CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. ADJ3668486 (SBA 0081243) ADJ2866077 (SBA 0073112) ADJ3676183 (SBA 0082815) ADJ3511801 (GOL 0090292) ADJ2318677 (GOL 0095094) ADJ658495 (SBR 0193676)
Regular
Jul 09, 2009

FRANCINE KOBLICK vs. PALM SPRINGS UNIFIED SCHOOL DISTRICT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ACE/ESIS

This case concerns ACE/ESIS seeking reconsideration of a WCJ's decision that CIGA was not responsible for a Blue Cross lien. ACE/ESIS and CIGA had settled the applicant's multiple injury claims via a Compromise and Release agreement which included an addendum obligating both parties to pay 50% of adjusted liens. CIGA argued it was not liable for the Blue Cross lien due to Insurance Code § 1063.1(c) excluding "covered claims" related to insurers, similar to the *Gorgi* case. The Appeals Board granted reconsideration, finding the WCJ erred by distinguishing this case from *Gorgi* due to CIGA's voluntary contractual agreement to pay 50% of liens, making it analogous to the *Carter* case. The Board rescinded the WCJ's finding and returned the matter for further proceedings, holding that CIGA's contractual promise overrides the statutory exclusion for liens.

CIGAACE/ESISCompromise & ReleaseLienBlue CrossInsurance Code § 1063.1(c)Contractual ObligationCovered ClaimReconsiderationWorkers' Compensation Appeals Board
References
2
Case No. ADJ10168186 ADJ10168303
Regular
Mar 17, 2020

JOSEFINA VALDIVIA vs. KING MEAT, INC., ACE/ESIS

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior decision concerning Josefin Valdivia's claims against King Meat, Inc. and ACE/ESIS. While affirming the January 10, 2020 decision, the WCAB amended it to defer specific issues. The determination of whether the injury arose out of and occurred in the course of employment (AOE/COE) is deferred. Furthermore, issues regarding permanent disability and entitlement to future medical treatment are also deferred.

AOE/COEPetition for ReconsiderationWorkers' Compensation Appeals BoardPermanent DisabilityFuture Medical TreatmentWCJ ReportDecision After Reconsideration
References
0
Case No. ADJ9527444
Regular
May 23, 2018

, REYES P. HERNANDEZ, vs. , QUALI RUN RANCH; STATE COMPENSATION INSURANCE FUND; OMA OJAI PACIFIC; ZENITH INSURANCE COMPANY; ACE USA INSURANCE COMPANY, Administered By ESIS; MICHAEL AND JODY CROMER, Homeowners; STATE FARM INSURANCE,

The Workers' Compensation Appeals Board granted ESIS's Petition for Removal because the WCJ's order denying ESIS a panel Qualified Medical Evaluator (PQME) evaluation was found to cause significant prejudice and irreparable harm. ESIS was not a party to the original Agreed Medical Examiner (AME) agreement between the applicant and SCIF, and the WCJ's decision unfairly bound ESIS to the AME's findings and effectively closed ESIS's discovery rights. The Board rescinded the WCJ's decision and ordered a PQME evaluation for ESIS, recognizing the denial violated ESIS's due process rights.

Petition for RemovalQualified Medical EvaluatorAgreed Medical ExaminerDue ProcessSignificant PrejudiceIrreparable HarmDiscoveryFindings and OrderWorkers' Compensation Appeals BoardCumulative Trauma
References
6
Case No. ADJ10717582
Regular
Mar 28, 2023

SCOTT SEHORN vs. DAVE & BUSTER'S, INC., ACE AMERICAN INSURANCE COMPANY, ADMINISTERED BY ESIS

The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's Petition for Reconsideration as it did not appeal a final order or decision. The WCAB also denied the defendant's Petition for Removal, finding no abuse of discretion by the judge regarding the admission of an Agreed Medical Evaluator's (AME) reports and the restriction of ex parte communications with a physician. The Board concluded that the defendant failed to demonstrate irreparable harm or that reconsideration would be an inadequate remedy. Therefore, both petitions were dismissed and denied respectively.

Agreed Medical EvaluatorPetition for ReconsiderationPetition for RemovalAdministrative Director RuleDue ProcessIrreparable HarmSubstantial PrejudiceFinal OrderInterlocutory OrderTimeliness
References
12
Case No. ADJ620686
Regular
Jul 06, 2015

YOLANDA ALVAREZ vs. BURNS INTERNATIONAL SECURITY SERVICES, ACE USA/ESIS

This case concerns a Petition for Removal filed by Burns International Security Services and ACE USA/ESIS. The Workers' Compensation Appeals Board denied the petition because removal is an extraordinary remedy requiring a showing of substantial prejudice or irreparable harm, which the defendants failed to demonstrate. The Board found that reconsideration would be an adequate remedy should an adverse final decision issue. The Board also noted a slight discrepancy regarding the closure of discovery, but ultimately adopted the WCJ's reasoning in denying removal.

Petition for RemovalWorkers' Compensation Appeals BoardMandatory Settlement ConferenceDiscoveryCompensable Consequence InjuryIncontinencyLumbar Spine InjuryUtilization ReviewAuthorizationPrejudice
References
2
Case No. ADJ1817132 (VNO 0556434)
Regular
Jun 22, 2012

JESUS MORAN vs. SANTA CLARITA CONCRETE, ACE AMERICAN INSURANCE CO c/o ESIS

The Appeals Board dismissed ACE American Insurance's Petition for Reconsideration because it was not filed against a final order. However, the Board granted ACE's Petition for Removal, rescinded the order denying joinder, and returned the case to the trial level for a hearing on the joinder issue. This decision provides ACE due process to present its evidence and arguments regarding joinder, and requires notice and an opportunity to be heard for the party ACE seeks to join. The Board's decision does not prejudice the merits of the joinder petition itself.

Petition for ReconsiderationPetition for RemovalPetition for JoinderOrder Denying Petition for JoinderOrder Approving Compromise and ReleaseDate of InjuryEquitable IndemnityReimbursementDue DiligenceSupplemental Petition
References
0
Case No. ADJ2624099 (AHM 0134865)
Regular
Nov 06, 2013

JACALYN HALE (Deceased) vs. MESA MEDICAL GROUP, ACE USA c/o ESIS, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Appeals Board dismissed ECIC's Petition for Reconsideration because the WCJ's order regarding contribution proceedings was not a final determination of substantive rights. The Board also denied ECIC's Petition for Removal, finding no evidence of substantial prejudice or irreparable harm from the WCJ's statement that the contribution issue might eventually be subject to mandatory arbitration. The WCJ had merely overruled ECIC's objection to ACE/ESIS's contribution petition and allowed discovery, not ordered arbitration itself. Therefore, any arguments about mandatory arbitration were premature.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalWCJ OrderContribution ProceedingsMandatory ArbitrationLabor Code Section 5500.5ACE/ESISECICIndustrial Injury
References
0
Case No. ADJ746026 (SJO 0221595) ADJ1315805 (SJO 0221596) ADJ2490198 (SJO 0221597) ADJ1525795 (SJO 0234303)
Regular
Feb 03, 2010

GILBERT GASKA vs. EAST SIDE UNION HIGH SCHOOL, ACE/USA, CALIFORNIA INSURANCE GUARANTEE ASSOCATION

This case involves claims for reimbursement between two insurers covering applicant's industrial injuries. CIGA, representing an insolvent insurer, sought reimbursement from ACE/USA for medical benefits paid. The arbitrator initially awarded CIGA approximately $105,000, later amended to $138,555.15 due to a clerical error. ACE/USA petitioned for reconsideration, arguing CIGA's claim was untimely and improperly based on contribution or subrogation. The Board dismissed CIGA's petition as moot because the corrected award had already been issued. The Board denied ACE/USA's petition, clarifying CIGA's claim was for reimbursement under Insurance Code section 1063.1, not untimely contribution or subrogation, and that ACE/USA was liable due to providing "other insurance" for the same injuries.

Workers' Compensation Appeals BoardCalifornia Insurance Guarantee AssociationCIGAACE/USAFremont Compensation Insurance Companyinsolvencycumulative injuryspecific injuryreimbursementcontribution
References
3
Case No. ADJ7110663
Regular
May 09, 2016

WILLIAM BO MATTHEWS vs. SAN DIEGO CHARGERS, ZENITH INSURANCE COMPANY, NEW YORK GIANTS, INSURANCE COMPANY OF NORTH AMERICA/ACE USA, DENVER GOLD, THE NORTH RIVER INSURANCE COMPANY

This case involves a petition for reconsideration of an arbitrator's decision regarding workers' compensation liability for a professional football player's cumulative trauma injuries. The Workers' Compensation Appeals Board (WCAB) granted reconsideration and modified the arbitrator's award, finding the applicant sustained two separate cumulative trauma injuries due to distinct periods of employment exposure. Consequently, the WCAB ruled that the petitioner, Insurance Company of North America/ACE USA (ESIS), is not liable for contribution to another insurer, The North River Insurance Company (NRIC), which had mistakenly paid a portion of a settlement. The Board affirmed the finding of two injuries, citing a significant break in employment as creating separate compensable periods, but rescinded the award to NRIC, holding NRIC should recover nothing from ESIS.

WCABPetition for ReconsiderationArbitration DecisionContributionCumulative InjuryProfessional Football PlayerInsurance Company of North America/ACE USAZenith Insurance CompanyThe North River Insurance CompanyLabor Code Section 5500.5
References
9
Case No. MISSING
Regular Panel Decision

Agriculture Ins. Co., Inc. v. Ace Hardware Corp.

Plaintiff Agricultural Insurance Company, Inc., as assignee of injured worker Robert T. Treadway, Jr., moved for partial summary judgment on liability under N.Y. Labor Law § 240(1) against defendants Ace Hardware Corporation and Butler Construction Company. Treadway was severely injured when he fell from an elevated height at a construction site after the steel beam he was standing on collapsed. Although provided with a safety harness and line, these were attached to the very beam that failed, rendering them inadequate. The court granted the plaintiff's motion, concluding that the defendants violated § 240(1) by failing to provide proper protection and that this failure was the proximate cause of Treadway's injuries. The court rejected arguments regarding the admissibility of an accident report, a superceding cause (wind), and Treadway's contributory negligence.

N.Y. Labor LawSummary JudgmentLiabilityConstruction AccidentElevated WorkSafety DevicesProximate CauseContributory NegligenceHearsay ExceptionParty Admission
References
31
Showing 1-10 of 785 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational