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

Case No. ADJ11391724, ADJ11391757
Regular
Oct 03, 2019

PABLO LOPEZ DURAN vs. SOUTH HILLS ACADEMY, CHURCH MUTUAL INSURANCE COMPANY, SECURITY NATIONAL INSURANCE COMPANY, AMTRUST NORTH AMERICA, CRESCENT HOTELS & RESORTS, LLC, CHUBB INSURANCE GROUP, GALLAGHER BASSETT SERVICES, INC.

This Workers' Compensation Appeals Board case involves applicant Pablo Lopez Duran and multiple defendants including South Hills Academy, Church Mutual Insurance Company, Security National Insurance Company, Crescent Hotels & Resorts, LLC, and Chubb Insurance Group. The Board granted a petition for reconsideration and affirmed a prior order regarding sanctions and costs. Specifically, Chubb Insurance Group, administered by Gallagher Bassett Services, Inc., was ordered to pay an additional $395 for attorneys' fees related to a petition for fees, less any credit for prior payments.

WORKERS' COMPENSATION APPEALS BOARDSOUTH HILLS ACADEMYCHURCH MUTUAL INSURANCE COMPANYSECURITY NATIONAL INSURANCE COMPANYAMTRUST NORTH AMERICACRESCENT HOTELS & RESORTSLLCCHUBB INSURANCE GROUPGALLAGHER BASSETT SERVICESINC.
References
Case No. ADJ1543782
Regular
Aug 18, 2009

Richard E. Knudsen vs. CITY OF BEVERLY HILLS

In this workers' compensation case, the Board denied the defendant City of Beverly Hills' reconsideration of its prior decision. The Board had overturned a judge's finding that a police officer's shoulder injury sustained while exercising in the station gym during off-duty hours was not industrial. The Board determined the injury was compensable because it was a reasonable expectancy of employment under the specific circumstances. This decision reinforces the finding that the officer's workout was a reasonable part of his employment, even during off-duty hours.

Workers Compensation Appeals BoardCity of Beverly Hillspolice officerleft shoulder injuryindustrial injuryreasonable expectancyoff-duty hoursgymcompensablereconsideration
References
Case No. ADJ10565692
Regular
Nov 08, 2018

BRIAN CLARK vs. LOS RIOS COMMUNITY COLLEGE DISTRICT, YORK RISK SERVICES GROUP

This case involves a sports athletic trainer, Brian Clark, who sustained head and psyche injuries at work. Both the applicant and the defendant sought reconsideration of the initial award. The applicant argued his occupational group was misclassified, while the defendant contended the judge wrongly rejected the medical evaluator's apportionment of permanent disability. The Workers' Compensation Appeals Board denied both petitions, upholding the original findings. The Board found the applicant failed to prove factual error in his occupational group classification and adopted the WCJ's reasoning regarding the apportionment.

WORKERS' COMPENSATION APPEALS BOARDLOS RIOS COMMUNITY COLLEGE DISTRICTYORK RISK SERVICES GROUPFindings and Awardsports athletic traineroccupational group 390occupational group 311permanent disability apportionmentPanel Qualified Medical Evaluator (PQME)substantial evidence
References
Case No. ADJ6587935
Regular
Aug 14, 2012

BRENT HAWKINS vs. FOOD FOR LESS, SEDGWICK CMS, INC.

The Workers' Compensation Appeals Board granted reconsideration and rescinded an order that awarded a lien claimant $900. The defendant argued the Workers' Compensation Judge (WCJ) improperly considered an informal agreement not submitted for approval. The Board found it a due process violation for the WCJ to treat a proposed exhibit as a stipulated agreement without it being formally submitted. The case is returned to the trial level for further proceedings and a new decision.

Workers' Compensation Appeals BoardAspen Medical Grouplien claimantinformal agreementstipulation and orderdue processGangwish v. Workers' Comp. Appeals Bd.Rucker v. Workers' Comp. Appeals Bd.Beverly Hills Multispecialty GroupInc. v. Workers' Comp. Appeals Bd.
References
Case No. ADJ10443669
Regular
Oct 04, 2017

Donna Carter vs. Rose International Group, OneBeacon Insurance Group

The Appeals Board affirmed the Workers' Compensation Judge's finding that Donna Carter sustained an industrial injury to her right knee and left wrist on May 18, 2016. Despite inconsistencies in the applicant's testimony regarding a slip and fall incident, her account was corroborated by a witness who found her on the floor. Medical records from the day of the incident also supported the applicant's claim, establishing a clear mechanism of injury. The Board found that the common sense nature of a slip and fall does not require expert medical opinion to establish industrial causation for the incident itself.

ADJ10443669Rose International GroupOneBeacon Insurance GroupDonna CarterWorkers' Compensation Appeals BoardOpinion and Decision After Reconsiderationslip and fallindustrial injuryright kneeleft wrist
References
Case No. ADJ2357169 (VNO 0476110) ADJ3613914 (VNO 0476111) ADJ1007900 (VNO 0476112) ADJ3475183 (VNO 0476113) ADJ1139437 (VNO 0476115)
Regular
Jan 05, 2009

LUIZA ZIEGLER vs. FIRST BANK AND TRUST, CHUBB GROUP OF INSURANCE CO.

The Appeals Board dismissed the lien claimant's petition for reconsideration as untimely, filed 26 days after the October 9, 2008, Order of Dismissal.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien ClaimantOrder of DismissalTimelinessJurisdictionalLabor CodeCode of Civil ProcedureCalifornia Code of RegulationsWCJ
References
Case No. ADJ8453844
Regular
Aug 05, 2016

ISOBETH CABRERA vs. LABOR READY, ESIS

The Workers' Compensation Appeals Board affirmed an order dismissing a lien claim filed by Orthopedic Sports and Spine Medical Group. The lien claimant failed to appear at a lien conference and did not file a proper verified objection, which is required to seek relief from dismissal under Code of Civil Procedure section 473. The Board found the lien claimant's objection lacked the necessary sworn affidavit detailing excusable neglect. Therefore, the dismissal of the lien was upheld.

Workers' Compensation Appeals BoardReconsiderationLien ClaimantOrder Dismissing LienPetition for ReconsiderationNotice of Intention to Dismiss LienVerified ObjectionExcusable NeglectCode of Civil Procedure Section 473WCJ
References
Case No. ADJ3871980 (SBR 0332495) ADJ1578450 (SBR 0333829) ADJ7125261
Regular
Nov 05, 2010

ANITA BAKER vs. SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP, PSI, Adjusted and Administered By KAISER PERMANENTE MEDICAL GROUP

This case involves Anita Baker's workers' compensation claim against Southern California Permanente Medical Group. The Workers' Compensation Appeals Board denied reconsideration of the judge's decision. The primary dispute centered on the calculation of diminished future earning capacity, with the applicant arguing for a calculation based on actual lost earnings and the defendant relying on statutory guidelines and expert testimony. The Board adopted the judge's report, which found in favor of the applicant regarding the calculation of permanent disability, incorporating aspects of both expert opinions and considering the applicant's specific circumstances.

Workers Compensation Appeals BoardSouthern California Permanente Medical GroupKaiser Permanente Medical GroupPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeOgilvie v. City and County of San Franciscodiminished future earning capacityFindings and Awardcontinuous traumabilateral upper extremities
References
Case No. PAS 37026, LAO 771108
Regular
Aug 04, 2008

Betty Noujaim vs. TRANSAMERICA FINANCIAL, CRAWFORD AND COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded an order dismissing a lien claimant's claim. The claimant had failed to appear at a lien trial, leading to a notice of intention to dismiss the lien. Although the administrative law judge believed the claimant's subsequent objection lacked good cause, the Board found that due process required consideration of the objection's merits. The case is returned to the trial level for further proceedings on the lien claimant's entitlement to payment.

Wilshire SurgicenterNotice of Intention to DismissLien claimantPetition for ReconsiderationOrder Dismissing Lien ClaimsWCJGood causeDue processJoint Compromise and Release AgreementCumulative trauma injuries
References
Case No. ADJ2639881
Regular
Jun 07, 2013

DINA MESSIER vs. COUNTY OF SACRAMENTO

This case involves a lien claimant, Access Mediquip, seeking reconsideration of an order dismissing its lien. The claimant argues the dismissal was erroneous because it lacked notice and an opportunity to present arguments regarding the statute of limitations. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, finding that the claimant was denied due process. The WCAB rescinded the dismissal order and returned the matter to the trial level for further proceedings and a new decision.

Lien claimantReconsiderationOrder Dismissing LienStatute of limitationsDue processWCJWorkers' Compensation Appeals BoardAccess MediquipPinnacle Lien ServicesCounty of Sacramento
References
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