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Case Law Database

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

Case No. ADJ10125079
Regular
Feb 22, 2017

BIRGIT GALINDO vs. AMERICAN MEDICAL RESPONSE, ACE AMERICAN INSURANCE COMPANY

This case involves a petition for removal filed by the defendants, American Medical Response and its insurer. The Workers' Compensation Appeals Board (WCAB) denied the petition, citing that removal is an extraordinary remedy only granted in cases of substantial prejudice or irreparable harm. The WCAB found that the defendants failed to demonstrate such harm and that reconsideration would be an adequate remedy if an adverse decision is eventually issued. Therefore, the defendants' contentions can be raised with the trial judge.

Petition for RemovalWorkers' Compensation Appeals BoardSubstantial PrejudiceIrreparable HarmReconsiderationWCJ AnalysisAdministrative Law JudgeExtraordinary RemedyFinal DecisionTrial Judge
References
Case No. ADJ3254428 (SRO 0136801) ADJ1661194 (SRO 0139193) ADJ7923965
Regular
May 14, 2012

WENDY O'SULLIVAN vs. RADNET/DIS, EVEREST NATIONAL INSURANCE COMPANY, Administered By AMERICAN COMMERCIAL, GOODWILL OF THE REDWOOD EMPIRE, STATE COMPENSATION INSURANCE FUND, SUBSEQUENT INJURIES BENEFITS TRUST FUND

In O'Sullivan v. Radnet/DIS, et al., the Workers' Compensation Appeals Board (WCAB) granted petitions for reconsideration filed by both the applicant and defendant. The Board found it necessary to grant reconsideration to allow for further study of the factual and legal issues. This action is intended to ensure a complete understanding of the record and enable a just and reasoned decision. All future filings in this matter are ordered to be submitted in writing to the WCAB Commissioners' office, not to district offices or via e-filing.

Workers' Compensation Appeals BoardPetitions for ReconsiderationGranting ReconsiderationStatutory Time ConstraintsFactual and Legal IssuesJust and Reasoned DecisionFurther ProceedingsOffice of the CommissionersSan FranciscoElectronic Adjudication Management System
References
Case No. ADJ10541840
Regular
Nov 10, 2016

FRANCIS ESPINOZA vs. COMMERCIAL METALS COMPANY, AMERICAN ZURICH INSURANCE COMPANY

In this Workers' Compensation Appeals Board case, the Board granted reconsideration to further review the issues. However, the Defendant subsequently withdrew their Petition for Reconsideration. Consequently, the Board has dismissed the Defendant's Petition. The decision to dismiss the Petition for Reconsideration was issued after the Defendant's withdrawal.

Workers' Compensation Appeals BoardReconsiderationPetition for ReconsiderationDismissedCommercial Metals CompanyAmerican Zurich Insurance CompanyFrancis EspinozaADJ10541840San Francisco District OfficeDecision After Reconsideration
References
Case No. SRO 0110490
Regular
Jan 14, 2008

DIANE INGRAM vs. DENNY'S RESTAURANTS, CIGA For HIH INSURANCE, In Liquidation, INTERCARE INSURANCE SERVICES, American Casualty Company

This case involves a dispute over reimbursement between the California Insurance Guarantee Association (CIGA) and American Casualty Company (American). CIGA, having paid benefits for an applicant's cumulative trauma injury, sought reimbursement from American, the solvent insurer during a portion of that injury period. The Workers' Compensation Appeals Board affirmed an award of $29,988.31 to CIGA, finding that American's delay in assuming responsibility and existing case law required American to cover CIGA's interim payments, despite American's res judicata arguments.

Workers Compensation Appeals BoardCIGAHIH InsuranceAmerican Casualty CompanyReconsiderationFindings and AwardArbitratorLien ClaimRes JudicataCumulative Trauma
References
Case No. ADJ1607898 (LAO 0879867) ADJ2804252 (LAO 0879869) ADJ4136955 (LAO 0879868)
Regular
Sep 20, 2016

JON VERDOULIS vs. INK SYSTEMS, INC., AMERICAN INSURANCE/FIREMANS FUND INSURANCE COMPANY

This case involves a worker's cumulative trauma claims against Ink Systems, Inc. and American Insurance. The Administrative Law Judge (ALJ) initially found American Insurance liable for certain periods and allowed the applicant to elect against them. American Insurance sought reconsideration, arguing a prior settlement barred claims and their liability was limited by Labor Code section 5500.5. The Appeals Board granted reconsideration, adopting the ALJ's recommendation to amend the decision. The Board ultimately affirmed the original decision except for finding that the applicant *cannot* elect against American Insurance for these cumulative trauma claims.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactCompromise and ReleaseRes JudicataLabor Code section 5500.5cumulative traumaelection against insurerWCJadministrative law judge
References
Case No. LBO 0351450 LBO 0351451
Regular
Jan 18, 2008

KIMBERLY CARTER vs. BROWNING AUTOMOTIVE, MATRIX ABSENCE MANAGEMENT, INC.

The Workers' Compensation Appeals Board granted reconsideration to correct a clerical error in a prior award. The Board amended the findings and award to accurately identify Everest National Insurance Company, adjusted by American Commercial Claims Administrators, as the liable carrier for the May 25, 2002 injury. The amendment also clarifies the employer's insurance coverage periods and the correct administrator.

Workers' Compensation Appeals BoardReconsiderationJoint Findings & Award & OrderIndustrial InjuryCervical SpineLumbar SpineKnee InjuryWorkers' Compensation CarrierMatrix Absence ManagementInc.
References
Case No. POM 283452
Regular
Aug 07, 2007

GUADALUPE OLAGE vs. STAFFMARK, AMERICAN HOME INSURANCE, Adjusted By AIG/AMERICAN INTERNATIONAL CLAIMS

The Workers' Compensation Appeals Board granted reconsideration of a prior award, rescinding it due to insufficient evidence regarding the applicant's average weekly earnings. The Board found the applicant's irregular work hours necessitated a calculation based on earning capacity, but the record lacked evidence to accurately predict this capacity. The case is remanded to the trial level for further proceedings to determine the applicant's average weekly earnings.

Workers' Compensation Appeals BoardGuadalupe OlageStaffmarkAmerican Home InsuranceAIG/American International ClaimsCase No. POM 283452Opinion and Order Granting ReconsiderationDecision after ReconsiderationFindings and AwardIndustrial Injury
References
Case No. ADJ4484214, ADJ1095231, ADJ1532047, ADJ7900801
Regular
May 17, 2017

CANA SWARTOUT vs. ENTERTAINMENT PARTNERS, AMERICAN HOME ASSURANCE, AIG CLAIMS SERVICES, CAST & CREW ENTERTAINMENT, ZURICH NORTH AMERICA, ENTERTAINMENT PARTNERS, AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA, CNA CLAIMS PLUS

This case involved multiple employers and insurance carriers for Dana Swartout's various work-related injuries sustained between 2002 and 2007. The Workers' Compensation Appeals Board (WCAB) initially issued findings but granted reconsideration to study the issues, including contentions about permanent total disability and statute of limitations. Following settlement conferences, the parties entered into a Compromise and Release agreement, which the WCAB has now approved. The WCAB rescinded its prior order and approved the settlement, finding it adequate and in the applicant's best interest.

Workers Compensation Appeals BoardDana SwartoutEntertainment PartnersAmerican Home AssuranceAIG Claims ServicesCast & Crew EntertainmentZurich North AmericaAmerican Casualty CompanyCNA Claims PlusPermanent Total Disability
References
Case No. ADJ2239874 (STK 0170112) ADJ472994 (STK 0198041) ADJ3391005 (STK0208641)
Regular
Dec 15, 2008

MITCHELL PACHECO vs. INNOVATIVE STEEL SYSTEMS and CALIFORNIA INSURANCE GUARANTEE ASSOCIATION on behalf of FREMONT COMPENSATION INSURANCE COMPANY, in liquidation, LENNAR CORPORATION and OLD REPUBLIC INSURANCE COMPANY, RICHMOND AMERICAN HOMES and AMERICAN HOME ASSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration, rescinded the previous award, and returned the case to the trial level. The Board found that the WCJ erred by applying the wrong disability rating schedule and by issuing a combined award for three separate successive injuries. The matter is remanded for separate determinations of permanent disability for each injury, with the 2005 and 2006 injuries to be rated under the 2005 Schedule.

CIGAFremont Compensation Insurance CompanyliquidationInnovative Steel SystemsLennar CorporationOld Republic Insurance CompanyRichmond American HomesAmerican Home Assurance Companyindustrial injuriesneck
References
Case No. ADJ7552195, ADJ7564482
Regular
Feb 22, 2013

REYNA MARQUEZ vs. SENSIENT TECHNOLOGIES, ZURICH AMERICAN INSURACE CO., SEDGWICK CMS, ACE AMERICAN INSURANCE CO., SPECIALTY RISK SERVICES

This case concerns two workers' compensation claims for industrial injuries to the applicant's left shoulder and low back, respectively. The defendants, Zurich and ACE, petitioned for reconsideration, arguing that the findings of industrial injury were not supported by substantial medical evidence and that they were denied due process regarding an agreed medical evaluator's supplemental report. The Appeals Board denied reconsideration, finding that the defendants waived their due process objections by failing to raise them at the trial level or in their initial petition. The Board incorporated the WCJ's report, which found no basis for the defendants' arguments.

WORKERS' COMPENSATION APPEALS BOARDSENSIENT TECHNOLOGIESZURICH AMERICAN INSURANCE COMPANYACE AMERICAN INSURANCE COMPANYSEDGWICK CMSSPECIALTY RISK SERVICESAGREED MEDICAL EVALUATORDR. CHARLES F. XELLERSUPPLEMENTAL REPORTFINDINGS OF FACT
References
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