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

Case No. ADJ2263363 (SAC 0291821) ADJ2654728 (SAC 0291246)
Regular
Dec 05, 2008

LEROY ARMSTRONG vs. ENVIRONMENTAL CONSTRUCTION, STATE COMPENSATION INSURANCE FUND, SLIPFORM CONCRETE, BROADSPIRE, California Insurance Guarantee Association (CIGA), Legion Insurance, State Compensation Insurance Fund (SCIF), Fireman's Fund

The Workers' Compensation Appeals Board dismissed CIGA's petition for reconsideration because the WCJ's deferral of CIGA's requested issues was not a final order, and CIGA was not aggrieved. The Board also denied CIGA's petition for removal, finding no extraordinary circumstances. Finally, the Board denied SCIF's petition for reconsideration, agreeing with the WCJ's determination that the applicant's claim against Environmental Construction was timely.

Workers Compensation Appeals BoardCIGASCIFReconsiderationRemovalPetitionFinal OrderStatute of LimitationsIndustrial InjuryDeferred Issue
References
7
Case No. ADJ1143803 (OXN 0128653) ADJ2709854 (OXN 0142376)
Regular
Nov 01, 2011

SALVADOR PAZ vs. MARTINEZ PAINTING & WALL COVERING, MB PAINTING, CIGA, for CREDIT GENERAL INSURANCE COMPANY, INTERCARE, CIGA for UNITED PACIFIC INSURANCE COMPANY, INTERCARE, STATE FARM INSURANCE COMPANY, ACE USA

This case involves a painter, Salvador Paz, who sustained cumulative and specific injuries to his back, shoulder, wrist, neck, and foot. The Workers' Compensation Appeals Board denied petitions for reconsideration from State Farm, CIGA, and the applicant. The Board upheld the original findings, which apportioned permanent disability at 72% to the specific injury (CIGA via Credit General) and 28% to the cumulative trauma (ACE USA and State Farm). Liability for temporary disability was also divided, and State Farm's arguments regarding an unequal division and due process were rejected.

CIGAState Farmcumulative injuryspecific injuryapportionmenttemporary disabilitypermanent disabilityvocational expertPetition for ReconsiderationCredit General Insurance
References
1
Case No. ADJ2141542
Regular
Oct 12, 2010

CELESTINO MORALES vs. MAINTENANCE MATCH INC., CIGA on behalf of SUPERIOR PACIFIC INSURANCE COMPANY, BROADSPIRE

This case concerns CIGA's petition for reconsideration of an arbitrator's decision that barred CIGA's recovery from Travelers Insurance due to laches. The Appeals Board granted reconsideration, rescinded the arbitrator's decision, and returned the matter for further proceedings. The Board found that Travelers failed to prove prejudice resulting from CIGA's delay in joining them as a party. Therefore, Travelers' defense of laches was not established, allowing the case to proceed.

CIGASuperior Pacific Insurance CompanyliquidationLachesEquitable EstoppelArbitratorTravelers Insurancereimbursementother insuranceInsurance Code section 1063.1(c)(9)
References
4
Case No. ADJ3257025 (LAO 0731675) ADJ127700 (LAO 0744086)
Regular
Jul 09, 2012

JOSE LUIS ARELLANO vs. R.B.R. MEAT COMPANY, CIGA by BROADSPIRE for SUPERIOR NATIONAL INC. CO.

The Workers' Compensation Appeals Board affirmed a judge's order finding applicant sustained industrial spinal and psychiatric injuries. The Board ruled that CIGA failed to prove Coast Plaza Doctors Hospital's lien claim was not a "covered claim," rejecting CIGA's argument that an assignment to Innovative Medical Management invalidated the claim. This decision aligns with established appellate precedent. Therefore, the original findings and order requiring CIGA and the hospital to adjust the lien remain in effect.

CIGAInsurance Code section 1063.1(c)(9)covered claimlien claimIndustrial InjurySpinePsycheReconsiderationJoint Findings and OrderWCJ
References
1
Case No. ADJ2510153 (MON 0272426) ADJ1370718 (MON 0285125)
Regular
Jul 12, 2011

WAYNE W. WESTBY vs. INTERTEC DESIGN, INC., CIGA by its servicing facility, BROADSPIRE, A CRAWFORD COMPANY, SUPERIOR NATIONAL INSURANCE COMPANY in liquidation, DART INC., ZURICH INSURANCE COMPANY, INTERNATIONAL/REDLANDS INSURANCE, as administrated by GALLAGHER BASSETT

The Workers' Compensation Appeals Board granted CIGA's petition for reconsideration, rescinded the prior Findings and Award, and returned the case for further proceedings. The Board found CIGA was not liable because "other insurance" from Dart's carrier, Redlands, was available to cover the applicant's specific injury. Furthermore, the Board found no substantial medical evidence supported a cumulative trauma injury claim, despite CIGA's arguments. The matter will return to the trial level for a new decision.

CIGAIntertec DesignWayne Westbyspecific injurycumulative trauma injurygeneral employerspecial employerSuperior National Insurance CompanyZurich Insurance CompanyRedlands Insurance
References
22
Case No. ADJ756255 (AHM 0069873)
Regular
Jun 10, 2010

DAVID HANNA vs. UNITED STAFFING SOLUTIONS, INC., CHINO VALLEY MEDICAL, CIGA serviced By BROADSPIRE for SUPERIOR NATIONAL INSURANCE in liquidation, TRANSPORTATION INSURANCE (RSKCO) c/o BROADSPIRE

This case involves Transportation Insurance Company's petition for removal, seeking to avoid joinder as a defendant in a workers' compensation claim. Transportation argues they were prejudiced by not having an opportunity to defend against the original claim due to CIGA's alleged failures. The Board denied the petition, finding that Transportation has not yet established significant prejudice or irreparable harm. The joinder order is not final, and Transportation still has the opportunity to litigate the special/general employment issue, which will determine their ultimate liability.

Petition for RemovalJoinder as Party DefendantIrreparable HarmSignificant PrejudiceCIGASpecial/General EmploymentStatute of LimitationsDue ProcessContribution ClaimWorkers' Compensation Appeals Board
References
0
Case No. ADJ2754339, ADJ2982695
Regular
Feb 22, 2023

VIRGINA VASQUEZ vs. KING MEAT, INC., FREMONT INSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION (CIGA)

The Workers' Compensation Appeals Board denied a petition for reconsideration filed by CIGA. CIGA challenged a prior finding that allowed payment for medical treatment and a specific medical-legal report by Dr. Konstat. The Board adopted the Workers' Compensation Judge's report, which found that Dr. Konstat's treatment was reasonable and necessary, and that her 2007 medical-legal report was properly requested. The Board also determined that the prior judge's findings on reasonableness were binding in the subsequent lien trial.

CIGAPetition for ReconsiderationLien ClaimantPrimary Treating PhysicianMedical-Legal ReportsSelf-Procured TreatmentUtilization ReviewLabor Code section 4620Rules 9785(e)(3)Rules 9785(e)(4)
References
4
Case No. ADJ4022825 (AHM 0126552)
Regular
Aug 20, 2009

EMILIA MONROY vs. TEMPSTAR SERVICES, INC., CIGA By Its Servicing Facility BROADSPIRE For CALIFORNIA COMPENSATION INSURANCE COMPANY; In Liquidation, ITT CANNON INT'L, INC., ACE/USA

The Workers' Compensation Appeals Board granted CIGA's petition for reconsideration, overturning the dismissal of applicant Emilia Monroy's case. The prior dismissal, due to applicant's failure to prosecute, was modified to only dismiss the applicant's claim. This ensures CIGA, having paid benefits, can still pursue its statutory right to reimbursement from co-defendant ACE USA, regardless of the applicant's claim status.

CIGACalifornia Insurance Guarantee AssociationreimbursementIn liquidationACE USAPetition for ReconsiderationOrder Dismissing CaseApplicant's Application for Adjudication of Claimfailure to prosecutestatutory right
References
0
Case No. ADJ4234150 (SRO 0140257), ADJ1167624 (SRO 0139040), ADJ6595882 (NO WCAB No.)
Regular
May 06, 2009

FRANCES OTANI vs. EXCHANGE BANK, STATE COMPENSATION INSURANCE FUND, CIGA, adjusted by BROADSPIRE, on behalf of SUPERIOR NATIONAL INSURANCE COMPANY and LEGION INSURANCE COMPANY, in liquidation

This case involves CIGA seeking reconsideration of a Workers' Compensation Appeals Board decision that found an applicant sustained three cumulative trauma injuries. The WCJ awarded permanent disability for upper extremity injuries through March 15, 2000, and April 19, 2001, and for neck injuries through August 20, 2002. CIGA argued the WCJ erred by selecting specific findings from medical reports and by awarding attorney fees against them. The Board denied reconsideration, affirming the WCJ's findings on the dates of injury based on physician reports and the applicant's disability.

CIGAcumulative traumadate of injurypermanent disabilitytemporary disabilityLabor Code 5412medical reportsprimary treating physicianreconsiderationjoint findings award order
References
4
Case No. ADJ2425191 (LAO 0775944) ADJ3230477 (LAO 0775943) ADJ3919134 (LAO 0793799)
Regular
Apr 05, 2010

MARTHA ARIAS vs. CUSTOM FOODS PRODUCTS, INC., FIREMAN'S FUND, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, BROADSPIRE SERVICES, INC., SUPERIOR NATIONAL INSURANCE COMPANY

This case concerns CIGA's petition for reconsideration of a denial of reimbursement from Fireman's Fund for workers' compensation benefits paid to Martha Arias. CIGA sought reimbursement, arguing Fireman's Fund's coverage for other injuries constituted "other insurance." However, the WCAB denied CIGA's petition, adopting the WCJ's reasoning that CIGA failed to prove applicant's injuries in the other cases contributed to the benefits CIGA paid. CIGA had the burden of establishing entitlement to reimbursement under the "other insurance" provision, which it did not meet.

CIGAreimbursementFireman's Fundindustrial injurymeat packerlow backleft handhipcumulative injuryspecific injury
References
3
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