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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ9932467
Regular
Oct 16, 2017

THERESA MCFARLAND vs. REDLANDS UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied an applicant's petition for reconsideration, affirming the WCJ's decision that "Return-To-Work" supplemental payments under Labor Code section 139.48 are not "compensation" as defined by Labor Code section 3207. Therefore, the applicant was not entitled to a second penalty under Labor Code section 5814 for the employer's delay in providing a Supplemental Job Displacement Benefit voucher, as that delay did not cause a delay in a compensable benefit. The Board found that the applicant's penalty claim for the voucher delay was already resolved and that imposing a second penalty for a non-compensable benefit delay would be unfair and against the principle of balancing justice.

Labor Code section 139.48Return-To-Work supplemental paymentscompensation definitionLabor Code section 3207Labor Code section 5814 penaltyLabor Code section 4658.7 voucherSupplemental Job Displacement Benefitcompromise and release agreementGage v. Workers' Comp. Appeals Bd.unreasonable delay
References
Case No. ADJ599176 (SAC 0333692) ADJ2396484 (RDG 0122019) ADJ7950339
Regular
Mar 21, 2017

Fernando Muniz Villalpando vs. Doherty Brothers, Martin Dusters, State Compensation Insurance Fund

This case involves an applicant seeking to self-administer his Medical Set-Aside Account (MSA) after previously agreeing to third-party administration by Bridge Pointe/NuQuest. The Appeals Board granted reconsideration, rescinded the prior order, and returned the matter to the trial level. The Board found that the trial judge needs to review the original agreement to determine if it allows for a change of administration or if applicant has contractual rights to pursue this. Further proceedings will assess applicant's competency for self-administration and any opposition from the defendant.

Medical Set-Aside AccountMSAPetition for ReconsiderationJoint Findings and OrderMedical Set-Aside Account administrationself-administrationBridge PointeNuQuestState Compensation Insurance FundCompromise and Release Agreement
References
Case No. VNO 113665 VNO 113666 VNO 113667 VNO 113668
Regular
Aug 06, 2007

MARIA A. GARCIA vs. CITY OF LOS ANGELES LIBRARY SERVICES

The Workers' Compensation Appeals Board granted reconsideration and reversed a WCJ's award of penalties and attorney fees against the City of Los Angeles for delayed payment of home healthcare charges. The Board found that while payments were delayed, Labor Code section 5814(e) bars penalties when the only dispute concerns the payment of a provider's bill, not a denial of treatment. Furthermore, the Board found no basis to assess penalties under Labor Code section 5814.6 for a pattern of business practice violation.

Labor Code 5814Labor Code 5814.5Labor Code 5814.6unreasonable delayhome health carebilling disputemedical treatmentnursing servicespenaltyattorney fees
References
Case No. ADJ4579659
Significant
Sep 09, 2008

Dee Anne Ramirez, Applicant vs. Drive Financial Services, One Beacon Insurance Co.

The Appeals Board, in an en banc decision, holds that penalties under Labor Code section 5814(a) are discretionary, successive penalties are permissible under specific circumstances, and attorney's fees under section 5814.5 apply to private employers for unreasonable delays occurring after January 1, 2003, regardless of the injury date.

WCABLabor Code section 5814Labor Code section 5814.5penaltyattorney feesen bancreconsiderationdiscretionary penaltysuccessive penaltyunreasonable delay
References
Case No. ADJ2353136 (STK 0213635)
Regular
Dec 19, 2016

AHMED SHOAIB vs. CAMBELL SOUP COMPANY

This case concerns a dispute over the payment of a workers' compensation settlement. The applicant, Ahmed Shoaib, settled a discrimination claim against Campbell Soup Company for $55,000. Campbell Soup unilaterally withheld over $19,000 from the applicant's share of the settlement for alleged payroll taxes. The Workers' Compensation Appeals Board denied Campbell Soup's petition for reconsideration, finding that the company unreasonably delayed payment by taking a unilateral credit. The Board affirmed the WCJ's decision and the awarded 25% penalty for the delayed payment.

Workers' Compensation Appeals BoardPetition for ReconsiderationStipulation and AwardLabor Code Section 132aAmended Petition for PenaltyDelayed PaymentLabor Code Section 5814Labor Code Section 5814.5Contract EnforcementUnilateral Credit
References
Case No. ADJ4659072 (FRE 0250287)
Regular
May 23, 2018

JIM WILLIAMS vs. INTERSTATE DISTRIBUTING, INC., ZURICH AMERICAN INSURANCE CO., ZURICH NORTH AMERICA

This case involves a defendant's petition for reconsideration of an administrative law judge's (WCJ) order awarding penalties for delayed permanent disability benefits and out-of-pocket expense reimbursement, along with attorney's fees. The Workers' Compensation Appeals Board (WCAB) granted reconsideration. The WCAB affirmed the penalty for delayed permanent disability payments, finding that the off-calendar orders did not resolve penalties accrued after the initial award. However, the WCAB amended the order to defer the issue of out-of-pocket expense reimbursement penalties, returning the matter to the WCJ for further proceedings on that specific issue.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactAdministrative Law JudgePenaltyPermanent Disability BenefitsOut-of-pocket ExpensesLabor Code Section 5814Labor Code Section 5814.5Mandatory Settlement Conference
References
Case No. ADJ6650899
Regular
Jan 04, 2013

IVAN MORENO vs. SOSA GRANITE & MARBLE, MAJESTIC INSURANCE COMPANY

In this workers' compensation case, the Board granted reconsideration to clarify an existing award. The administrative law judge had previously imposed a $10,000 penalty for unreasonable delay in paying permanent disability benefits, based on 25% of the overdue amount, capped as allowed by law. The defendants contended the penalty was improperly calculated on the total awarded benefits rather than the amount delayed. The Board affirmed the penalty and its amount, clarifying that it was based on the unpaid permanent disability indemnity due at the time of the award, not the total sum. This penalty was justified because the defendants unreasonably delayed paying any permanent disability advances for over three years after the applicant's condition became permanent and stationary.

permanent disabilityLabor Code section 5814penaltyunreasonable delayreconsiderationFindings of Fact and Awardadministrative law judgeSosa Granite & MarbleMajestic Insurance CompanyWCJ
References
Case No. ADJ2786953 (ANA 0317684), ADJ3789377 (ANA 0393014), ADJ3880205 (ANA 0317683), ADJ808964 (ANA 0317682)
Regular
Oct 04, 2011

OSCAR ORTEGA vs. DATA ANALYSIS; CHARTIS INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration regarding a penalty award. The Board rescinded the prior award, finding the Administrative Law Judge erred in applying penalty provisions and attorney fees without sufficient findings on unreasonable delay and a proper consideration of relevant factors. The case is returned to the trial level for further proceedings to determine the reasonableness of the delay and the appropriate penalty amount, with a requirement for the WCJ to explain their reasoning. Any claims for attorney fees should be properly submitted with supporting documentation.

WCABIndustrial InjuryPenaltyLabor Code Section 5814Labor Code Section 5814.5Petition for ReconsiderationAmended Findings and AwardCompromise & ReleaseSelf-Imposed PenaltyUnreasonable Delay
References
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