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

Case No. ADJ6865421
Regular
Sep 08, 2017

DAVID BERRIOS-SEGOVIA vs. EJ DISTRIBUTION CORPORATION, SOUTHERN INSURANCE COMPANY, MARKEL dba FIRST COMP, STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS, UNINSURED EMPLOYERS BENEFITS TRUST FUND

This case returns to the Appeals Board after the Court of Appeal determined that the rescission of an insurance policy is subject to mandatory arbitration. The Court annulled the arbitrator's prior findings, ordering further proceedings to determine the legal effectiveness of the insurer's rescission. The insurer must prove the employer's misrepresentations were material and that rescission is not being used to circumvent policy approval requirements. The matter is remanded to the arbitrator for further proceedings and a new decision.

Workers' Compensation Appeals BoardRemittiturMandatory ArbitrationLabor Code Section 5275Policy RescissionMaterial MisrepresentationUninsured Employers Benefits Trust FundDepartment of InsuranceInsurance CommissionerPrior Approval
References
Case No. ADJ1785165 (OAK 0297869) ADJ2923303 (OAK 0312736)
Regular
Nov 01, 2013

MICHAEL BORMAN vs. ACME STEEL CO., ILLINOIS TOOL WORKS, ACE, ZURICH NORTH AMERICA, SENTRY CLAIMS SERVICE

This case involves a worker's claim for permanent total disability due to an industrial injury including hearing loss. The Court of Appeal annulled the WCAB's denial of reconsideration, holding that the WCAB erred by failing to apportion the hearing loss portion of the cumulative trauma. Consequently, the prior award is rescinded, and the case is remanded for further proceedings to ensure an award consistent with the Court of Appeal's opinion regarding apportionment.

RemittiturAnnulledApportionmentLabor Code Section 4663Cumulative TraumaHearing LossBilateral Upper ExtremitiesWorkers' Compensation Appeals BoardCourt of AppealFindings and Award
References
Case No. ADJ7170139, ADJ7176930
Regular
Mar 22, 2017

ROBERT GAONA vs. CAPITAL BUILDERS HARDWARE, SOUTHERN INSURANCE COMPANY, ENDURANCE REINSURANCE CORPORATION OF AMERICA

This case involves Robert Gaona's workers' compensation claims against Capital Builders Hardware and their insurers. The Court of Appeal previously annulled its writ of review and remanded the case to the Workers' Compensation Appeals Board (WCAB). The WCAB has now affirmed its prior decision from March 24, 2016, which dismissed the defendants' Petition for Reconsideration and denied their Petition for Removal. Therefore, the original Joint Findings and Orders issued by the WCJ on June 5, 2015, stand affirmed.

Workers' Compensation Appeals BoardRemittiturCourt of AppealPetition for ReconsiderationPetition for RemovalJoint Findings and OrdersAdministrative Law JudgeAnnulledAffirmedSubstitution of Commissioner
References
Case No. ADJ8815575
Regular
Mar 12, 2019

DEAN FITZPATRICK vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS AND REHABILITATION

The Third District Court of Appeal has determined that Labor Code section 4660, not 4662(b), governs the calculation of permanent disability ratings. The Court annulled a prior 100% permanent and total disability award, finding it was erroneously based on 4662(b). The Appeals Board granted the defendant's petition for reconsideration and will rescind the original award. The case is returned to the WCJ to issue a new decision consistent with the Court of Appeal's ruling that the undisputed scheduled rating of 99% was not rebutted.

RemittiturOpinion and Decision After RemittiturLabor Code section 4660Labor Code section 4662(b)Permanent total disabilityCumulative traumaWCJFindings Award and OrderPetition for ReconsiderationAnnulled
References
Case No. ADJ2927671 (SAC 0293121)
Regular
Apr 18, 2012

JAYNA POPOVICH vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant diagnosed with Hepatitis C, an insidious disease, who filed a workers' compensation claim. A 2002 stipulation extended the Workers' Compensation Appeals Board's (WCAB) jurisdiction beyond five years for an insidious disease, but was interpreted by the WCAB to apply only to permanent disability. The Court of Appeal annulled the WCAB's denial of temporary disability benefits, holding the applicant suffered no disability until 2010, thus the statute of limitations began to run then. Consequently, the WCAB granted reconsideration, rescinded the prior order, and returned the case for further proceedings on the merits of the temporary disability claim.

Workers' Compensation Appeals BoardRemittiturCourt of AppealAnnulledOrder Denying ReconsiderationReport and RecommendationWorkers' Compensation Administrative Law JudgeTemporary Disability BenefitsJurisdictionDate of Injury
References
Case No. SAC 280551
Regular
Jul 10, 2007

JANET STROTH vs. ELK GROVE UNIFIED SCHOOL DISTRICT, KEENAN & ASSOCIATES

This case concerns an applicant teacher who sustained an industrial injury from a violent student. The Workers' Compensation Appeals Board initially awarded increased compensation for serious and willful misconduct by the employer, finding the employer knew of the student's violent propensities. However, the Court of Appeal annulled this award, holding that while the employer knew of the danger, there was insufficient evidence of a deliberate failure to act for the applicant's safety. Consequently, the Appeals Board has rescinded its prior decision and denied the serious and willful misconduct claim, returning the matter for further proceedings.

Serious and willful misconductRemittiturCourt of AppealEmployer's knowledgeDangerous conditionDeliberate failure to actTeacher injuryStudent misconductSchool bus incidentCompromise and release
References
Case No. ADJ8710988
Regular
Jan 23, 2015

POPE POWELL vs. CITY AND COUNTY OF SAN FRANCISCO

This Workers' Compensation Appeals Board decision, following a Court of Appeal remittitur, mandates a redetermination of the applicant's permanent disability rating. The Court clarified that the appropriate occupational group must be based on the physical activities of the employee's job duties, not solely on job title. Consequently, the Board reinstated its prior decision but amended Finding 5 to defer issues of occupational group and permanent disability. The case is returned to the WCJ for further proceedings to establish the correct occupational group and permanent disability.

RemittiturOccupational groupPermanent disabilityPhysical activitiesWCJPQME reportCourt of AppealReconsiderationAnnulledRemand
References
Case No. ADJ819895 (LAO 0852444) ADJ640798 (VNO 0517617)
Regular
Apr 08, 2010

JAMIE LEE FOSTER (deceased), GLORIA FOSTER vs. CITY OF LOS ANGELES FIRE DEPARTMENT, CAMBRIDGE INTEGRATED SERVICES

This case involved a deceased firefighter whose estate received partial death benefits under an unconstitutional statute. The Court of Appeal ruled that because the employer had already paid the estate, no further payment was owed to the Death Without Dependents (DWD) Unit. Consequently, the Workers' Compensation Appeals Board (WCAB) amended its prior order to deny the DWD Unit's claim. The Supreme Court declined review, making the appellate court's decision final.

Workers' Compensation Appeals BoardDeath Without Dependents UnitCity of Los Angeles Fire DepartmentJamie Lee FosterGloria FosterremittiturLabor Code section 4702(a)(6)(B)unconstitutionalestate of deceased employeeDWD Unit
References
Case No. ADJ9230789
Regular
Aug 26, 2016

Henry Hill vs. Designer 8 Event Furniture, Employers Compensation Insurance Group

Applicant Henry Hill sought reconsideration of an approved Compromise and Release agreement, alleging fraud. The Board dismissed his petition, finding it procedurally defective in multiple ways, including lack of verification and failure to serve all parties. Even if procedurally sound, the petition lacked evidence of fraud and a basis to overturn the settlement approved by the WCJ while Hill was represented by counsel. Therefore, the Board upheld the original order approving the settlement.

Petition for ReconsiderationOrder Approving Compromise and ReleaseFraudulent behaviorTimelyDefectiveUnverifiedWCAB Rule 10856WCAB Rule 10846Mandatory Settlement ConferenceCompromise and Release
References
Case No. ADJ721289 (POM 0278079) ADJ820025 (LBO 0312141) ADJ1988208 (POM 0278080) ADJ6759922
Regular
Sep 06, 2012

GEORGE VELASQUEZ vs. RALPHS, Permissibly Self-Insured

The Court of Appeal ruled that Ralphs' initial appeal of vocational rehabilitation benefits was timely despite lacking a Declaration of Readiness. However, the applicant's vocational rehabilitation award was not final before Labor Code section 139.5 was repealed on January 1, 2009. Consequently, the applicant's right to these benefits expired, and the Appeals Board lost jurisdiction. The Appeals Board rescinded the prior award and ordered that the applicant take nothing for vocational rehabilitation benefits.

RemittiturRehabilitation UnitDeclaration of Readiness to Proceed (DOR)vocational rehabilitation benefitsLabor Code section 139.5finality of awardjurisdictionappeal timelinessannulmentreconsideration
References
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