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

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. ADJ7024559
Regular
Sep 24, 2013

ANTONIA PEDRO vs. KAISER FOUNDATION HOSPITAL, SEDGWICK CLAIMS MANAGEMENT SERVICES

Defendant Kaiser Foundation Hospital sought reconsideration of an award, claiming newly discovered evidence of EDD payments to the applicant during a period of permanent disability advances. The parties subsequently reached an agreement resolving the issue of EDD reimbursement. Consequently, the Appeals Board granted reconsideration, rescinded the original award, and remanded the matter to the WCJ. The WCJ is to issue an amended award based on the parties' revised stipulations.

Workers' Compensation Appeals BoardPetition for ReconsiderationStipulations with Request for AwardAwardNewly Discovered EvidenceEDDPermanent Disability AdvancesPermanent Disability IndemnityAmended AwardReimbursement
References
Case No. ADJ7627051
Regular
Apr 26, 2012

ALEJANDRA AMBRIZ vs. ACCENT CARE, INC.; AIG INSURANCE administered by SEDGWICK

The Workers' Compensation Appeals Board granted reconsideration of a prior award approving stipulations for an applicant's industrial injury. The defendant sought reconsideration due to a mutual mistake in calculating permanent disability. Subsequently, the parties agreed to amend the original stipulations and the defendant withdrew its petition. The Board rescinded the original award and returned the matter to the trial judge to consider the amended stipulations.

WCABPetition for ReconsiderationStipulations with Request for AwardPermanent DisabilityMutual Mistake of FactStipulation Amending Stipulated AwardRescind AwardReturned to Trial LevelWCJ DecisionAdjudication
References
Case No. ADJ9865530
Regular
Mar 20, 2015

Baldemar Gonzalez, Jr. vs. Morganite Industries, Gallagher Bassett

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration of a prior award. The petition was dismissed because it was filed untimely and was not properly verified. Although the applicant alleged fraud in obtaining the award, and the stipulations appear to lack a required signature, the Board cannot act on these grounds due to procedural deficiencies and expired timeframes. The applicant may still pursue relief under the Board's continuing jurisdiction concerning rescission, alteration, or amendment of the award within five years of the date of injury.

Petition for ReconsiderationStipulations with Request for Awardfraudmisrepresentationuntimely filingverificationLabor Code Section 5902Labor Code Section 5903continuing jurisdictionLabor Code Sections 5803-5804
References
Case No. ADJ3190591 (SFO 0510866) ADJ9088362 ADJ9524437
Regular
Nov 21, 2014

ISAIAH KACYVENSKI vs. OAKLAND RAIDERS; ACE USA Administered by ESIS; ST. LOUIS RAMS and GREAT DIVIDE INSURANCE COMPANY Administered by BERKLEY SPECIALTY UNDERWRITING MANAGER, LLC

This case concerns a workers' compensation award against the St. Louis Rams and the Oakland Raiders for an injured professional athlete. The Rams petitioned for reconsideration, arguing they were improperly included in a joint award based on stipulations they were not a party to, violating their due process rights. The Appeals Board granted reconsideration, finding the Rams' due process claim had merit. The award was amended to be solely against the Oakland Raiders, as the Rams had elected not to proceed and their employment liability was not established.

Workers' Compensation Appeals BoardJoint AwardPetition for ReconsiderationLabor Code section 5500.5(c)Stipulations with Request for Awardcumulative injuryprofessional athletepermanent disabilitydue processexcess of WCJ's powers
References
Case No. ADJ8211594
Regular
Jan 17, 2014

ERROL GRIFFIN vs. COUNTY OF LOS ANGELES DEPARTMENT OF HEALTH, Permissibly Self-Insured, Administered By TRISTAR RISK MANAGEMENT

This case involves a dispute over the applicant's average weekly wage (AWW) for temporary disability benefits. Initially, the parties stipulated to an AWW of $1,676.04, but the defendant sought reconsideration based on mutual mistake, claiming the correct AWW was $859.16. Subsequently, both parties filed an amended stipulation agreeing to an AWW of $800.07. The Appeals Board granted reconsideration to defer the issue of temporary disability indemnity and returned the matter to the WCJ to consider the amended stipulation and determine the correct benefits.

Petition for ReconsiderationFindings and AwardTemporary Disability IndemnityStipulated FactsMutual MistakeAverage Weekly WageAmended StipulationWorkers' Compensation Appeals BoardWCJMutual Mistake
References
Case No. ADJ9371315
Regular
Sep 08, 2014

JOHN STEPHEN CHACON vs. SACRAMENTO MUNICIPAL UTITILITY DISTRICT, INTERCARE HOLDINGS INSURANCE SERVICES

The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's petition for reconsideration and denied their petition for removal. This action was taken because the underlying stipulated award was void as the unrepresented applicant never reviewed or signed the amended stipulations. The WCAB found this procedural defect rendered the award invalid, and therefore, the judge's order vacating it was appropriate and the defendant's subsequent appeals were moot. The case will return to the trial level for a status conference and further proceedings to ensure due process.

Order Vacating AwardStipulationsRemovalReconsiderationVoid StipulationsUnrepresented ApplicantInformation and Assistance OfficerDue ProcessEx Parte CommunicationSupplemental Pleading
References
Case No. ADJ4667602
Regular
Nov 12, 2008

ROBERT ULEP vs. COUNTY OF SACRAMENTO

In this workers' compensation case, the Appeals Board is affirming an existing award but amending it to include previously stipulated terms in paragraphs 8 and 9. This amendment is being made after the Board issued a notice of intention to approve these stipulations, and no objections were filed. Consequently, the original award is now formally modified to incorporate these agreed-upon provisions.

Robert UlepCounty of SacramentoADJ4667602SAC 0368522Opinion and DecisionReconsiderationAwardStipulationsParagraphs 8 and 9Rescind
References
Case No. ADJ1 149112 (VNO 0348507) ADJ3447806 (VNO 0382613)
Regular
Oct 23, 2015

Debra Fraley vs. Santa Clarita Health Care Association, CIGA by its servicing facility, Broadspire, for Superior Pacific Casualty Company in liquidation

This case involves a lien claimant's petition for reconsideration of a prior denial of their petition. The lien claimant argued the Appeals Board erred in finding they misrepresented the contents of a Stipulations with Request for Award because the defendant failed to serve the Lien Affidavit with the Amended Award. The Appeals Board denied reconsideration, finding the lien claimant was in possession of both the Stipulations and the Lien Affidavit prior to the Amended Award. Even if service was deficient, the lien claimant had other recourse and failed to articulate sufficient legal or factual grounds for reconsideration.

Workers' Compensation Appeals BoardReconsiderationLien ClaimantPetition for ReconsiderationAmended AwardStipulations with Request for AwardLien AffidavitAttorneys' FeesMisrepresentationService of Documents
References
Case No. ADJ2839869 (EUR 0036695)
Regular
Mar 03, 2009

Darlene Counts vs. Sam Kennedy, D.D.S., Zenith Insurance Company

The Workers' Compensation Appeals Board denied Zenith Insurance Company's petition for reconsideration. Zenith argued the WCJ exceeded jurisdiction by awarding benefits beyond the five-year limit without a petition to reopen and challenged medical treatment awards. The Board affirmed the WCJ's decision, finding the original stipulations focused only on medical treatment and did not preclude later determinations on other issues within the statutory timeframe. The WCJ correctly found applicant sustained an industrial injury and ordered appropriate medical treatment, including chronic pain specialist care.

WCABDarlene CountsSam Kennedy DDSZenith Insurance CompanyADJ2839869Supplemental Findings and Awardindustrial injuryright shoulderpsycheleft shoulder
References
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