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

Case No. ADJ312652 (STK 0204453)
Regular
Nov 14, 2008

AMADOR CISNEROS vs. CBC FRAMING and VIRGINIA SURETY, adjusted by CAMBRIDGE INTEGRATED RESOURCES

This case involves a dispute over a Workers' Compensation Appeals Board (WCAB) decision to set aside a prior order and require the defendant to produce the claims adjuster for testimony. The WCAB denied the defendant's petition for removal, finding no abuse of discretion by the judge who properly used WCAB Rule § 10859 to rescind the prior order and allow for further proceedings. The defendant's arguments regarding the applicant's failure to produce the adjuster at trial were deemed premature as no order compelling appearance had been issued.

WCABPetition for RemovalOrder Setting Aside FindingsWCJ DiscretionWCAB Rule 10859Claims AdjusterMandatory Settlement ConferencePetition for ReconsiderationWCAB Rule 10843(b)AOE/COE
References
Case No. LBO 0366043
Regular
Jul 02, 2008

STEVEN DUGAN vs. COCA-COLA, Permissibly Self-Insured, SEDGWICK CLAIMS MANAGEMENT SERVICES

In this workers' compensation case, the Workers' Compensation Appeals Board granted reconsideration to correct a calculation error. The Board found that the applicant's permanent disability rating should be adjusted for his actual age of 47, not the older age group used by the initial judge. Consequently, the permanent disability rating was reduced from 34% to 31%.

WCABPetition for ReconsiderationPermanent DisabilityAge AdjustmentIndustrial InjuryFindings and AwardWorkers' Compensation JudgeAdjusting AgentSelf-InsuredAttorney's Fees
References
Case No. ADJ7166686
Regular
Jul 24, 2012

RICHARD ANDERSON vs. JAGUAR/LANDROVER OF VENTURA, COMPWEST INSURANCE COMPANY

This case involves an applicant who suffered a stroke and subsequent 100% permanent disability following surgery for an industrial shoulder injury. The defendant sought reconsideration, arguing for apportionment to pre-existing conditions and challenging the attorney's fee calculation. The Appeals Board affirmed the 100% permanent disability finding, finding no basis for apportionment as the applicant's pre-existing conditions did not cause the disability itself. However, the Board modified the attorney's fee award, requiring commutation using a specific method and a 3% cost of living adjustment, finding the previously assumed 4.6% to be speculative.

Workers Compensation Appeals BoardRichard AndersonJaguar/Landrover of VenturaCompwest Insurance CompanyADJ7166686ReconsiderationFindings and AwardIndustrial InjuryBrain InjuryNeurological System
References
Case No. ADJ6674098
Regular
Apr 25, 2013

ROSA NASH vs. GENERAL HOSPITAL - COUNTY OF LOS ANGELES

The Appeals Board granted reconsideration of the WCJ's decision concerning penalties and attorney's fees for delayed compensation payments. The Board found that the defendant's persistent failure to timely pay the May 7, 2012 award, due to adjusters lacking a complete copy of the decision, was unreasonable and warranted increased attorney's fees. Consequently, the Board rescinded the WCJ's decision and substituted its own, awarding additional attorney's fees of $19,200.00, along with sanctions against the defendant's adjusters and claims administrator.

Labor Code sections 581358145814.5Petition for ReconsiderationUnreasonable DelaySanctionsAttorney's FeesPermanent DisabilityTemporary DisabilityAdjuster
References
Case No. ADJ9497391
Regular
Nov 19, 2014

STEVEN TOTH vs. KAISER PERMANENTE, administered by SEDGWICK CMS

The Workers' Compensation Appeals Board (WCAB) dismissed Kaiser Permanente's Petition for Removal because the issue giving rise to the petition was resolved. Kaiser sought removal of a WCJ's order requiring their claims adjuster to appear with the entire claims file. However, the adjuster appeared, the case was resolved, and no further issues remained pending. Consequently, the WCAB deemed the removal petition moot and dismissed it.

Petition for RemovalWorkers' Compensation Appeals BoardClaims FileMootDismissedWCJClaims AdjusterResolved CaseADJ9497391Kaiser Permanente
References
Case No. ADJ8484771, ADJ6747914
Regular
Jun 18, 2014

MIKE REIS vs. SILVAS OIL COMPANY, INC., EMPLOYERS INSURANCE OF WAUSAU, LIBERTY MUTUAL INSURANCE COMPANY

This case involves a defendant's petition challenging an administrative law judge's (WCJ) order compelling a claims adjuster to attend an expedited hearing. The Appeals Board dismissed the petition for reconsideration as the order was not final but granted removal. The Board rescinded the WCJ's order for the adjuster's appearance, finding no good cause, and vacated a subsequent WCJ decision issued while the matter was pending before the Board. The case is returned for further proceedings and a new decision.

WCABRemovalReconsiderationExpedited HearingClaims AdjusterUtilization ReviewCarpal Tunnel SurgeryFinal OrderProcedural OrderSubstantial Prejudice
References
Case No. ADJ9496258
Regular
Nov 04, 2016

ANTONIO AGUIRRE vs. CAPITAL BUILDERS, LIBERTY MUTUAL INSURANCE

The defendant sought removal of a WCJ's order compelling the claims adjuster's appearance to determine the adequacy of a Compromise and Release (C&R). However, the parties subsequently withdrew the original C&R due to a change in the applicant's condition. They then submitted and obtained approval for a new C&R that settled the case for a larger sum. Since the issue requiring the adjuster's presence was resolved by the withdrawal of the original C&R and approval of a new settlement, the defendant's Petition for Removal is dismissed as moot.

Petition for RemovalOrder to AppearCompromise and ReleaseApplicant's Physical ConditionMoot DisputeWorkers' Compensation Appeals BoardWCJClaims AdjusterNew C&R ApprovalDismissed as Moot
References
Case No. MON 322663, LAO 0850418
Regular
Dec 10, 2007

DANIEL PAN vs. STATE OF CALIFORNIA, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the administrative law judge's decision. The Board found that the defendant must include projected future cost-of-living adjustments based on the State Average Weekly Wage (SAWW) when calculating the present value of the permanent disability award to determine attorney's fees. The Board affirmed that a 4.7% SAWW adjustment, representing a 50-year average, is a rational basis for these calculations, and the defendant's contention of speculation was unfounded.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Findings and AwardPermanent Total DisabilityLabor Code Section 4659(c)State Average Weekly WagePresent Value of AwardCommutation of Attorney's FeesDisability Evaluation UnitAnnual Adjustments
References
Case No. ADJ4197101 (GOL 0096890)
Regular
Jun 21, 2010

DAVID HENKEL vs. WEYRICK COMPANIES, INC., STATE COMPENSATION INSURANCE FUND

The Appeals Board granted the defendant's petition for removal and rescinded the Order to Show Cause re: Sanctions. The Board found the WCJ's order compelling the claims adjuster's attendance at a Mandatory Settlement Conference with only 90 minutes notice and a 47-mile commute was unreasonable and violated due process. While the WCJ has authority to order appearances, the manner of the order and the lack of reasonable notice rendered the subsequent sanction order an excess of authority. The Board concluded that the adjuster's failure to appear under these circumstances did not constitute bad-faith tactics.

Workers' Compensation Appeals BoardPetition for RemovalOrder to Show Cause re: SanctionsMandatory Settlement ConferenceClaims AdjusterCompelling AttendanceReasonable NoticeDue ProcessExcess of AuthoritySettlement Negotiations
References
Case No. ADJ7412202
Regular
Mar 29, 2012

CHRISTOPHER BLACKWELL vs. CARDINAL HEALTH; SEDGWICK CMS

The Workers' Compensation Appeals Board denied Defendant Cardinal Health's petition for removal, affirming the Administrative Law Judge's order allowing Applicant's attorney to depose the claims adjuster. The deposition is relevant to Applicant's claims for penalties and sanctions concerning alleged failures to pay temporary disability indemnity and for other delays in benefits. While the Board cautioned Applicant's counsel regarding extravagant rhetoric in his petitions, it found no sufficient prejudice to Defendant to warrant rescinding the deposition order. The Board determined the adjuster likely possesses information pertinent to the alleged misconduct supporting Applicant's claims.

Petition for RemovalPetition for Penalties and SanctionsTemporary Disability IndemnityDeposition of AdjusterAbuse of DiscretionStipulation and AwardLabor Code Section 5814(b)Labor Code Section 5813Bad-Faith ActionSanctions
References
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