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Case Law Database

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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ7264969
Regular
Feb 22, 2011

Richard Warner vs. COUNTY OF LOS ANGELES, INTERCARE INSURANCE SERVICES

Applicant Richard Warner, a firefighter on Catalina Island, sustained injuries while trimming wisteria at his home, which he was required to maintain as a condition of employment and from which he sometimes worked. The Board denied reconsideration, affirming the WCJ's finding that the injury was not arising out of and occurring in the course of employment (AOE/COE). The applicant's home was not considered employer premises under the bunkhouse rule as he owned and maintained it personally, receiving a stipend instead of provided housing. Although working from home was sometimes necessary, trimming wisteria was deemed a purely personal act unrelated to employment duties.

AOE/COEbunkhouse ruleemployer premisessecondary jobsitecourse of employmentperforming serviceproximate causepersonal taskincidental to employmentstipend
References
Case No. ADJ11968759
Regular
Apr 13, 2023

JESUS ORTEGA GONZALEZ vs. MAJOR TRANSPORTATION SERVICES, INC., BALJINDER S. GILL, PEOPLEASE LLC, NATIONAL INTERSTATE RICHFIELD.

This case involves an applicant injured while employed by both Major Transportation Services and Peoplease, a Professional Employer Organization (PEO). Peoplease sought reconsideration of a finding that they jointly employed the applicant on the date of injury, arguing payroll was not processed through them. The Board denied reconsideration, adopting the WCJ's reasoning that a co-employment relationship existed. The WCJ found that despite Peoplease's argument about payroll timing, evidence showed Peoplease benefitted from the applicant's work and their actions were inconsistent with strict contract adherence, akin to precedent in Gulam v. Patel. Ultimately, Peoplease's arguments regarding payroll timing were deemed coverage issues subject to arbitration and not grounds to deny the finding of co-employment.

Professional Employer OrganizationPEOdual employmentgeneral employerspecial employerco-employmentclient policyLabor Code section 3602(d)presumption of employmentsubstantial evidence
References
Case No. ADJ2136789 (MON 0357209)
Regular
Feb 27, 2012

ROBERT FLORES vs. GARNET PROTECTIVE SERVICES AND SECURITY, INC., JOSEPH'S CAFE, INC., PENNSYLVANIA MANUFACTURERS' ASSOCIATION INSURANCE COMPANY, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the original decision, and found the applicant was solely employed by Garnet Protective Services, not Joseph's Cafe. The Board further determined the applicant did not sustain an industrial injury on July 12, 2007. The majority concluded the applicant's commute to an extra shift did not constitute a special mission and fell under the "going and coming" rule. A dissenting commissioner argued the extra shift constituted a special mission, making the injury compensable.

Workers' Compensation Appeals BoardGarnet Protective ServicesJoseph's CafePennsylvania Manufacturers' Insurance CompanyUninsured Employers Benefits Trust FundPetition for ReconsiderationArbitrator's DecisionEmployee StatusDual EmploymentSpecial Employer
References
Case No. SBR 309137
Regular
Aug 28, 2007

JOSE CARMONA vs. ARROW EMPLOYMENT SERVICES dba ARROW STAFFING SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for LEGION INSURANCE COMPANY, in liquidation, by CAMBRIDGE INTEGRATED SERVICES, KELLY PRODUCTIONS, INC., FARMDALE CREAMERY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board is reconsidering a prior award due to CIGA's contention that the applicant's claim is not a "covered claim" because other insurance was available. The central issue is whether the special employer's (Farmdale Creamery) workers' compensation policy with SCIF constitutes "other insurance" under Insurance Code section 1063.1(c)(9), which would exclude the claim from CIGA's coverage. The case is remanded for further proceedings to definitively determine the availability of this "other insurance" and its impact on CIGA's liability.

CIGALegion Insurance CompanyArrow Employment ServicesFarmdale CreameryState Compensation Insurance Fundcovered claimother insuranceInsurance Code section 1063.1(c)(9)general employerspecial employer
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. SFO 0499272
Regular
Jul 07, 2008

Helen Miller vs. Green Gulch Farm and Zen Center, EVEREST NATIONAL INSURANCE

The Workers' Compensation Appeals Board affirmed the administrative law judge's finding that Helen Miller was an employee of Green Gulch Farm and Zen Center and sustained an industrial injury to her left ankle. The Board found Miller was not a volunteer due to the extensive benefits received and the employer's control, and her jogging injury during a lunch break was a reasonable expectancy of employment, not barred by Labor Code section 3600(a)(9). Therefore, her injury arose out of and occurred in the course of her employment.

Workers' Compensation Appeals BoardHelen MillerGreen Gulch Farm and Zen CenterEverest National InsuranceGallagher BassettSFO 0499272Opinion and Decision After ReconsiderationLabor Code Section 3351Labor Code Section 3352(i)Employee definition
References
Case No. VNO 0470470
Regular
May 12, 2008

GERARDO RAMIREZ vs. WILLIAM ALONSO, UNINSURED EMPLOYERS FUND

The Workers' Compensation Appeals Board granted reconsideration to further develop the record concerning applicant Gerardo Ramirez's employment status at the time of his injury. The Board rescinded the previous findings, finding the evidence insufficient to support dual employment and needing clarification on whether applicant was a casual employee, which might affect his eligibility for benefits. The case was returned to the trial level for additional evidence gathering, including a review of the defendant's insurance policy for the property where the injury occurred.

Workers' Compensation Appeals BoardUninsured Employers Fundindustrial injuryright major extremitydefendant's contentiondual employmentthreshold issueemployment relationshippresumption of employmentjoint venture
References
Case No. LBO 0355505
Regular
Feb 26, 2008

REBECCA BETANCOURT vs. CHECKMATE STAFFING SERVICES, UNINSURED EMPLOYERS FUND, J.C. PENNEY, INC., AMERICAN HOME ASSURANCE c/o AIG CLAIM SERVICES

This case involves an applicant injured while working for Checkmate Staffing Services, a general employer, and J.C. Penney, Inc., a special employer. The Workers' Compensation Appeals Board (WCAB) reconsidered a prior decision, notably reversing the administrative law judge's (ALJ) assessment of penalties against Checkmate and remanding the issue of Checkmate's insurance coverage to the trial level. The WCAB affirmed joint and several liability for benefits against Checkmate, J.C. Penney, American Home Assurance, and the Uninsured Employers Fund (UEF), ordering American Home Assurance to administer benefits while reserving jurisdiction to determine ultimate liability.

Workers' Compensation Appeals BoardReconsiderationJoint and Several LiabilitySpecial EmployerGeneral EmployerUninsured Employers FundLabor Code Section 3722Certificate of Liability InsuranceDue ProcessDual Employment Relationship
References
Case No. ADJ10009703 ADJ10043837
Regular
Feb 19, 2019

ZULAY DAVILA vs. EMPLOYERS RESOURCE GROUP, VENSURE HR, INC., LCF LIBERTY JR, LLC/SECURITY NATIONAL INSURANCE COMPANY, AMTRUST NORTH AMERICA, PROPORTION FOODS, LLC/REDWOOD FIRE AND CASUALTY INSURANCE COMPANY, BERKSHIRE HATHAWAY HOMESTATE COMPANIES

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the WCJ's decision due to a due process violation. The WCJ had determined employment by ERG without providing ERG notice and an opportunity to be heard. The WCAB returned the case to the trial level for further proceedings to determine employment status. Issues of insurance coverage will be subject to mandatory arbitration once employment is established.

Workers' Compensation Appeals BoardVENSURE HRSecurity National Insurance CompanyProportion FoodsLLCREDWOOD FIRE AND CASUALTY INSURANCE COMPANYBERKSHIRE HATHAWAY HOMESTATE COMPANIESAMTRUST NORTH AMERICAEMPLOYMENT RESOURCES GROUPINC.
References
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