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

Case No. ADJ2239874 (STK 0170112) ADJ472994 (STK 0198041) ADJ3391005 (STK0208641)
Regular
Dec 15, 2008

MITCHELL PACHECO vs. INNOVATIVE STEEL SYSTEMS and CALIFORNIA INSURANCE GUARANTEE ASSOCIATION on behalf of FREMONT COMPENSATION INSURANCE COMPANY, in liquidation, LENNAR CORPORATION and OLD REPUBLIC INSURANCE COMPANY, RICHMOND AMERICAN HOMES and AMERICAN HOME ASSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration, rescinded the previous award, and returned the case to the trial level. The Board found that the WCJ erred by applying the wrong disability rating schedule and by issuing a combined award for three separate successive injuries. The matter is remanded for separate determinations of permanent disability for each injury, with the 2005 and 2006 injuries to be rated under the 2005 Schedule.

CIGAFremont Compensation Insurance CompanyliquidationInnovative Steel SystemsLennar CorporationOld Republic Insurance CompanyRichmond American HomesAmerican Home Assurance Companyindustrial injuriesneck
References
Case No. LAO 863258, LAO 863456
Regular
Oct 02, 2007

JULIE A. ALBRIGHT vs. SUN HEALTH CARE, AMERICAN HOME ASSURANCE COMPANY, BROADSPIRE

The Workers' Compensation Appeals Board denied reconsideration of a finding that American Home Assurance, administered by Broadspire, was liable for administering an award for applicant Julie Albright's cumulative trauma injury. Despite covering only 39% of the period, the Board found it equitable for American Home Assurance to administer the award, given their responsibility for a specific injury and the potential confusion of dual administrators. The Board also upheld the determination of the cumulative trauma injury date and the administrator's responsibility for temporary disability payments.

WCABReconsiderationPetitionFindings and AwardAmerican Home AssuranceBroadspireCumulative TraumaDate of InjuryLabor Code § 5412Labor Code § 4656 (c) (1)
References
Case No. OAK 0337799; OAK 0337800
Regular
May 19, 2008

LI-PING LI vs. WAL-MART ASSOCIATES, INC., AMERICAN HOME ASSURANCE/AIG

The Workers' Compensation Appeals Board granted reconsideration to amend factual findings and the case caption. The Board affirmed the finding of temporary total disability for the applicant, Li-Ping Li, due to an industrial injury sustained while employed by Wal-Mart Associates, Inc., insured by American Home Assurance. The decision was amended to correct the employer's name, identify the correct insurance carrier, and exclude a specific period from the temporary total disability award.

Workers Compensation Appeals BoardLi-Ping LiWal-Mart AssociatesInc.American Home AssuranceFrank Gates Service CompanyOAK 0337799OAK 0337800Opinion and Order Granting ReconsiderationDecision After Reconsideration
References
Case No. ADJ4484214, ADJ1095231, ADJ1532047, ADJ7900801
Regular
May 17, 2017

CANA SWARTOUT vs. ENTERTAINMENT PARTNERS, AMERICAN HOME ASSURANCE, AIG CLAIMS SERVICES, CAST & CREW ENTERTAINMENT, ZURICH NORTH AMERICA, ENTERTAINMENT PARTNERS, AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA, CNA CLAIMS PLUS

This case involved multiple employers and insurance carriers for Dana Swartout's various work-related injuries sustained between 2002 and 2007. The Workers' Compensation Appeals Board (WCAB) initially issued findings but granted reconsideration to study the issues, including contentions about permanent total disability and statute of limitations. Following settlement conferences, the parties entered into a Compromise and Release agreement, which the WCAB has now approved. The WCAB rescinded its prior order and approved the settlement, finding it adequate and in the applicant's best interest.

Workers Compensation Appeals BoardDana SwartoutEntertainment PartnersAmerican Home AssuranceAIG Claims ServicesCast & Crew EntertainmentZurich North AmericaAmerican Casualty CompanyCNA Claims PlusPermanent Total Disability
References
Case No. ADJ1725847
Regular
Jan 21, 2009

FLOR FERNANDEZ vs. DISTRIBUTION ALTERNATIVES, INC., UNITED STATES FIRE INSURANCE COMPANY, TEMPORARY SERVICES, INC., UNINSURED EMPLOYERS FUND, VOLT INFORMATION SCIENCES, AMERICAN HOME ASSURANCE COMPANY

The WCJ's determination that Volt was applicant's general employer is affirmed. Finding of fact number 3 is amended to strike the language applying the doctrine of estoppel.

Workers' Compensation Appeals BoardFlor FernandezDistribution AlternativesInc.United States Fire Insurance CompanyTemporary ServicesInc.Uninsured Employers FundVolt Information SciencesAmerican Home Assurance Company
References
Case No. POM 248928
Regular
May 12, 2006

MARK MICELI vs. JACUZZI, INC., REMEDYTEMP, INC., AMERICAN HOME ASSURANCE CO., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for RELIANCE NATIONAL INDEMNITY CO., In Liquidation

The Court of Appeal reversed the Appeals Board's prior decision, finding that the special employer's insurance (American Home Assurance Co.) was not "other insurance" available to the applicant. This ruling invalidated the previous dismissal of CIGA and dictated that the case be returned for further proceedings. The Appeals Board, following this remittitur, rescinded the prior consolidation and stay order, denying RemedyTemp's request for dismissal and CIGA/RemedyTemp's request for a new consolidation. Assurance's petition for appeal costs was also dismissed as it was filed with the wrong entity.

CIGARemedyTempJacuzziAmerican Home Assurance Co.Reliance National Indemnity Co.special employergeneral employerother insuranceInsurance Code section 1063.1(c)(9)remittitur
References
Case No. ADJ7160968
Regular
Sep 20, 2013

KIM FICK vs. WAL MART ASSOCIATES, INC., AMERICAN HOME ASSURANCE

This case involves a Petition for Reconsideration filed by the applicant, Kim Fick, against Walmart Associates, Inc. and American Home Assurance. The Workers' Compensation Appeals Board (WCAB) dismissed the petition because it was not verified, violating Labor Code section 5902. Furthermore, the petition was deemed skeletal and insufficient under California Code of Regulations, title 8, section 10846. Consequently, the WCAB found the petition procedurally deficient and ordered its dismissal.

Petition for ReconsiderationVerifiedLabor Code section 5902Skeletal PetitionCalifornia Code of Regulations title 8 section 10846DismissedWorkers' Compensation Appeals BoardWCJApplicantDefendants
References
Case No. ADJ559526 (STK 0208625)
Regular
Jan 03, 2011

MICHAEL OZUNA vs. WEBCOR BUILDERS, ZURICH NORTH AMERICA, AMERICAN HOME ASSURANCE COMPANY

This case concerns whether Zurich North America or American Home Assurance Company provided workers' compensation coverage for an applicant's severe injury. An arbitrator initially ruled Zurich solely responsible, finding American Home's policy was limited and did not cover the claim. Zurich contends American Home's policy endorsement limiting coverage to a specific site was invalid due to non-compliance with Insurance Code requirements. The Appeals Board granted reconsideration to allow further proceedings, holding American Home bears the burden to prove its policy effectively excluded this claim.

Workers Compensation Appeals BoardReconsiderationArbitrationInsurance CoverageDefense and IndemnificationPolicy EndorsementInsurance Code Section 11657Insurance Code Section 11660Burden of ProofAffirmative of the Issue
References
Case No. ADJ244571 (VEN 0110022) ADJ3315572 (VEN 0110023) ADJ3817980 (OXN 0145232) ADJ2004405 (OXN 0145234) ADJ4239471 (OXN 0145235)
Regular
Jan 19, 2010

DIANA HARDMAN vs. COMMUNITY MEMORIAL HOSPITAL, AIG DOMESTIC CLAIMS, INC./CHARTIS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, BROADSPIRE, CALIFORNIA COMPENSATION INSURANCE COMPANY, FREMONT COMPENSATION INSURANCE COMPANY, American Home Assurance

This case involves five workers' compensation claims by applicant Diana Hardman against Community Memorial Hospital, with American Home Assurance (AIG) as a defendant insurer. AIG seeks reconsideration of the WCJ's findings, arguing it should only be liable for permanent disability directly arising from injuries covered by its policies, not those covered by insolvent insurers now handled by CIGA. The Appeals Board granted reconsideration, rescinded the WCJ's decisions, and returned the matter for further proceedings. Key issues include the admissibility of a deposition, the apportionment of permanent disability based on recent appellate decisions, and clarification of liability for injuries that occurred during periods covered by multiple insurers, including insolvent ones.

Workers' Compensation Appeals BoardDiana HardmanCommunity Memorial HospitalAIG Domestic ClaimsCalifornia Insurance Guarantee AssociationBroads PireCalifornia Compensation Insurance CompanyFremont Compensation Insurance CompanyOpinion and Order Granting ReconsiderationDecision After Reconsideration
References
Case No. ADJ9090850
Regular
Jun 28, 2017

VINCE FERRAGAMO vs. ST. LOUIS RAMS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT INDEMNITY COMPANY, in liquidation, HOME INSURANCE COMPANY, in liquidation, BUFFALO BILLS, INC., GREEN BAY PACKERS, NORTHWESTERN NATIONAL INSURANCE COMPANY merged with HIGHLANDS INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) reversed a prior decision, finding that Vince Ferragamo's current claim for cumulative brain injury is not barred by a 1988 compromise and release agreement. The Board determined that the brain injury was unknown and not intended to be covered by the prior settlement, which focused on orthopedic and other known injuries. Therefore, the doctrine of res judicata did not preclude this new claim, and the case was returned for further proceedings.

Workers' Compensation Appeals BoardVince FerragamoSt. Louis RamsFremont Indemnity CompanyHome Insurance CompanyBuffalo BillsGreen Bay PackersNorthwestern National Insurance CompanyHighlands Insurance Companycumulative trauma
References
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