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

Case No. ADJ9 088743
Regular
Jan 26, 2016

LEO ESTRELLA vs. MILWAUKEE BREWERS, SAN FRANCISCO GIANTS, ACE USA

The Workers' Compensation Appeals Board denied Leo Estrella's petition for reconsideration, upholding the administrative law judge's finding that his cumulative injury claim against the Milwaukee Brewers and San Francisco Giants was time-barred by the one-year statute of limitations. The Board found that applicant knew or should have known of his right to file a claim more than one year prior to filing, precluding application of the five-year "new and further disability" statute. Applicant's contention that the statute of limitations was tolled due to lack of knowledge was rejected, as the evidence indicated he was aware of the industrial causation of his injuries by 2009. One commissioner dissented, arguing the date of injury should be 2013 and that defendants failed to prove applicant's knowledge of his rights or the statute of limitations.

Workers' Compensation Appeals BoardCumulative InjuryStatute of LimitationsLabor Code Section 5405Labor Code Section 5410New and Further DisabilityTollingDate of InjuryIndustrial CausationProfessional Baseball Player
References
14
Case No. ADJ10425864, ADJ7159539
Regular
Dec 24, 2018

GHASSAN MOSRIE vs. CHURCH OF THE CHIMES, GUIDEONE INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration, rescinding a prior finding that the applicant's 2008 injury claim was barred by the statute of limitations. The Board determined that imputed knowledge from the applicant's attorney does not constitute actual knowledge for tolling purposes. The employer's failure to provide statutory notice of rights, coupled with the applicant's lack of actual knowledge, prejudiced the applicant. Therefore, the Board found the applicant's claim for the November 8, 2008 injury is not barred by the statute of limitations, deferring other issues.

Workers' Compensation Appeals BoardPetition for ReconsiderationStatute of LimitationsTollingClaim FormNotice of Potential EligibilityWaiverMandatory Settlement ConferenceAffirmative DefenseActual Knowledge
References
6
Case No. ADJ8739571
Regular
Dec 11, 2015

MARVIN BENARD vs. SAN FRANCISCO GIANTS, ACE INSURANCE COMPANY, U.S. FIDELITY AND GUARANTY INSURANCE COMPANY

In this workers' compensation case, the Appeals Board reversed the WCJ's decision, finding the applicant's claim was not barred by the statute of limitations. The Board determined the defendant failed to meet its burden of proving the applicant had actual knowledge of his workers' compensation rights more than one year before filing his claim. Crucially, the defendant did not provide notice of these rights, and the applicant's knowledge of his injury's industrial cause did not equate to knowledge of his rights to benefits. Therefore, the case was returned for further proceedings.

Cumulative traumaStatute of limitationsDate of injuryKnowledge of rightsTollingAffirmative defenseReconsiderationBurden of proofProfessional athleteNotice of rights
References
10
Case No. ADJ6937263
Regular
Sep 09, 2014

PAUL ESCUDERO vs. CISCO SYSTEMS, INC., ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Cisco Systems' petition for reconsideration, upholding the finding that the applicant's claim was not barred by the statute of limitations. The Board adopted the WCJ's reasoning that Cisco failed to prove the applicant had actual knowledge of his workers' compensation rights. Specifically, the employer did not provide legally required notices, and the applicant's vague consultation with a civil attorney did not constitute sufficient actual knowledge to start the statute of limitations. The Board also noted that actual knowledge cannot be imputed solely by an employee's representation by counsel.

Statute of limitationsTollingActual knowledgeWorkers' compensation rightsEmployer noticeCivil attorneyImputed knowledgePetition for ReconsiderationWorkers' Compensation Appeals BoardAdministrative law judge
References
8
Case No. ADJ1054155 (LAO 0854446) ADJ1247741 (LAO 0854447) ADJ1895803 (LAO 0854448)
Regular
May 03, 2011

HIRITI OKUAMICHAEL vs. PAUL OWENS SHOES INC., STATE FARM FIRE AND CASUALTY COMPANY, STATE COMPENSATION INSURANCE FUND

This amended order clarifies that the Workers' Compensation Appeals Board has granted the applicant's petition for reconsideration of the February 8, 2011 Findings and Awards. This reconsideration aims to allow the Board to thoroughly study the factual and legal issues, including those to be raised in the applicant's supplemental petition. The applicant's request to file a supplemental petition has also been granted and reaffirmed. All future communications regarding these cases should be directed to the Office of the Commissioners of the WCAB.

Supplemental PetitionReconsiderationAppeals Board Rule 10848Findings and AwardsDecision After ReconsiderationOffice of the CommissionersWCABADJ1054155ADJ1247741ADJ1895803
References
0
Case No. MISSING
Regular Panel Decision

Margiasso v. Levitt

This case involves a petitioner's application for accidental disability retirement benefits, which was denied by the State Comptroller. The petitioner, a police officer for the City of Syracuse, claimed total and permanent disability due to arthritis resulting from a motorcycle accident in 1951. His application was filed in 1976, and denied due to the petitioner's failure to file notice of the accident with the Comptroller, as required by subdivision c of section 363 of the Retirement and Social Security Law. The court confirmed the Comptroller's determination, noting that the petitioner did not personally file the notice and no good cause was shown for the omission. The court also rejected the argument that notice to the employer, who had actual knowledge, sufficed under the Workers’ Compensation Law, as the employer did not provide compensation coverage.

Accidental Disability Retirement BenefitsPolice Officer DisabilityNotice of Accident FilingRetirement and Social Security LawWorkers' Compensation Law NoticeArthritis DisabilityState Comptroller DeterminationJudicial Review CPLR Article 78Employer Knowledge of AccidentCompensation Coverage Requirement
References
3
Case No. ADJ9016733
Regular
May 03, 2016

TYSON CONGER vs. CARE AMBULANCE, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration of a prior award concerning industrial injuries to his low back and psyche. The applicant argues the original findings did not properly weigh evidence and support a higher permanent disability rating. The Board also permitted the applicant to file a supplemental petition to address new information, allowing defendants an opportunity to respond. Reconsideration was granted to ensure a complete review of the record and a just decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationSupplemental PetitionEmergency Medical TechnicianLow Back InjuryPsyche InjuryTemporary DisabilityFuture Medical TreatmentPermanent DisabilityApportionment
References
1
Case No. ADJ11207300
Regular
Jan 14, 2020

THOMAS BATISTA vs. LEE'S PAVING, INC., TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The Board affirmed the WCJ's finding that the applicant failed to prove his injury arose out of and in the course of employment from a motor vehicle accident. Furthermore, the applicant's claim was found to be time-barred as the employer lacked specific knowledge of a work-related injury claim, not merely knowledge of an accident. The applicant's arguments regarding exceptions to the going-and-coming rule and tolling of the statute of limitations were rejected.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactOrderMotor Vehicle AccidentGoing and Coming RuleHinojosa v. Workers' Comp. Appeals Bd.Labor Code Section 5405Claim FormCalifornia Ins. Guarantee Ass. v. Workers' Comp. Appeals. Bd.
References
5
Case No. ADJ927676 (MON 0354428)
Regular
Jun 05, 2009

LA VERNE KELLY-LUSK vs. DELTA AIRLINES, INC.; ACE USA, Administered By ESIS

The Workers' Compensation Appeals Board denied reconsideration of the finding that applicant's claim is barred by the statute of limitations. The applicant alleged cumulative industrial injury as a flight attendant from 1973 to 1993, but filed her claim over 14 years after her employment ended. Medical reports in 2002 and 2004 linked her condition to her work, establishing her knowledge of industrial causation. The Board found the applicant's arguments regarding tolling due to lack of a claim form unconvincing given the medical evidence of her knowledge.

Workers' Compensation Appeals BoardPetition for ReconsiderationStatute of LimitationsCumulative InjuryDate of InjuryCompensable DisabilityIndustrial CausationTollingClaim FormFlight Attendant
References
9
Case No. ADJ8855485
Regular
Nov 07, 2019

IMELDA SOSA vs. BRAWLEY UNION HIGH SCHOOL DISTRICT, ATHENS ADMINISTRATORS, LIBERTY MUTUAL INSURANCE, SELF-INSURED SCHOOLS OF CALIFORNIA

This case involves an employer's reconsideration request concerning a finding of cumulative trauma injury. The applicant was found to have sustained a cumulative trauma injury through June 13, 2011, resulting in 23% permanent disability and an award for indemnity and future medical treatment. The employer argued against compensable temporary disability for a single day's absence and questioned the applicant's knowledge of the cumulative trauma's industrial cause. The Board affirmed the original award, finding the applicant had knowledge of an industrial injury and suffered disability on June 13, 2011.

Cumulative trauma injuryDate of injuryLabor Code section 5412Compensable temporary disabilityPermanent disabilityIndustrial accident leaveEducation CodeWorkers' Compensation Appeals BoardReconsiderationFindings Award and Order
References
2
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