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

Case No. ADJ994369
Regular
Jan 19, 2014

JOSE JUAREZ vs. WATKINS MANUFACTURING CORPORATION

The Workers' Compensation Appeals Board (WCAB) is reconsidering a decision that awarded the applicant medical mileage and a penalty for unreasonable delay in compensation payments but denied attorney's fees. The WCAB believes attorney's fees are warranted under Labor Code section 5814.5 for enforcing the payment of awarded compensation. The case is being returned to the trial level for the judge to determine and award these attorney's fees.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardMedical Mileage Expense ReimbursementAttorney's FeesLabor Code Section 5814Labor Code Section 5813Labor Code Section 5814.5Cumulative Industrial InjuryPulmonary System Injury
References
0
Case No. AHM 108812 AHM 108813 AHM 108814
Regular
Nov 06, 2007

OLIVIA ZAVALA vs. METROPOLITAN WATER DISTRICT

This case involves an award of attorney's fees under Labor Code § 5801 following a successful defense against the defendant's Petition for Writ of Review. The Court of Appeal remanded the matter for the Board to determine reasonable attorney's fees for the applicant's counsel's services. The applicant's attorney requested $5,171.89, but both parties ultimately stipulated to a total of $5,000.00 for attorney's fees and appellate costs.

Workers' Compensation Appeals BoardAttorney's FeeLabor Code § 5801Petition for Writ of ReviewCourt of AppealStipulationAppellate CostsMetropolitan Water DistrictReasonable Attorney's Fees
References
1
Case No. ADJ7103630
Regular
May 21, 2012

DENISE SANCHES vs. COUNTY OF SACRAMENTO

This case involves Denise Sanches' workers' compensation claim against the County of Sacramento. The Workers' Compensation Appeals Board dismissed Sanches' Petition for Removal as untimely. The dismissal was based on the petition being filed on March 8, 2012, which was more than the allowed 25 days after the February 13, 2012, decision. This delay violated the time limits prescribed by 8 Cal. Code Regs. § 10843 and Code of Civil Procedure § 1013.

Petition for RemovalUntimelyDecision DateFiling Date25 Days20 Days8 Cal. Code Regs. 10843Code of Civil Procedure § 1013Served by MailDismissed
References
0
Case No. ADJ7535016, ADJ7536297, ADJ8099855
Regular
Sep 05, 2013

DAVID MURILLO-RAMOS vs. NATIONAL RETAIL TRANSPORTATION, TRAVELERS INSURANCE

This Workers' Compensation Appeals Board order dismisses the Applicant's Petition for Reconsideration. The dismissal is based on two procedural defects: the petition was not verified as required by Labor Code section 5902, and there was no proof of proper service under Cal. Code Regs., tit. 8, § 10565(d). The Board cites prior case law supporting dismissal for these types of violations. Consequently, the Petition for Reconsideration filed by David Murillo-Ramos against National Retail Transportation and Travelers Insurance is formally rejected.

Petition for ReconsiderationDismissalVerificationLabor Code section 5902Proof of ServiceCal. Code Regs.tit. 8§ 10565(d)WCJ ReportWorkers' Compensation Appeals Board
References
2
Case No. RDG 0083560 RDG 0072880
Regular
Jul 18, 2007

LOUIS LUOND vs. RON PORTER, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, TIG INSURANCE COMANY

This case concerns an appeal by TIG Insurance Company regarding its liability to reimburse CIGA for workers' compensation benefits paid to an applicant with successive knee injuries. The Appeals Board denied TIG's reconsideration, upholding its prior decision that CIGA is entitled to 100% reimbursement of benefits paid after the insolvency of Cal Comp, because TIG is a solvent insurer providing "other insurance" for the applicant's medical benefits. The Board found that the 50/50 stipulation between TIG and Cal Comp was not binding on CIGA and that Labor Code section 5500.5 was inapplicable to this successive injury claim.

Workers' Compensation Appeals BoardCIGACal CompTIG Insurancereconsiderationreimbursementmedical benefitsinsolvencyliquidationstipulation
References
2
Case No. ADJ3218661 (OAK 0339889)
Regular
Feb 07, 2011

CHANCE ROLLINS vs. JOHN MARTIN STABLES, INC.; AMERICAN HOME ASSURANCE administered by AIG, CLAIMS SERVICES

The Appeals Board vacated its prior order granting reconsideration and dismissed the defendant's petition for reconsideration, finding the WCJ's ruling was not a final order. However, the Board granted removal, rescinded the WCJ's order, and denied the applicant's request for a neurology consultation under Labor Code §4601(a). The matter was returned to the trial level with instructions to issue an order for a new QME panel in neurology, as Dr. Jamasbi's request for a consultative neurological evaluation constituted good cause for a new panel under 8 Cal. Code Regs. §31.7. Attorney fees for the ex parte communication were upheld.

WCABPetition for ReconsiderationPetition for RemovalLabor Code 4601(a)Labor Code 4062.3QMEAgreed Medical EvaluatorNeurological ConsultMedical DirectorSpecialty Panel
References
0
Case No. ADJ1309169 (AHM 0045971)
Regular
Jul 30, 2009

MARY PRUITT vs. CNA INSURANCE CO., AMERICAN CASUALTY

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award of attorneys' fees under Labor Code § 5814.5. The Board found the prior decision lacked a proper evidentiary record and the necessary predicate finding of increased compensation under Labor Code § 5814 required for § 5814.5 attorneys' fees. The case was returned to the trial level for further proceedings to ensure compliance with evidentiary record requirements and to re-evaluate the § 5814.5 attorneys' fees issue.

WCABReconsiderationLabor Code § 5814.5Attorneys' FeesIncreased CompensationLabor Code § 5814Findings and AwardWCJEvidence RecordMinutes of Hearing
References
1
Case No. ADJ3905674 (SRO 0031254)
Regular
Feb 02, 2011

DAVID PELLETIER vs. UNITED STRUCTURES, INC., CIGA by its Servicing Facility CAMBRIDGE on behalf of FREMONT COMPENSATION, in liquidation

The Workers' Compensation Appeals Board denied reconsideration of its decision regarding attorney's fees. The applicant's attorney sought fees under Labor Code sections 4607 and 5814.5, arguing the defendant unreasonably failed to appoint a new case manager and pay prior bills. The Board affirmed the judge's finding that Labor Code § 4607 fees are inapplicable when the entire award is not terminated, and Labor Code § 5814.5 fees require an existing award and unreasonable refusal to pay. The Board found no evidence of unreasonable delay by the defendant in appointing a new case manager, thus denying the petition.

Workers' Compensation Appeals BoardReconsiderationAttorney's FeesLabor Code Section 4607Labor Code Section 5814.5Medical TreatmentCompromise and ReleasePetition for PenaltyNurse Case ManagerStipulations
References
2
Case No. ADJ8967361
Regular
Nov 26, 2014

FELIPE GARCIA (DECEASED) GUILLERMINA GARCIA (WIDOW) vs. SALVADOR GAYTAN dba G\&P AG MANAGEMENT CONTRACTORS, INC.; STAR INSURANCE, Adjusted by MEADOWBROOK INSURANCE GROUP

This case involved a petition for reconsideration by the applicant in a workers' compensation matter where the deceased worker, Felipe Garcia, was initially found to be an employee but later deemed an independent contractor by the Appeals Board. The applicant argued the Board erred by disregarding the WCJ's credibility assessment and by not applying Labor Code section 2750.5 to unlicensed contractors. The Board denied the petition, finding no evidence the deceased worker was engaged in activities requiring a contractor's license under Business and Professions Code sections 7000 and 7026. Therefore, Labor Code section 2750.5 was inapplicable, and the prior decision finding the applicant an independent contractor was upheld.

Workers' Compensation Appeals BoardIndependent contractorEmployee statusReconsiderationLabor Code section 2750.5Contractors' State License LawBlew v. HornerGarza v. Worker's Comp. Appeals Bd.Rinaldi v. Workers' Comp. Appeals Bd.Unlicensed contractor
References
4
Case No. ADJ6671169
Regular
Oct 16, 2013

Christian Fauria vs. Carolina Panthers, Great Divide Insurance Co., Berkley Specialty Underwriting Managers, LLC, Washington Redskins, ESIS Insurance, New England Patriots, Liberty Mutual Insurance Co., Travelers Indemnity Co., Golf Insurance Co., Seattle Seahawks

The Workers' Compensation Appeals Board (WCAB) rescinded a prior award finding California jurisdiction over Christian Fauria's claim due to lack of "regular employment" in California, as defined by Labor Code Section 3600.5(a). The case was remanded to the trial level to determine if jurisdiction exists based on injuries sustained within California or if the contract of hire was made in California, as per Labor Code Section 5305. The WCAB also instructed the judge to address all issues, including apportionment and liability periods under Labor Code Section 5500.5. The decision highlights the need for substantial evidence to establish jurisdiction and injury contribution within the state.

Workers' Compensation Appeals BoardChristian FauriaProfessional AthleteIndustrial InjuryPermanent DisabilityFurther Medical TreatmentLabor Code Section 3600.5(a)Statute of LimitationsLabor Code Section 5500.5Jurisdiction
References
29
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