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

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 Therefore, the WCAB rescinded the denial, allowing the parties to arbitrate the new and further disability claim.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. 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 The WCAB rescinded the arbitrator's decision, returning the matter for further proceedings.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. ADJ6940334
Regular
Jan 28, 2011

AURELIO RAMOS LOPEZ vs. JESUS AGUILAR dba C&A FRAMING et al.

The Workers' Compensation Appeals Board granted reconsideration, rescinded a deficient arbitrator's judgment, and returned the matter for further proceedings. The original "Judgment" failed to comply with statutory requirements for a decision, lacking an opinion and a signature. Defendant Granite argued denial of due process due to insufficient time for discovery after being joined as a party. Defendant C&A contended substantial evidence supported coverage by AIG on the date of injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationJudgmentArbitrationCoverageDate of InjuryDue ProcessDiscoverySubstantial EvidenceWaiver
References
Case No. ADJ7405264
Regular
Jun 19, 2012

IVORY PHILLIPS vs. IRWIN INDUSTRIES, INC., ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board sanctioned claims adjuster Richard Bailey $250 for failing to appear at an arbitration hearing. Despite Bailey's contentions about lack of written notice and fear of the arbitrator, the Board found he had actual notice of the verbal order. While the underlying issue was resolved, Bailey should have sought permission for his non-appearance, and his disregard for the arbitrator's order undermined the system's integrity.

Workers' Compensation Appeals BoardSanctionsClaims AdjusterArbitrationWritten ObjectionGood CauseArbitratorVerbal OrderLabor Code Section 5701Independent Medical Examination
References
Case No. ADJ1525428
Regular
Aug 20, 2013

Raymond Barrios vs. Irwin Industries, Inc., California Insurance Guarantee Association, For California Compensation Insurance Company, In Liquidation, Mobil Corporation, Petroleum Casualty Company

The Workers' Compensation Appeals Board (WCAB) vacated an arbitrator's findings due to an incomplete arbitration file, lacking essential evidence and documentation. The WCAB found the arbitrator failed to comply with regulations requiring minutes of hearing, stipulations, and a summary of evidence. Consequently, the WCAB rescinded the arbitrator's decision and returned the case to the trial level for further proceedings. The prior order compelling arbitration was also vacated, allowing parties to resubmit to arbitration if desired.

WCABCIGAarbitrationreconsiderationarbitration fileminutes of hearingsummary of evidencedocumentary evidencetestimonial evidencestipulated facts
References
Case No. SDO 0341777
Regular
Sep 21, 2007

ARMANDO GALLEGOS vs. A.O. REED & COMPANY, ST. PAUL TRAVELERS INSURANCE, UNIVERSAL MECHANICAL (EMCOR), AMERICAN CASUALTY COMPANY OF READING, PA., SPECIALTY RISK SERVICES

The Workers' Compensation Appeals Board affirmed an arbitration award against A.O. Reed & Company, finding that the arbitrator had jurisdiction despite Reed not being a signatory to the collective bargaining agreement. Reed waived its objections by participating in the arbitration and discovery without protest, thus effectively agreeing to the process. The Board also found that Reed could have discovered its signatory status with reasonable diligence prior to the arbitration.

Workers' Compensation Appeals BoardArmando GallegosA.O. Reed & CompanySt. Paul Travelers InsuranceUniversal MechanicalAmerican Casualty CompanySpecialty Risk ServicesSDO 0341777Opinion and Decision After ReconsiderationArbitrator jurisdiction
References
Case No. ADJ7188251; ADJ7188272
Regular
Mar 08, 2013

Raymond Mark vs. City of Los Angeles

This case involves a petition by applicant Raymond Mark to resubmit or remove two workers' compensation cases, alleging the City of Los Angeles refused to fund an arbitrator. The Appeals Board dismissed the petition for three reasons: no arbitrator decision existed for review, the underlying claims were previously dismissed giving the Board no jurisdiction, and the Board lacks jurisdiction over disputes concerning the administration of the Alternative Dispute Resolution Agreement itself. The Board concluded that the applicant's recourse for funding disputes lies in collective bargaining, arbitration, or petitioning the Administrative Director to decertify the agreement.

Petition for ResubmissionADR CasesL.C. § 3201.7ADR ARB IVCity of Los AngelesFunding ArbitratorOpinion and Order Granting ReconsiderationDecision After ReconsiderationOrder of DismissalJurisdiction
References
Case No. ADJ7286100; ADJ7286102
Regular
Apr 06, 2012

VILMA LAMBEY vs. MY OWN LIFE FOUNDATION, STATE COMPENSATION INSURANCE FUND, STATE FARM FIRE AND CASUALTY COMPANY, KHEESA SLAUGHTER

The Workers' Compensation Appeals Board granted reconsideration to determine the applicant's employer, as this issue was erroneously sent to arbitration. The Board found that the arbitrator lacked jurisdiction to decide employment status, which is a matter for the WCJ. Consequently, the prior arbitration order is rescinded and the case is returned to the trial level for a new decision on employer identity and coverage. The Board also directed that Kheesa Slaughter and State Farm be joined as defendants if not already properly done.

Workers' Compensation Appeals BoardReconsiderationArbitrationInsurance CoverageIdentity of EmployerAOE/COELabor Code Section 5275Labor Code Section 3300Labor Code Section 3351Labor Code Section 3357
References
Case No. ADJ3911273 (LAO 0865370) ADJ735474 (LAO 0865371)
Regular
Jun 24, 2010

PATRICIA DIAZ vs. J.T. POSEY CO.

This case involves a defendant's petition for reconsideration regarding a Workers' Compensation Appeals Board arbitrator's decision on a cumulative trauma injury. The defendant argued the arbitrator erred in determining the date of injury and the applicable liability period. The Appeals Board granted the petition and rescinded the arbitrator's prior order. The matter was returned to the arbitrator due to a deficient record, specifically the absence of a Minutes of Hearing and Summary of Evidence, which are required for proper appellate review. The arbitrator is to reconstruct the record and issue a new decision thereafter.

Petition for ReconsiderationFindings and OrderDate of InjuryPeriod of LiabilityCumulative TraumaCIGAArbitrator's RecommendationMinutes of HearingSummary of EvidenceLabor Code Section 5412
References
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