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

Case No. ADJ9433736
Regular
Nov 01, 2014

BRIAN KLOEPFER vs. COUNTY OF SAN BERNARDINO, COUNTY OF SAN BERNARDINO DEPARTMENT OF RISK MANAGEMENT

The Workers' Compensation Appeals Board dismissed Brian Kloepfer's petition for reconsideration because it was not filed from a final order. The Board also denied his request for removal, finding no showing of substantial prejudice or irreparable harm. The case is returned to the trial level for further proceedings.

Petition for ReconsiderationFinal OrderInterlocutory OrderSubstantive RightRemovalWCJ ReportTrial LevelDismissedDeniedReturned
References
9
Case No. MISSING
Regular Panel Decision

Brian Fay Construction, Inc. v. Morstan General Agency, Inc.

Brian Fay Construction, Inc. (plaintiff) contracted with J.E Spano and Company, agreeing to indemnify Spano. The plaintiff then instructed its insurance agents, DFW Associates, Inc. and Douglass Fenning (together DFW), and later Morstan General Agency, Inc., to add Spano as an additional insured to its general liability policy with Burlington Insurance Company. An employee of Brian Fay Construction was injured, leading to a claim against Spano and a third-party action against the plaintiff. Burlington denied coverage, citing an employee exclusion and stating there was no evidence Spano was an additional insured. The plaintiff sued the agents for failing to properly procure insurance, seeking a declaration that they were obligated to defend and indemnify. The Supreme Court granted the plaintiff's motion for summary judgment, but the appellate court reversed, finding that the plaintiff failed to prove that Burlington would have been obligated to cover the claim even if Spano had been properly named as an additional insured.

Insurance Broker LiabilityAdditional InsuredSummary JudgmentDuty to Procure InsuranceIndemnificationGeneral Liability PolicyEmployee Liability ExclusionAppellate ReviewConstruction ContractInsurance Coverage Dispute
References
6
Case No. MISSING
Regular Panel Decision

Brian v. Johns

Petitioner Carol Brian initiated an action against respondent Frank T. Johns to establish paternity for her child, Sara, born March 4, 1973, and to secure child support. A court-ordered blood grouping test, conducted at the respondent's expense following an order on January 2, 1974, excluded Mr. Johns as the father. Unsatisfied with these results, the petitioner requested a second blood test, but the court denied this motion after reconsideration, citing respondent's opposition and the lack of statutory authority in Section 532 of the Family Court Act for ordering a second test over objection. The court ruled that the trial should proceed, requiring the respondent to present the performing doctor as a witness to explain the test's basis and procedure, allowing the petitioner to question its accuracy. The decision acknowledged a potential margin of error in such tests and affirmed the petitioner's opportunity to rebut the blood test evidence, as it is not the sole determinant of paternity.

paternityblood testFamily Court Actevidencetrialmotion deniedchild supportmedical examination accuracyserologyhemotology
References
2
Case No. CV-23-1921
Regular Panel Decision
Dec 12, 2024

In the Matter of the Claim of Brian Giesselmann

Claimant Brian Giesselmann appealed two decisions from the Workers' Compensation Board. The Board found that Giesselmann violated Workers' Compensation Law § 114-a by misrepresenting his physical condition during a permanency evaluation for a right shoulder injury sustained in June 2016. Video surveillance and medical expert testimony from Dr. Daniel Bowman indicated discrepancies between Giesselmann's reported limitations and his actual physical activities. The Board affirmed the WCLJ's finding of a mandatory penalty of forfeiture of any SLU award and a discretionary penalty of permanent disqualification from future indemnity benefits due to egregious misrepresentations. The Appellate Division affirmed the Board's decisions, finding substantial evidence to support the violation and the imposed penalties.

Workers' CompensationFraudMisrepresentationSchedule Loss of UseIndemnity BenefitsDisqualificationMedical ExaminationSubstantial EvidenceAppellate ReviewWitness Credibility
References
10
Case No. ADJ7236428
Regular
Oct 01, 2012

BRIAN CAMPBELL vs. COUNTY OF SAN BERNARDINO

This case involves a dispute over a $2,017.04 lien filed by VQ OrthoCare for medical equipment provided to injured worker Brian Campbell. The Workers' Compensation Appeals Board granted reconsideration and rescinded the previous order allowing the lien. The Board found that VQ OrthoCare failed to meet its burden of proof under Labor Code section 4600, as there was insufficient medical evidence establishing the necessity of the OrthoStim4 equipment for the applicant's industrial injury. The prior findings regarding inadequate utilization review and service issues were rendered moot by this determination.

VQ OrthoCarelien claimantLabor Code section 4600burden of proofmedical treatmentutilization revieworthopedic consultationsprimary treating physicianagreed medical examinerOrthoStim4
References
3
Case No. ADJ3362574
Regular
Oct 18, 2012

LAURA BIGGS vs. SAN BERNARDINO COUNTY MEDICAL CENTER, SAN BERNARDINO COUNTY

The Workers' Compensation Appeals Board (WCAB) dismissed Laura Biggs' Petition for Reconsideration in this case against San Bernardino County Medical Center and San Bernardino County. The dismissal was based on the WCAB's review of the record and adoption of the administrative law judge's report and recommendation. The report provided the reasoning for the dismissal, which the WCAB incorporated by reference. Therefore, the petition for reconsideration was officially dismissed.

Petition for ReconsiderationWorkers' Compensation Appeals BoardDismissalReport and RecommendationAdministrative Law JudgeSan Bernardino County Medical CenterLaura BiggsWorkers' Compensation CaseLegal DocumentCase Number
References
0
Case No. MISSING
Regular Panel Decision

Claim of Di Nicola v. Crucible Steel, Inc.

Claimant Samuel Di Nicola became disabled from obstructive pulmonary disease, an occupational disease, as a result of his 11-year employment by the self-insured employer, Crucible Steel. He worked in conditions with poor ventilation and significant dust, leading to respiratory complaints that began in 1971. Medical experts, Dr. Enders and Dr. Sipple, diagnosed chronic obstructive pulmonary disease aggravated by industrial exposure, while Dr. Miller, initially skeptical, conceded a possible work-related link. The employer appealed the Workers’ Compensation Board's finding of occupational disease and continuing disability, arguing it was contrary to case law. The court affirmed the board's decision, finding its classification consistent with prior rulings and supported by substantial medical evidence that the work environment aggravated claimant's pre-existing bronchitis and asthma.

Occupational DiseasePulmonary DiseaseChronic Obstructive Pulmonary DiseaseIndustrial ExposureDust ExposureBronchitisAsthmaWorkers' CompensationMedical EvidenceDisability
References
8
Case No. ANA 0347858
Regular
Sep 12, 2008

KEYIN L. ROSS vs. SAN DIEGO CHARGERS and LEGION INSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION (CIGA), SAN DIEGO CHARGERS, KANSAS CITY CHIEFS, TIG

The WCA's decision is affirmed for two reasons: Kansas City is wrong in claiming that San Diego was self-insured, and CIGA's statutes preclude Kansas City from recovering from San Diego.

Workers' Compensation Appeals BoardCIGALegion Insurance CompanyKansas City ChiefsSan Diego Chargerscontributioninsolvent insurercovered claimsInsurance Code section 1063.1(c)(5)deductible reimbursement
References
5
Case No. 2025 NY Slip Op 00281
Regular Panel Decision
Jan 16, 2025

Santana v. San Mateo Constr. Corp.

William Santana appealed an order dismissing his complaint against San Mateo Construction Corp. and Consolidated Edison Company of New York, Inc. The Appellate Division modified the order, denying dismissal of the first cause of action entirely and partially denying dismissal of the second cause of action. The court held that Administrative Code § 19-142, which mandates prevailing wages for work involving street use or opening, applies broadly and not solely to public works projects. It affirmed that workers, as third-party beneficiaries, can enforce agreements made under this provision, and contractual disclaimers of these rights are void against public policy.

Prevailing wagesAdministrative Code § 19-142Third-party beneficiary rightsContractual disclaimersPublic policyMotions to dismissAppellate reviewLabor lawConstruction contractsStreet permits
References
8
Case No. SAL 107113, SJO 220636
Regular
Aug 10, 2007

BRIAN SAN NICOLAS vs. PEPSI BOTTLING GROUP, OLD REPUBLIC INSURANCE, SEDGWICK/CMS, CONTINENTAL CASUALTY, CNA

The Workers' Compensation Appeals Board affirmed an award for applicant's cumulative trauma injury to his back and psyche but rescinded the award of additional temporary disability in a prior specific injury case. This rescission was due to the Appeals Board lacking jurisdiction for benefits commencing more than five years after the initial injury date, as the applicant had not experienced a new and further disability within that timeframe. The case was remanded for adjustment of the cumulative trauma award and clarification on medical treatment administration by Old Republic Insurance.

Workers' Compensation Appeals BoardOld Republic InsuranceContinental CasualtyBrian San NicolasPepsi Bottling Groupcumulative traumaindustrial injurytemporary disability indemnitymedical treatmentLabor Code section 4656(c)(1)
References
7
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