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Case Law Database

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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ7485185, ADJ9885267
Regular
Sep 18, 2017

LAURA ORTIZ vs. FARMERS INSURANCE GROUP, MID CENTURY INSURANCE

This Workers' Compensation Appeals Board decision denies a petition for reconsideration, affirming the applicant's timely invocation of jurisdiction to seek additional benefits. The Board adopted the WCJ's reasoning that the applicant's filings of an Application for Adjudication of Claim and an Amended Application, along with documented medical evidence of worsening condition, satisfied the requirements for reopening and seeking further compensation. These actions put the defendants on notice of the applicant's intent to pursue increased benefits, even without a formal petition to reopen.

Petition for ReconsiderationLabor Code section 5410Application for Adjudication of ClaimRiel v. State of CaliforniaBeaida v. Workers' Comp. Appeals Bd.stipulated awardpro perfuture medical treatmentincreased symptomsworsening condition
References
Case No. ADJ9708932
Regular
Dec 04, 2015

HECTOR ORTEGA vs. VELOCITY EXPRESS LEASING, INC., LEXINGTON INSURANCE COMPANY, c/o AMERICAN INSURANCE GUARANTEE

This case concerns Hector Ortega's claim for workers' compensation benefits for an alleged injury on June 7, 2007. The Workers' Compensation Appeals Board (WCAB) denied his petition for reconsideration, upholding the finding that his claim was barred by the one-year statute of limitations. Ortega argued that a date-stamped Application for Adjudication of Claim, received by the WCAB on July 1, 2010, proved timely filing or warranted a due process hearing. However, the WCAB found this Application was not submitted into evidence at trial, and an Amended Application, filed later, did not relate back to overcome the statute of limitations as no timely original application was in evidence. Consequently, the Board concluded that the claim was not timely filed and denied reconsideration.

Workers' Compensation Appeals BoardStatute of LimitationsLabor Code Section 5405Petition for ReconsiderationApplication for Adjudication of ClaimAmended ApplicationPre-Trial Conference StatementTollingDue ProcessGood Cause
References
Case No. ADJ10073542, ADJ10073543
Regular
Oct 23, 2015

Mike L. Luallen vs. SYSCO VENTURA, INC., GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board (WCAB) granted the applicant's petition for removal, overturning a prior order that denied a change of venue. The applicant, residing and injured in Santa Barbara County, sought to transfer his cases from the San Luis Obispo office to Santa Barbara, arguing substantial prejudice due to geographical inconvenience. The WCAB found that Santa Barbara office functions as a regular district office despite its "satellite" designation, making venue proper there per Labor Code § 5501.5(a). Consequently, the WCAB ordered venue transferred to the Santa Barbara office for both cases.

Petition for RemovalJoint Order Denying Change of VenueWCJApplicant's ResidenceEmployer's WorkplaceInjury LocationAttorney's Principal Place of BusinessLabor Code Section 5501.5VenueAppeals Board
References
Case No. ADJ11276421
Regular
Mar 15, 2019

SABAS GAMBOA vs. FULLERTON PACIFIC INTERIORS, INC., INSURANCE COMPANY OF THE WEST

The applicant sought reconsideration of an order dismissing defendant Clark Builders and others, arguing it was improper as Clark Builders was not a party. The Appeals Board dismissed the applicant's petition for reconsideration as untimely and from a non-final order. However, the Board granted removal on its own motion to correct the record, as Clark Builders was never properly a party. The Board rescinded the original dismissal order and issued a new order dismissing Arch Indemnity Insurance Company and Gallagher Bassett Services, Inc. without prejudice.

Workers' Compensation Appeals BoardPetition for ReconsiderationRemovalOrder DismissingLack of EmploymentClark BuildersArch Indemnity Insurance CompanyGallagher Bassett ServicesInc.Fullerton Pacific Interiors
References
Case No. ADJ9904638, ADJ7352002
Regular
Jul 25, 2017

Carmen Caez vs. California Department of Social Services (IHSS), administered by YORK RISK SERVICES GROUP, INC.

The Workers' Compensation Appeals Board granted reconsideration, amending the prior decision to defer the statute of limitations issue for the applicant's low back and other injuries sustained on November 1, 2008. The Board found the initial determination barring benefits lacked substantial evidence, particularly regarding the timeliness of the claim under Labor Code section 5405. Further development of the record is required to address potential tolling of the statute of limitations due to the employer's failure to provide proper workers' compensation notification. The case is returned for further proceedings to resolve these issues.

ADJ9904638ADJ7352002IHSS caregiverLabor Code sections 35503551statute of limitations tolledclaim formHoneywell v. Workers' Comp. Appeals Bd.denial letterApplication for Adjudication
References
Case No. ADJ7940890
Regular
Dec 13, 2013

Katherine Hunter vs. Cedars-Sinai Medical Center

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior finding, ruling that the applicant's claim is barred by the statute of limitations. The applicant filed her claim over one year after receiving a denial of benefits, which restarted the one-year limitations period. The Board found no evidence presented by the applicant to support any exceptions to the statute of limitations, despite her arguments of confusion regarding a withdrawal form. Therefore, the applicant's claim was dismissed, except for potential medical-legal costs.

Statute of LimitationsWorkers' Compensation Appeals BoardReconsiderationFindings of FactDWC-1Notice of DenialTollingAffirmative DefenseBurden of ProofLabor Code Section 5405
References
Case No. ADJ8855485
Regular
Nov 07, 2019

IMELDA SOSA vs. BRAWLEY UNION HIGH SCHOOL DISTRICT, ATHENS ADMINISTRATORS, LIBERTY MUTUAL INSURANCE, SELF-INSURED SCHOOLS OF CALIFORNIA

This case involves an employer's reconsideration request concerning a finding of cumulative trauma injury. The applicant was found to have sustained a cumulative trauma injury through June 13, 2011, resulting in 23% permanent disability and an award for indemnity and future medical treatment. The employer argued against compensable temporary disability for a single day's absence and questioned the applicant's knowledge of the cumulative trauma's industrial cause. The Board affirmed the original award, finding the applicant had knowledge of an industrial injury and suffered disability on June 13, 2011.

Cumulative trauma injuryDate of injuryLabor Code section 5412Compensable temporary disabilityPermanent disabilityIndustrial accident leaveEducation CodeWorkers' Compensation Appeals BoardReconsiderationFindings Award and Order
References
Case No. ADJ3192115 (SBR 0342658)
Regular
Feb 03, 2014

YONIR ALARCON vs. STELLAR ENTERPRISES, CALIFORNIA INSURANCE COMPANY

This case involves an applicant seeking workers' compensation benefits for injuries stemming from a fall. The WCJ initially awarded benefits for chest pain, right hand, and head injury, but denied claims for sleep apnea, shortness of breath, scarring, right eye, jaw, psyche, and neck. The applicant requested reconsideration, arguing the WCJ erred in denying these additional claims and in failing to further develop the medical record. The Appeals Board affirmed the WCJ's decision, finding applicant failed to properly object to medical findings and that discovery had closed. A dissenting commissioner argued for reconsideration to allow further development of the record, citing inadequate initial medical treatment and potential for more extensive injuries.

Workers' Compensation Appeals BoardIndustrial InjuryPetition for ReconsiderationFindings and AwardMedical DeterminationsLabor CodeMandatory Settlement ConferenceDissenting OpinionOccupational InjuryMedical Provider Network
References
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