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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ8231311
Regular
Mar 29, 2013

RON JENSEN vs. STEVENS CREEK TOYOTA, AUTO DEALERS COMPENSATION OF CALIFORNIA (ADCOMP), CORVEL CORPORATION

The Workers' Compensation Appeals Board denied a petition for reconsideration, upholding a finding that Ron Jensen's claim for a March 11, 2005 injury was not barred by the statute of limitations. The WCJ determined the statute was tolled due to the defendant's failure to provide proper notice of benefits. The defendant argued the applicant was repeatedly notified of time limitations, but the Board adopted the WCJ's credibility determination regarding the defendant's misstatements about permanent disability. A dissenting opinion argued the claim was time-barred, asserting the applicant received timely notices and that the defendant's assessment of no permanent disability was factually supported by medical reports at the time.

Workers' Compensation Appeals BoardStatute of LimitationsReconsiderationFindings and OrderApplicantDefendantWCJTolledNotice of BenefitsPermanent Disability
References
Case No. LAO 0869924
Regular
Jun 06, 2008

MIRNA SOSA vs. JESI-CARE, INC., STATE COMPENSATION INSURANCE FUND

The applicant's claim for workers' compensation was denied because the evidence did not support her claim of an industrial injury, and the claim was barred by the statute of limitations and post-termination claim rules. The Board found the applicant's testimony regarding reporting the injury to be not credible, citing contradictory medical evidence and employer testimony. Because the applicant did not report the alleged injury within one year of its occurrence, the statute of limitations was not tolled, and the claim also failed as a post-termination claim due to lack of employer notice or medical records indicating injury prior to termination.

Workers' Compensation Appeals Boardapplicant's claimstatute of limitationspost-termination claimcredible testimonyemployer noticemedical recordsdate of injuryindustrial injuryWCJ credibility determination
References
Case No. ADJ11134083
Regular
Nov 09, 2018

STEVE PAUL DELMAR vs. CONCORDE BATTERY CORPORATION, ALASKA NATIONAL INSURANCE COMPANY

This case involves a defendant's petition for reconsideration, arguing the applicant's workers' compensation claim was barred by the statute of limitations. The Workers' Compensation Appeals Board denied the petition, upholding the administrative law judge's finding that the defendant failed to prove the applicant knew his disability was industrially caused. Crucially, the Board found no medical evidence or applicant testimony establishing a date of disability, and the applicant's role in managing workers' compensation claims did not equate to knowledge of his own industrial injury. Therefore, the defendant did not meet its burden to establish the date of injury for statute of limitations purposes.

Workers' Compensation Appeals BoardPetition for ReconsiderationStatute of LimitationsLabor Code Section 5405Cumulative TraumaDate of InjuryCompensable DisabilityMedical EvidenceBurden of ProofApplicant's Testimony
References
Case No. ADJ9708932
Regular
Dec 04, 2015

HECTOR ORTEGA vs. VELOCITY EXPRESS LEASING, INC., LEXINGTON INSURANCE COMPANY, c/o AMERICAN INSURANCE GUARANTEE

This case concerns Hector Ortega's claim for workers' compensation benefits for an alleged injury on June 7, 2007. The Workers' Compensation Appeals Board (WCAB) denied his petition for reconsideration, upholding the finding that his claim was barred by the one-year statute of limitations. Ortega argued that a date-stamped Application for Adjudication of Claim, received by the WCAB on July 1, 2010, proved timely filing or warranted a due process hearing. However, the WCAB found this Application was not submitted into evidence at trial, and an Amended Application, filed later, did not relate back to overcome the statute of limitations as no timely original application was in evidence. Consequently, the Board concluded that the claim was not timely filed and denied reconsideration.

Workers' Compensation Appeals BoardStatute of LimitationsLabor Code Section 5405Petition for ReconsiderationApplication for Adjudication of ClaimAmended ApplicationPre-Trial Conference StatementTollingDue ProcessGood Cause
References
Case No. ADJ2610658 (BAK 0153868)
Regular
Sep 14, 2012

EUNICE WHELDON vs. GOLDEN EMPIRE TRANSIT

The Workers' Compensation Appeals Board granted reconsideration to reverse a prior decision, finding the applicant's claim barred by the statute of limitations. The applicant, a bus driver, injured her knees in 2005 but did not file a claim until May 2008 and received medical treatment in 2010. Although the employer did not provide the statutory notice of rights, the Board found this was not required as the applicant lost no time from work and initially stated she did not need medical treatment beyond first aid. Therefore, the Board concluded the employer was not estopped from raising the statute of limitations defense.

Workers' Compensation Appeals BoardGolden Empire Transitindustrial injurybilateral kneestemporary disabilityfurther medical treatmentLabor Code section 5401(a)statute of limitationstollingApplication for Adjudication of Claim
References
Case No. ADJ9175109
Regular
Feb 05, 2016

GABRIEL GALLAND vs. LOS ANGELES UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board granted reconsideration and reversed a previous decision, finding the applicant's claim time-barred. The Board determined that the employer provided the applicant with a claim form and notice of benefits on August 13, 2009, which started the statute of limitations. Despite the applicant reporting the injury, there was uncontradicted evidence that he received the claim form. Consequently, the applicant's failure to file his claim within the statutory period after denial resulted in dismissal.

Workers' Compensation Appeals BoardStatute of LimitationsPetition for ReconsiderationFindings of FactLabor Code Section 5405Date of InjuryDisability IndemnityMedical TreatmentTollingEmployer's Report of Occupational Injury
References
Case No. ADJ10110073
Regular
Aug 19, 2016

JAROD HANDEL vs. CONFERENCE DIRECT, LLC, THE HARTFORD SACRAMENTO

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to amend a prior finding. The Board affirmed the finding of injury to the applicant's back but removed the finding of injury to his sleep due to insufficient evidence. The WCAB found that the statute of limitations did not bar the claim because the defendant failed to prove they provided adequate notice of workers' compensation rights to the applicant, who credibly testified about his injury and subsequent surgery.

WORKERS' COMPENSATION APPEALS BOARDPETITION FOR RECONSIDERATIONFINDINGS OF FACTLABOR CODE SECTION 5405STATUTE OF LIMITATIONSSUBSTANTIAL MEDICAL EVIDENCEAPPLICATION FOR ADJUDICATIONAFFIRMATIVE DEFENSEBURDEN OF PROOFACTUAL NOTICE
References
Case No. ADJ7485185, ADJ9885267
Regular
Sep 18, 2017

LAURA ORTIZ vs. FARMERS INSURANCE GROUP, MID CENTURY INSURANCE

This Workers' Compensation Appeals Board decision denies a petition for reconsideration, affirming the applicant's timely invocation of jurisdiction to seek additional benefits. The Board adopted the WCJ's reasoning that the applicant's filings of an Application for Adjudication of Claim and an Amended Application, along with documented medical evidence of worsening condition, satisfied the requirements for reopening and seeking further compensation. These actions put the defendants on notice of the applicant's intent to pursue increased benefits, even without a formal petition to reopen.

Petition for ReconsiderationLabor Code section 5410Application for Adjudication of ClaimRiel v. State of CaliforniaBeaida v. Workers' Comp. Appeals Bd.stipulated awardpro perfuture medical treatmentincreased symptomsworsening condition
References
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