipulated AwardMutual MistakeDisability Evaluation SpecialistPetition to Set AsideJurisdiction
References
Case No. SFO 0472837
Regular
Jul 17, 2007

SHANE HUNTER vs. FRANCISCAN RESTAURANT, LLC, PIER 431 / 2 PARKING CORP., ALEA-NORTH AMERICA, CHUBB SERVICES GROUP

The Workers' Compensation Appeals Board denied a petition for removal but granted reconsideration regarding Alea North America's request to set aside a prior stipulation on insurance coverage. The Board determined that Labor Code section 5804 does not preclude reconsideration of Alea's stipulation to coverage and remanded the case for an evidentiary hearing on good cause to rescind that stipulation. The joinder of Republic Indemnity Insurance Company was reinstated, and Alea remains liable for benefits pending further proceedings.

Workers' Compensation Appeals BoardPetition for RemovalPetition for ReconsiderationFindings and AwardLabor Code Section 5803Labor Code Section 5804Order of JoinderRepublic Indemnity Insurance CompanyAlea North America Insurance CompanyStipulation to Coverage
References
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