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

Case No. ADJ6697300
Regular
Aug 31, 2015

Lorenzo Yanez vs. Universal Label Printers, Sparta Insurance Company, Employers Compensation Insurance Company

This case involves an insurance dispute over contribution liability for a workers' compensation claim. The applicant, Lorenzo Yanez, sustained an injury while employed by Universal Label Printers, with coverage from Sparta Insurance Company and Employers Compensation Insurance Company. A Compromise and Release (C&R) agreement was approved, which included an addendum purportedly allocating liability between Sparta (17%) and Employers (87%). Sparta sought to enforce this addendum for reimbursement, but the trial judge denied their petition, finding a lack of jurisdiction due to no separate petition for contribution being filed within the statutory one-year period. The Appeals Board granted reconsideration, finding continuing jurisdiction to enforce the C&R and its addendum under Labor Code section 5803, and returned the matter to the trial judge to determine the enforceability and terms of the addendum.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderCompromise and ReleaseOrder Approving Compromise and ReleasePetition for ContributionLabor Code Section 5500.5Continuing JurisdictionLabor Code Section 5803Apportionment of Liability
References
Case No. ADJ9641921, ADJ9640385
Regular
Mar 29, 2016

PAZ CORRALES vs. KIMPTON HOTEL AND RESTAURANT GROUP dba KHRG GOLETA, LLC, FEDERAL INSURANCE COMPANY

The Appeals Board granted reconsideration and rescinded the Order Approving Compromise and Release (OACR) due to a problematic Addendum "A". Applicant contends Addendum "A" incorrectly settled their right to future attorney's fees and contains conflicting, unenforceable provisions regarding future claims and confidentiality. The Board found potential jurisdictional issues and inconsistencies with the law, returning the case for an evidentiary hearing to determine if the C&R should be set aside.

Petition for ReconsiderationCompromise and ReleaseAddendum ALabor Code section 5710attorney's feesrescinded OACRevidentiary hearingmistake inadvertence excusable neglectunenforceable provisionsconfidential provision
References
Case No. ADJ9942080 ADJ10381122 ADJ10260028
Regular
Apr 07, 2017

MARIO PADILLA vs. RIO FARMS, LLC, NATIONAL UNION FIRE INS. CO.

The Workers' Compensation Appeals Board granted reconsideration to address whether the defendant was entitled to a credit for $11,020 in permanent disability advances. The applicant argued against the credit, citing that the Compromise and Release explicitly stated "0.00" permanent disability indemnity paid and did not include any deductions for such advances. The Board found the defendant's interpretation of the addendum ambiguous and against the explicit language of the settlement agreement. Therefore, the Board amended the award to permit credit only for permanent disability advances made *after* the date of the Compromise and Release.

Permanent disability advancesCompromise and ReleasePetition for ReconsiderationJoint Findings and Awardcreditaddendumsettlement negotiationscontract interpretationmutual intentionWCJ
References
Case No. ADJ7900836
Regular
Jul 24, 2012

JUAN MONROY CURIEL vs. NEENAH ENTERPRISES, WAUSAU INSURANCE COMPANY

The defendant sought reconsideration of an order denying their petition to set aside a Compromise and Release agreement. The defendant argued the agreement contained a clerical error by not allocating funds for future medical care, thus violating Medicare Secondary Payer laws. The Board denied reconsideration, finding the defendant failed to demonstrate sufficient cause to set aside the agreement. The Board noted parties may file an addendum to allocate settlement proceeds for future Medicare-covered expenses due to bona fide disputes.

Workers' Compensation Appeals BoardReconsiderationCompromise and ReleaseOrder Approving Compromise and ReleaseSet Aside OrderClerical ErrorMedicare Secondary PayerFuture Medical CareAllocation of SettlementBona Fide Dispute
References
Case No. ADJ1644458 (SJO 0259802)
Regular
Apr 29, 2011

KENNY PHAN vs. TOBAR INDUSTRIES

In this workers' compensation case, the applicant sought reconsideration after the WCJ found his Labor Code section 132a claim was waived in a Compromise and Release (C&R) agreement. The applicant argued that paragraph 9 of the C&R form, requiring initials for included issues, did not show a waiver of the 132a claim, despite a conflicting provision in an addendum. The Appeals Board found ambiguity in the C&R documents and resolved it in favor of the applicant, amending the WCJ's finding to state no waiver occurred. The case was returned for further proceedings on the 132a claim.

Workers' Compensation Appeals BoardReconsiderationCompromise and ReleaseLabor Code section 132awaiverAddendumambiguityOffer of Proofhearsayburden of proof
References
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
Case No. ADJ7467289
Regular
Nov 30, 2012

RONALD ROBINSON vs. METROPOLITAN WATER DISTRICT OF SOUTHERN CALIFORNIA, JT2 INTEGRATED

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding that good cause did not exist to set aside a Compromise and Release agreement. The Administrative Law Judge found the defendant's claimed mutual mistake was unilateral, stemming from the defendant's own oversight in failing to notice the applicant's unsigned Addendum A and signing the agreement without the applicant's signature. The defendant's argument of mutual mistake regarding the scope of the settlement and a prior stipulation was insufficient to warrant setting aside the agreement. The Board also admonished the defendant for submitting unnecessary documents, violating a procedural rule.

Compromise and ReleasePetition for ReconsiderationMutual MistakeUnilateral MistakeFraudDuressUndue InfluenceStipulation and AwardCumulative TraumaAddendum A
References
Case No. RIV 0027402, RIV 0064770
Regular
Jun 02, 2008

DELIA BEJARANO vs. Riverside Community Hospital, INTERCARE INSURANCE SERVICES, ALLIANZ INSURANCE COMPANY, CONTINENTAL CASUALTY COMPANY C/O BROADSPIRE CLAIMS SERVICES, ZURICH AMERICAN INSURANCE C/O BROADSPIRE CLAIMS SERVICES

The Workers' Compensation Appeals Board granted reconsideration, rescinded the trial judge's decision, and remanded the case, finding no final agreement on settlement terms was reached between the parties. The applicant signed a compromise and release, but a subsequent addendum unilaterally introduced by one defendant, altering contribution and lien responsibilities, was not agreed upon by all parties. Therefore, no enforceable settlement existed, and the case was returned for further proceedings.

COMPROMISE AND RELEASEMANDATORY SETTLEMENT CONFERENCEADDENDUM CUNILATERAL MODIFICATIONMEETING OF THE MINDSSETTLEMENT AUTHORITYTENTATIVE AGREEMENTLIABILITY AND CONTRIBUTIONLABOR CODE SECTION 5001FAILURE OF CONSIDERATION
References
Case No. ADJ10199969
Regular
Jun 13, 2017

RAYMUNDO FERNANDEZ vs. MBM CORP., ACE AMERICAN, SEDGWICK CMS

The Workers' Compensation Appeals Board granted the applicant's petition to reconsider an approved Compromise and Release (C&R). The applicant claimed he did not understand that the settlement included waiving his Labor Code section 132a discrimination claim. The Board found that it was unclear if the parties intended to resolve the 132a claim, especially given the boilerplate language in Addendum B and the lack of inquiry into the applicant's understanding. Consequently, the Board rescinded the approval order and returned the matter to the trial level for an evidentiary hearing on the circumstances surrounding the C&R's execution.

Compromise and ReleasePetition for ReconsiderationLabor Code Section 132aDiscriminationSet Aside OrderGood CauseRescind OrderWalk-through BasisAddendum BBoilerplate Language
References
Case No. ADJ7096356
Regular
Jul 07, 2017

DAVID MARQUEZ vs. PACKAGING CORPORATION OF AMERICA, ZURICH INSURANCE COMPANY, GALLAGHER BASSETT

The Workers' Compensation Appeals Board denied David Marquez's petition for reconsideration of an order approving a compromise and release settlement. Marquez sought to set aside the settlement, alleging mutual mistake regarding the resolution of Section 5710 fees and a Civil Code Section 1542 release. The Board found no evidence of good cause for rescission based on mutual mistake, affirming the WCJ's report. However, the Board noted a separate petition to set aside the addendum and remanded it for a hearing to allow Marquez to present evidence.

Compromise and ReleasePetition for ReconsiderationMutual Mistake of FactSection 1542 Civil CodeSection 5710 feesOrder ApprovingWCJ ReportGood CauseStipulationsAttorney's Fees
References
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