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

Case No. ADJ2588415
Regular
Jun 04, 2012

Hilda Marron vs. Celstron International, Continental Casualty Company, c/o CNA ClaimPlus

This case involves a petition for reconsideration by CNA Claims Plus/American Casualty Company concerning a prior Workers' Compensation Appeals Board (WCAB) decision. CNA was ordered to reimburse the California Insurance Guarantee Association (CIGA) $203,208.35 for payments made. CNA argued CIGA failed to prove the necessity and reasonableness of these payments, but the WCAB denied reconsideration. The Board adopted the Workers' Compensation Judge's report, finding CNA had ample opportunity to rebut CIGA's evidence at trial and failed to do so.

WORKERS' COMPENSATION APPEALS BOARDCELESTRON INTERNATIONALCONTINENTAL CASUALTY COMPANYCNA CLAIMPLUSCalifornia Insurance Guarantee AssociationCIGAREIMBURSEMENTMEDICAL REPORTSBILLSEOR
References
Case No. ADJ7968587
Regular
Aug 07, 2015

RAFAEL RODRIGUEZ vs. SWEET TEMPTATIONS USA, INC., AMERICAN CASUALTY COMPANY, COMPWEST INSURANCE

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration, upholding the prior finding that he could not proceed against CNA ClaimPlus. This is because a prior Compromise and Release (C&R) agreement, approved by a judge, resolved all issues for the entire cumulative trauma period, including future medical treatment, against both CompWest and CNA. The Board found that the C&R, having the effect of a judgment, constituted a bar to further claims against CNA for the released period, and the applicant's failure to properly address the C&R's terms did not constitute good cause to set it aside. CNA's citation of an unpublished case and procedural violations by their counsel were noted and admonished.

Workers' Compensation Appeals BoardRAFAEL RODRIGUEZSWEET TEMPTATIONS USAINC.AMERICAN CASUALTY COMPANYCNA CLAIMPLUSCOMPWEST INSURANCEADJ7968587Petition for ReconsiderationFindings of Fact
References
Case No. LAO 0840517
Regular
Aug 20, 2007

UZMA XINA KANG vs. ENTERTAINMENT PARTNERS, CNA CLAIMPLUS

The Workers' Compensation Appeals Board granted reconsideration and amended the original award. The Board found the applicant to be a "minimum earner" for both temporary and permanent disability indemnity purposes. Consequently, the temporary disability indemnity rate was reduced to \$126 per week and the total permanent disability indemnity was adjusted to \$11,576.25, reflecting a lower average weekly earnings calculation than initially awarded.

Uzma Xina KangEntertainment PartnersCNA ClaimplusPetition for ReconsiderationFindings and AwardWorkers' Compensation Appeals BoardIndustrial InjuryRight AnkleLow BackLungs
References
Case No. ADJ2502324 (POM 0281213) ADJ964225 (RIV 0026851)
Regular
Jun 19, 2009

Howard Gold vs. DENNY'S INC.; CIGA, BY ITS SERVICING AGENCY, INTERCARE INSURANCE SERVICES, FOR HIH INSURANCE COMPANY, IN LIQUIDATION, CNA Insurance

This case concerns applicant Howard Gold's cumulative trauma injury claim for back and spine issues, spanning September 2, 2000 to October 18, 2000. Defendant CNA Insurance sought reconsideration, arguing the claim was time-barred because applicant had knowledge of his disability and its industrial causation by October 2000. The Workers' Compensation Appeals Board denied CNA's petition, adopting the judge's report that found the claim not barred by the statute of limitations. Additionally, the Board affirmed a modification assigning CIGA responsibility for future medical treatment related to a prior 1997 injury, pending further development of the record on other insurance availability.

Workers' Compensation Appeals BoardCNA InsuranceDenny's Inc.CIGAHIH Insuranceliquidationcumulative traumastatute of limitationsindustrial injuryback and spine
References
Case No. ADJ4634338 (MON 0262377)
Regular
Jun 24, 2009

NINA GOODRICH vs. UNILAB/QUEST DIAGNOSTICS, SEDGWICK CLAIMS MANAGEMENT SERVICES, AMERICAN CASUALTY CO. OF READING, PA, CNA CLAIMSPLUS, VALLEY HEALTH SYSTEMS, TRISTAR RISK MANAGEMENT, ZURICH INSURANCE CO.

This case concerns a dispute over contribution claims following a cumulative injury to the applicant. The Workers' Compensation Appeals Board granted reconsideration, rescinded an arbitration finding, and remanded the matter for further proceedings. The Board found that Sedgwick, which paid over $180,000 in benefits, was not required to file a petition for contribution under section 5500.5 because it was not a signatory to the Compromise and Release (C&R). Furthermore, the Board held that even if Sedgwick had been required to file, the co-defendant CNA would be estopped from asserting the statute of limitations due to stipulations in the C&R reserving contribution rights. The Board concluded Sedgwick's claim for reimbursement was not time-barred.

Workers' Compensation Appeals BoardNina GoodrichUnilabQuest DiagnosticsSedgwick Claims Management ServicesAmerican Casualty Co.CNA ClaimsplusValley Health SystemsTristar Risk ManagementZurich Insurance Co.
References
Case No. ADJ266602 ( 0256585)
Regular
Mar 26, 2010

DELENA FREDERICK vs. ADP and CNA INSURANCE COMPANY/ RSK CO.

This case involves a Petition for Reconsideration filed by Delena Frederick concerning a workers' compensation claim against ADP and CNA INSURANCE COMPANY/ RSK CO. The Workers' Compensation Appeals Board reviewed the petition and the Workers' Compensation Judge's report. The Board has adopted the Judge's report and issued an Order Denying Reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeDenying ReconsiderationADJ266602ADPCNA Insurance CompanyRSK Co.Delena FrederickJames C. Cuneo
References
Case No. ADJ3578571
Regular

RONALD FUDALA vs. CONTRA COSTA ELECTRIC, INC., CNA INSURANCE CORPORATION

The Workers' Compensation Appeals Board dismissed Ronald Fudala's Petition for Removal against Contra Costa Electric, Inc. and CNA Insurance Corporation. The dismissal was based on the mediator's report, which indicated the disputed issue of entitlement to ankle surgery had been resolved. Consequently, the matter before the Board became moot.

Petition for RemovalAnkle SurgeryMoot IssueWorkers' Compensation Appeals BoardDismissalContra Costa ElectricCNA Insurance CorporationADJ3578571OAK 0266336Mediator Report
References
Case No. ADJ4112217 (ANA 0344909)
Regular
Dec 17, 2012

ANGEL MARTINEZ vs. KELLY SERVICES; CNA

The Workers' Compensation Appeals Board dismissed Angel Martinez's petition for reconsideration as untimely. The petition was filed on October 25, 2012, significantly after Martinez admits having notice of the WCJ's March 8, 2012, Findings and Award on July 5, 2012. California law requires petitions for reconsideration to be filed within twenty days of notice, with limited extensions for mailing. This jurisdictional deadline was not met, thus precluding the Board from granting the petition.

Petition for ReconsiderationUntimelyDismissedLabor Code section 5903WCAB Rule 10507JurisdictionalFindings and AwardNoticeWCJ's decisionADJ4112217
References
Case No. MON 323982 MON 323983
Regular
Mar 10, 2008

Gina Malcolm vs. KELLY STAFF LEASING, CNA

This case concerns Gina Malcolm's workers' compensation claims for a right hip injury and a left shoulder injury. The applicant sought reconsideration of a decision that apportioned 25% of her permanent disability for both injuries to pre-existing, non-industrial osteonecrosis. The Board denied reconsideration, affirming the original finding that the apportionment was proper based on the Agreed Medical Examiner's opinion regarding the causation of the permanent disability.

Gina MalcolmKelly Staff LeasingCNAPetition for ReconsiderationFindings and Awardpermanent disabilityapportionmentnon-industrial factorsAgreed Medical Examiner (AME)Dr. Jeffrey Berman
References
Case No. ADJ481283 (MON 0323982)
Regular
Sep 28, 2009

GINA MALCOLM vs. KELLY STAFF LEASING, CNA

The Workers' Compensation Appeals Board (WCAB) denied Gina Malcolm's petition for reconsideration of a prior decision. The Board adopted and incorporated the reasoning of the workers' compensation administrative law judge (WCJ). Therefore, the WCAB's order officially denies the petition for reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedAdministrative Law JudgeWCJKelly Staff LeasingCNAGina MalcolmRonnie G. CaplaneJames C. Cuneo
References
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