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Case Law Database

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. ADJ5806281
Regular
Jul 03, 2012

DEBBIE SCHLATER vs. NORTH COAST DRIVERS, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant's petition to reopen for new and further disability after an initial award became final. The Workers' Compensation Appeals Board (WCAB) granted removal to review an administrative law judge's denial of a voluntary arbitration request. The WCAB clarified that while arbitration is generally prohibited after testimony is taken, it is permissible for issues not decided in a final award. Therefore, the WCAB rescinded the denial, allowing the parties to arbitrate the new and further disability claim.

Petition for RemovalVoluntary ArbitrationWCAB Rule 10997Labor Code section 5275(b)Court Administrator Rule 10296(a)Findings and AwardNew and Further DisabilityReopen CaseDisability Evaluator TestimonyFinal Award
References
Case No. ADJ2653693
Regular
Jul 12, 2012

TIMETHY PORTEOUS vs. REAL ROCK INDUSTRIES, LUMBERMENS MUTUAL INSURANCE COMPANY

This case involves a dispute over voluntary arbitration after a prior Workers' Compensation Appeals Board (WCAB) award. The WCJ initially denied arbitration based on WCAB Rule 10997, which generally prohibits arbitration after testimony has been taken. However, the Appeals Board granted removal, reversing the WCJ's decision. They clarified that Rule 10997 only bars arbitration for issues previously decided in a final award after testimony, allowing parties to voluntarily arbitrate any *remaining, undecided* issues. Therefore, the parties were permitted to proceed with arbitration for outstanding matters.

Petition for RemovalVoluntary ArbitrationWCAB Rule 10997Labor Code section 5275(b)Court Administrator Rule 10296(a)Order Denying Request for Submittal to Voluntary ArbitrationFindings and Awardcumulative traumaindustrial injurytemporary disability indemnity
References
Case No. ADJ4124563
Regular
May 29, 2009

MARIO HERNANDEZ vs. WESLAR, INC., STATE COMPENSATION INSURANCE FUND

This case involves a lien claimant attorney challenging an arbitrator's award of withheld attorney fees. The lien claimant argued they were not properly notified of proceedings concerning the fee distribution. The Appeals Board granted reconsideration, rescinded the arbitrator's prior award, and returned the matter for a full determination on the merits of how the withheld attorney fees should be disbursed. This ensures both attorneys involved will have their claims fairly considered.

Workers' Compensation Appeals BoardLien ClaimantAttorney FeesReconsiderationArbitratorWithheld FeesPetition for ReconsiderationNotice of IntentionAward of Attorney FeesDisbursement
References
Case No. ADJ10850096 ADJ10851592
Regular
Oct 25, 2018

MARIA FLORINA PADRON DE HERNANDEZ vs. MERCHANTS BUILDING MAINTENANCE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of an arbitrator's decision concerning Maria Padron de Hernandez's workers' compensation claim. The arbitrator had found a specific back injury, awarded temporary disability, denied future medical treatment, and imposed sanctions. The WCAB rescinded the arbitrator's decision, returning the matter for further proceedings. This action was based on the finding that the parties' Alternative Dispute Resolution (ADR) agreement stipulated arbitration under American Arbitration Association rules, which were not provided nor followed. Consequently, it could not be determined if the arbitration proceeded according to the agreed-upon rules, thus potentially violating due process.

Workers Compensation Appeals BoardAlternative Dispute ResolutionLabor Code section 3201.7Arbitrator's Findings and AwardCosts and SanctionsContinuing InjuryTemporary DisabilityOverpaymentFuture Medical TreatmentReconsideration
References
Case No. ADJ12096808
Regular
2020-01-33

LARRY REASNER vs. CASEY JOHNSON, dba ROCKIN CJ TRANSPORT COMMERCE & INDUSTRY INSURANCE COMPANY, AIG; NEW YORK MARINE AND GENERAL INSURANCE COMPANY

This case concerns a Petition for Removal filed by Commerce and Industry Insurance Company regarding an order to proceed to trial on an injury AOE/COE. The dispute arises from a prior Stipulated Award between the applicant and New York Marine and General Insurance Company for a cumulative trauma injury. Commerce and Industry argues that its contribution claim against New York Marine is subject to mandatory arbitration under Labor Code section 5500.5. The Appeals Board granted removal, rescinded the trial order, and found that the inter-insurer dispute over contribution must be arbitrated, as the applicant is not involved in this separate proceeding.

Petition for RemovalStipulated AwardCumulative TraumaPetition for ContributionMandatory ArbitrationLabor Code Section 5500.5Successive EmployersInsurers Jointly and Severally LiableContribution ProceedingsDe Novo
References
Case No. ADJ4348361 (STK 0170600)
Regular
Aug 02, 2012

Richard Horton vs. Crown Cork and Seal, American Protection Insurance Company, BROADSPIRE, Travelers Property Casualty Company of America

This case concerns defendant American Protection Insurance Company's (APIC) petition for contribution from Travelers Insurance Company for benefits paid to applicant Richard Horton. The Arbitrator denied APIC's petition, finding contribution was precluded because a prior stipulated award did not grant "new and distinct benefits." The Appeals Board granted reconsideration, rescinding the Arbitrator's decision. The Board determined that a supplemental award granting new and further permanent disability, including a psyche injury claim, constituted new and distinct benefits subject to contribution, even if the original award was time-barred. The matter was returned for further proceedings to determine the extent of APIC's contribution rights.

ContributionReconsiderationPetition to ReopenNew and Further DisabilityInjury to the PsycheCompensable ConsequenceStipulated AwardArbitrator"New and Distinct Benefits"Labor Code Section 5500.5
References
Case No. ADJ758263 (VNO 0361187)
Regular
Feb 27, 2012

JOHN SCHAUFUS vs. SHIRLEY BROTHERS, INC., LIBERTY MUTUAL INSURANCE CO., FERRANTE CONSTRUCTION, GOLDEN EAGLE INSURANCE CORPORATION, STATE COMPENSATION INSURANCE FUND

The State Compensation Insurance Fund (SCIF) petitioned for reconsideration of an arbitrator's decision enforcing a prior award of contribution. SCIF argued that Liberty Mutual, acting in dual capacities as an insurer and successor, should have filed a separate contribution petition within one year of the applicant's Compromise and Release (C&R) approval. The arbitrator found the prior decision to be res judicata, determining SCIF's 41.79% liability for benefits paid outside the C&R, thus rendering a new contribution petition unnecessary. The Workers' Compensation Appeals Board adopted the arbitrator's report and denied SCIF's petition for reconsideration.

Workers Compensation Appeals BoardShirley Brothers Inc.Liberty Mutual Insurance Co.Ferrante ConstructionGolden Eagle Insurance CorporationState Compensation Insurance FundSCIFPetition for ReconsiderationArbitrator's ReportFindings and Award
References
Case No. ADJ10327919
Regular
Nov 08, 2019

MARIA SANCHEZ vs. BARON HR, LLC, BISON DATA SYSTEMS, INC., THE HARTFORD, UNINSURED EMPLOYERS BENEFITS TRUST FUND

This case involves a clerical error in the service date of a prior Board decision. The Board will correct the service date from October 8, 2019, to November 8, 2019. Separately, the defendant insurer sought reconsideration of a prior award, arguing fraud in the contractual relationship between employers and that insurance coverage disputes are subject to arbitration. The Board granted reconsideration, rescinded the prior award, and returned the matter for further proceedings and a new decision, clarifying that the WCJ should determine employer identity, while insurance coverage issues may proceed to arbitration.

Professional Employer OrganizationPEOLabor Code section 3602(d)general and special employmentjoint and several liabilityarbitrationLabor Code section 5275clerical errorPetition for ReconsiderationFindings and Award
References
Case No. ADJ2789055 (SAL 0090971) ADJ3651266 (SAL 0098921) ADJ3642697 (SAL 0115568)
Regular
Oct 06, 2017

MARIA CAMACHO vs. AGRILINK FOODS, LUMBERMENS MUTUAL CASUALTY COMPANY, NATIONAL CUSTOM PACKING, STATE COMPENSATION INSURANCE FUND

This case involves an appeal by Agrilink Foods regarding a WCJ's order that an arbitrator's decision did not extinguish prior medical awards. The WCJ directed the State Compensation Insurance Fund to administer existing medical awards and noted that the apportionment of current treatment needs to prior injuries was a medical issue requiring further development. The Appeals Board dismissed Agrilink's petition for reconsideration because it was not aggrieved by a final order, as the Opinion on Decision was not the operative decision. Any disputes regarding further medical record development should be addressed by the arbitrator, whose decisions remain subject to reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissedAggrieved PartyFinal OrderArbitrator DecisionMedical AwardCumulative InjurySpecific InjuryAdministrative Law Judge
References
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