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

Case No. ADJ7753735
Regular
Oct 23, 2015

JOSE VALENCIA vs. AL'S GARDEN ART, CYPRESS INSURANCE COMPANY, BERKSHIRE HATHAWAY HOMESTATE COMPANIES, ARGONAUT INSURANCE COMPANY, US RISK MANAGEMENT CLAIMS-XL INSURANCE

This case involves Cypress Insurance Company's (BHHC) petition for contribution against Argonaut Insurance Company regarding applicant Jose Valencia's cumulative injury claim. The arbitrator initially denied BHHC's petition, finding insufficient evidence of cumulative injury AOE/COE. BHHC sought reconsideration, arguing issues regarding Argonaut's defense and the sufficiency of medical evidence. The Appeals Board granted reconsideration to amend the findings to include previously omitted BHHC exhibits, but otherwise affirmed the arbitrator's decision. The Board adopted the arbitrator's report which noted issues with the PQME reports and gaps in medical documentation, ultimately upholding the denial of contribution.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for ContributionCumulative InjuryAOE/COELabor Code 3208.1Labor Code 5500.5Labor Code 5412Qualified Medical ExaminerPQME
References
0
Case No. ADJ9326359
Regular
Jan 17, 2020

ERNEST JOHNSON vs. JWCH INSTITUTE, INC.; CYPRESS INSURANCE, administered by BHHC

The Workers' Compensation Appeals Board denied the lien claimant's Petition for Reconsideration. The Board found that while the WCJ's decision included a threshold finding of injury AOE/COE, making it a final order, the lien claimant's challenge only pertained to an interlocutory issue regarding the nature of medical treatment. The Board determined that reconsideration was not the appropriate remedy for this interlocutory dispute and that the lien claimant failed to demonstrate the extraordinary circumstances required for removal. Therefore, the petition was denied.

Petition for ReconsiderationThreshold IssueFinal DecisionInterlocutory IssueRemoval StandardAOE/COELien ClaimantWorkers' Compensation Appeals BoardWCJ ReportSignificant Prejudice
References
4
Case No. ADJ11668611
Regular
Sep 16, 2019

MIGUEL LUNA vs. SOCAL STRUCTURAL STEEL FABRICATION, REDWOOD FIRE & CASUALTY/BHHC

The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for reconsideration and rescinded the prior findings of injury arising out of and in the course of employment. The WCAB found the original decision lacked substantial medical evidence to support the injury claim, as applicant's lay testimony alone is insufficient for causation when medical expertise is required. While giving deference to the WCJ's credibility determinations, the Board is returning the case to the trial level for further proceedings to develop the medical record.

AOE/COEPetition for ReconsiderationFindings and Ordersubstantial evidencecredibility determinationsindustrial causationmedical evidencedevelop the recordrescindedtrial level
References
13
Case No. ADJ7690991 ADJ7694966
Regular
Apr 18, 2013

MABEL MARK vs. CHINATOWN SERVICE CENTER (NON PROFIT), BHHC/CYPRESS INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's petition for removal because it was untimely filed. The defendant had notice of a lien hearing on October 30, 2012, but did not file the petition until February 22, 2013, exceeding the 20-day deadline. Even if timely, the petition would have been denied on its merits, as the WCAB has jurisdiction to schedule lien proceedings in any district office. Therefore, the petition for removal is dismissed.

Petition for RemovalTimely-FiledWCAB Rule 10843(a)Lien HearingOxnard District OfficeLabor Code Section 133Appeals Board JurisdictionCase-in-ChiefFlores v. United California BankDismissed
References
1
Case No. ADJ9116799
Regular
Nov 01, 2016

JOHN FLOYD vs. CYPRESS INSURANCE COMPANY (BHHC) for FLOYD, SKEREN & KELLY, LLP et al.

The Workers' Compensation Appeals Board denied the Petition for Removal in this case. Removal is an extraordinary remedy, and the Board only grants it when substantial prejudice or irreparable harm would result from denial, and reconsideration would be inadequate. In this instance, the Board found no persuasive evidence of such prejudice or harm, adopting the WCJ's reasoning for denial. Therefore, the petition was dismissed.

Workers' Compensation Appeals BoardPetition for RemovalSubstantial PrejudiceIrreparable HarmReconsiderationAdministrative Law Judgeextraordinary remedyCortez v. Workers' Comp. Appeals Bd.Kleemann v. Workers' Comp. Appeals Bd.CYPRESS INSURANCE COMPANY
References
2
Case No. ADJ7959497
Regular
May 22, 2019

ILDEFONSO ORTIZ vs. CITY FIBERS, INC., CYPRESS INSURANCE COMPANY, BERKSHIRE HATHAWAY HOMESTATE COMPANY (BHHC)

This case involves a petition for reconsideration that was dismissed by the Workers' Compensation Appeals Board (WCAB). The dismissal was based on the petition being untimely filed. The WCAB clarified that a petition must be *received* by the board within the statutory 25-day period, not merely mailed. Despite claims of defective service, the WCAB found proper service on the lien claimant's representative. As the petition was filed on March 28, 2019, after the jurisdictional deadline of March 18, 2019, it was dismissed.

Petition for ReconsiderationUntimely FilingJurisdictional Time LimitWCAB ServiceDefective ServiceLien ClaimantOfficial Address RecordAdministrative Law JudgeAppeals BoardDismissal
References
4
Case No. ADJ3302817
Regular
Sep 10, 2019

EULALIO CARDENAS vs. FOUNDRY SERVICE AND SUPPLIES, INC., BHHC, STATE COMPENSATION INSURANCE FUND, et aL.

The Workers' Compensation Appeals Board dismissed the defendant's Petition for Reconsideration because it challenged an interim procedural order, not a final decision determining substantive rights or liabilities. The Board also denied the Petition for Removal, finding no showing of substantial prejudice or irreparable harm, and that reconsideration would be an adequate remedy if a final adverse decision occurred. Thus, the Board affirmed the WCJ's order and dismissed the petitions.

Petition for ReconsiderationPetition for RemovalFinal OrderInterlocutory OrderSubstantive RightLiabilityThreshold IssueProcedural DecisionEvidentiary DecisionExtraordinary Remedy
References
6
Case No. ADJ3640816 (SBR 0317873) ADJ1343688 (SBR 0317874)
Regular
Apr 10, 2009

ROBERT W. LEE vs. LAEGER'S INC., EVEREST NATIONAL INSURANCE CO., ACCA/BHHC, MID-CENTURY INSURANCE COMPANY

This case concerns a workers' compensation claim for cumulative injury where the liability period for employer Everest National Insurance Company (ENIC) was at issue. The Appeals Board granted reconsideration, amending the previous order to establish the cumulative injury ended on March 6, 2003, aligning with the applicant's first date of disability. Consequently, ENIC is now ordered to reimburse Mid-Century Insurance Company for 61% of benefits paid during the preceding one-year liability period. The Board affirmed the finding of a single cumulative injury, distinguishing it from prior cases with separate periods of disability and continued medical treatment.

Labor Code § 5500.5cumulative injuryspecific injurycompromise and releasetemporary total disabilitypermanent disability advancedate of injurylast day of workemployer liabilityapportionment
References
6
Case No. ADJ6859530
Regular
Oct 16, 2012

ISSA FARRAJ, Deceased FATEN FARRAJ, Widow, vs. LDI TRUCKING; REDWOOD FIRE AND CASUALTY Administered By BHHC BERKSHIRE HATHAWAY HOMESTATE COMPANIES,

The Workers' Compensation Appeals Board dismissed the petition for reconsideration as it sought review of non-final interlocutory orders and was skeletal. The Board also denied the petition for removal because the petitioner failed to demonstrate substantial prejudice or irreparable harm, or that reconsideration would be an inadequate remedy. Therefore, both the petition for reconsideration and removal were denied.

WORKERS' COMPENSATION APPEALS BOARDISSA FARRAJLDI TRUCKINGREDWOOD FIRE AND CASUALTYBHHC BERKSHIRE HATHAWAY HOMESTATE COMPANIESPETITION FOR RECONSIDERATIONDISMISSINGNON-FINAL INTERLOCUTORY ORDERSSKELETAL PETITIONREMOVAL
References
3
Case No. ADJ2003074 (SFO 0486401) (ADJ3727915 - CONSOLIDATED
Regular
Apr 05, 2010

ALEXANDRA MONTEITH vs. EDWARD LITTLEJOHN, M.D., TIG SPECIALTY INSURANCE COMPANY, RISK ENTERPRISE MANAGEMENT, BERKSHIRE HATHAWAY HOMESTATE COMPANIES (BHHC)

The Workers' Compensation Appeals Board (WCAB) dismissed TIG Specialty Insurance Company's petition for reconsideration because it sought to appeal a non-final order. The WCAB also denied TIG's petition for removal, adopting the WCJ's reasoning that TIG failed to demonstrate substantial prejudice or irreparable injury. This decision confirms that appeals can only be made from final orders that determine substantive rights and liabilities. The WCAB found TIG's argument regarding a non-party's interference with the settlement was not properly before them due to the non-final nature of the appealed order.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalCompromise and ReleaseVacating OrderAdministrative Law JudgeNon-party InterferenceCalifornia Insurance Guarantee Association (CIGA)PrejudiceFinal Order
References
5
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