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

Case No. ADJ1529722
Regular
Apr 23, 2012

ALEXANDRA JAMISON vs. WELLS FARGO BANK, TRAVELERS INSURANCE

This case involves an applicant, Alexandra Jamison, and defendants Wells Fargo Bank and Travelers Insurance. The Workers' Compensation Appeals Board (WCAB) issued an order denying reconsideration of a prior decision. The WCAB adopted and incorporated the reasons presented in the workers' compensation administrative law judge's report for their denial. Therefore, the applicant's petition for reconsideration was unsuccessful.

Workers' Compensation Appeals BoardAlexandra JamisonWells Fargo BankTravelers InsuranceADJ1529722LAO 0830997Order Denying ReconsiderationPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeWCJ
References
Case No. ADJ3813213 (LAO 0880628) ADJ426875 (LAO 0739120) ADJ448791 (LAO 0739119)
Regular
May 18, 2015

ALEXANDRA McSPORRAN vs. MIDWAY HOSPITAL, TRAVELERS PROPERTY CASUALTY COMPANY, KAISER PERMANENTE FOUNDATION HOSPITAL, UCLA MEDICAL CENTER

This case involves applicant Alexandra McSporran's claims for industrial injuries sustained as a nurse across three distinct periods ending in 1999, 2003, and 2008, against defendants Midway Hospital, Travelers, Kaiser, and UCLA. The Workers' Compensation Appeals Board (WCAB) denied reconsideration for both the applicant and Kaiser. The applicant argued for a single cumulative injury and against apportionment of permanent disability, while Kaiser raised statute of limitations and evidentiary objections. The WCAB adopted the WCJ's reasoning, denying both petitions and affirming the prior award.

Workers' Compensation Appeals BoardAlexandra McSporranMidway HospitalTravelers Property Casualty CompanyKaiser Permanente Foundation HospitalUCLA Medical CenterPermissibly Self-InsuredJoint Findings Award and Ordercumulative injurystatute of limitations
References
Case No. ADJ8981807
Regular
Feb 04, 2019

ALEXANDRA SANDOVAL vs. STATE OF CALIFORNIA, SOUTHERN CALIFORNIA RECEPTION CENTER AND REHABILITATION, Legally Uninsured; STATE COMPENSATION INSURANCE FUND

This case involved Alexandra Sandoval's workers' compensation claim against the State of California. The Workers' Compensation Appeals Board denied Sandoval's Petition for Reconsideration. The Board adopted the WCJ's findings, giving great weight to their credibility determination of the witness. The decision hinges on the interpretation of Labor Code Section 5412, specifically the date an employee has knowledge of a cumulative injury being work-related. The Board found no substantial evidence to overturn the WCJ's determination regarding this knowledge.

Labor Code § 5412date of injurycumulative injurytemporary disabilitypermanent disabilitystatute of limitationscredibility determinationWCJ reportmedical advicereasonable diligence
References
Case No. MON 0299702 MON 0313489
Regular
Oct 15, 2007

REINA RIVERA vs. LSG SKY CHEFS, INC, LIBERTY MUTUAL INSURANCE CO.

In this workers' compensation case, the defendant, LSG Sky Chefs, Inc., filed a petition for reconsideration of a prior decision. The Workers' Compensation Appeals Board granted the petition, not on the merits, but to allow further study of the factual and legal issues. This means the original decision is effectively on hold pending further review and potential additional proceedings.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationLSG SKY CHEFSINCLIBERTY MUTUAL INSURANCE CO.MON 0299702MON 0313489Opinion and OrderReconsideration GrantedStatutory Time Constraints
References
Case No. SRO 0135735
Regular
Nov 06, 2007

ROBERT ANUSEWICZ vs. JOINT INDUSTRY BOARD OF PLUMBING, dba KONOCTI HARBOR INN AND RESORT, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant's entitlement to temporary disability indemnity beyond the standard 104-week limit. The Appeals Board rescinded the prior award, ruling that the applicant's hip and knee replacement surgeries did not constitute "amputations" as defined by Labor Code section 4656(c)(2)(C). Therefore, the applicant is limited to 104 weeks of temporary disability indemnity from the commencement of payments, precluding indemnity beyond January 31, 2007.

Workers' Compensation Appeals BoardRobert AnusewiczJoint Industry Board of PlumbingKonocti Harbor Inn and ResortState Compensation Insurance FundSRO 0135735Opinion and Decision After Reconsiderationtemporary disability indemnityindustrial injuryleft knee
References
Case No. ADJ3694832 (RDG 0125163)
Regular
Apr 09, 2009

MATHEW JAMISON vs. DEE FAIRBANKS ENTERPRISES, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration, rescinded the WCJ's decision disallowing a medical equipment lien, and remanded for further proceedings. The WCJ incorrectly relied solely on *Tapia* to disallow the lien without addressing the claimant's arguments regarding defendant's utilization review (UR) process compliance. The Board emphasized that the WCJ must determine whether the treatment was reasonable and necessary, consider the UR process, and explain the reasoning for the decision on all contested issues.

Workers' Compensation Appeals BoardLien ClaimantUtilization ReviewDurable Medical EquipmentPermanent DisabilityIndustrial InjuryCervical SpineLumbar SpineMaintenance LaborerReconsideration
References
Case No. ADJ1232764
Regular
Mar 24, 2009

ALEXANDRA CULLEN-WRIGHT vs. CUMMINS & WHITE, LLP, STATE COMPENSATION INSURANCE FUND

Applicant sought reconsideration of a WCAB decision denying jurisdiction to amend a prior award, arguing her RSD constitutes an insidious, progressive disease exempting it from the five-year statute of limitations. The Board denied reconsideration, finding the applicant failed to demonstrate her RSD met the criteria for an insidious, progressive disease as defined in *General Foundry Service v. WCAB*. Furthermore, the Board noted the original decision did not reserve jurisdiction and no timely petition to reopen was filed to address this possibility. Therefore, the WCAB lacked jurisdiction to amend the award over five years post-injury.

Workers' Compensation Appeals BoardLabor Code Section 5804cumulative injurycomplex regional pain syndromeRSDagreed medical examinersubstantial evidencepermanent and stationarysympathetic ganglion blockpetition to set aside
References
Case No. ADJ7953076
Regular
Feb 27, 2017

JAMES JAMISON vs. MICHAEL WEPPLO, INNOVATIVE BUSINESS PARTNERS, INC., AIG CLAIMS

The Workers' Compensation Appeals Board (WCAB) affirmed a judge's order denying arbitration on insurance coverage, as the prior superior court ruling established the WCAB's exclusive jurisdiction. The WCAB found the judge's order was an interim procedural step, not a final order, thus not subject to reconsideration. Defendant's admission of coverage also negated the need for arbitration on that issue. The case was returned to the trial level for a mandatory settlement conference to address remaining employment issues.

WCABPetition for ReconsiderationInsurance Coverage DisputeMandatory ArbitrationLabor Code Section 3706Evidentiary HearingEmployment StatusFinal OrderInterlocutory OrderJurisdiction
References
Case No. ADJ9175444 ADJ9175443 ADJ9182342 ADJ9863288
Regular
Sep 11, 2017

ALEXANDRA MOON (RAMIREZ) vs. LONG BEACH COMMUNITY ACTION PARTNERSHIP, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the State Compensation Insurance Fund's (SCIF) petition for reconsideration. SCIF sought to overturn penalties and attorney's fees awarded due to an alleged unreasonable delay in issuing settlement proceeds. The Board upheld the administrative law judge's decision, finding that SCIF failed to sufficiently prove that replacement settlement checks were mailed on the dates claimed, thus supporting the applicant's testimony of a delay. The exclusion of SCIF's exhibits for lack of authentication was also deemed proper.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award OrdersWCJSCIFSettlement ProceedsPenaltyInterestAttorney's FeesCompromise and Release
References
Case No. ADJ2003074 (SFO 0486401) (ADJ3727915 - CONSOLIDATED
Regular
Apr 05, 2010

ALEXANDRA MONTEITH vs. EDWARD LITTLEJOHN, M.D., TIG SPECIALTY INSURANCE COMPANY, RISK ENTERPRISE MANAGEMENT, BERKSHIRE HATHAWAY HOMESTATE COMPANIES (BHHC)

The Workers' Compensation Appeals Board (WCAB) dismissed TIG Specialty Insurance Company's petition for reconsideration because it sought to appeal a non-final order. The WCAB also denied TIG's petition for removal, adopting the WCJ's reasoning that TIG failed to demonstrate substantial prejudice or irreparable injury. This decision confirms that appeals can only be made from final orders that determine substantive rights and liabilities. The WCAB found TIG's argument regarding a non-party's interference with the settlement was not properly before them due to the non-final nature of the appealed order.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalCompromise and ReleaseVacating OrderAdministrative Law JudgeNon-party InterferenceCalifornia Insurance Guarantee Association (CIGA)PrejudiceFinal Order
References
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