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

Case No. ADJ9076626
Regular
Jul 17, 2015

CIPRIANO NIETO ROJAS vs. METALS, U.S.A., INC.; ACE U.S.A., Administered by GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for reconsideration of a prior decision. This was done to allow the Board further opportunity to study the factual and legal issues presented. All future filings related to the petition for reconsideration must be submitted directly to the WCAB's Office of the Commissioners, not district offices or e-filed. This order ensures a thorough review for a just decision, and prohibits WCJs from acting on settlements while reconsideration is pending.

Petition for ReconsiderationWorkers' Compensation Appeals BoardADJ9076626Metals U.S.A. Inc.Ace U.S.A.Gallagher Bassett Services Inc.Opinion and OrderStatutory Time ConstraintsFactual and Legal IssuesJust and Reasoned Decision
References
Case No. ADJ1529722
Regular
Apr 23, 2012

ALEXANDRA JAMISON vs. WELLS FARGO BANK, TRAVELERS INSURANCE

This case involves an applicant, Alexandra Jamison, and defendants Wells Fargo Bank and Travelers Insurance. The Workers' Compensation Appeals Board (WCAB) issued an order denying reconsideration of a prior decision. The WCAB adopted and incorporated the reasons presented in the workers' compensation administrative law judge's report for their denial. Therefore, the applicant's petition for reconsideration was unsuccessful.

Workers' Compensation Appeals BoardAlexandra JamisonWells Fargo BankTravelers InsuranceADJ1529722LAO 0830997Order Denying ReconsiderationPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeWCJ
References
Case No. ADJ9389953
Regular
Mar 08, 2019

IGNACIO BARRON vs. PAK’S CABINETS, SOUTHERN INSURANCE

The Workers' Compensation Appeals Board granted reconsideration and amended its prior decision regarding Ignacio Barron's claim against Pak's Cabinets. The amended decision affirmed the original award of permanent disability at 40%, payable at $230.00 per week for 201 weeks, totaling $46,230.00, less attorney fees. Crucially, the amendment acknowledged that the Employment Development Department paid unemployment benefits during the period of indemnity and allowed a lien for overlapping payments, to be determined by a workers' compensation judge.

Petition for ReconsiderationWCJ reportAMENDED decisiontemporary disability indemnitypermanent disability indemnityEmployment Development Departmentunemployment compensation disability benefitsoverlapping paymentslien claimaward
References
Case No. SAC 0056952
Regular
Mar 07, 2008

EDWIN D. REES vs. CHEVRON U.S.A., INC.

This Workers' Compensation Appeals Board case involves a petition for reconsideration filed by the defendant, Chevron U.S.A., Inc. The Board has granted this petition, not based on a final determination, but to allow further study of the factual and legal issues presented. This grants Chevron the opportunity for a more thorough review and potentially further proceedings to ensure a just decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationGranting PetitionDecision After ReconsiderationStatutory Time ConstraintsFactual and Legal IssuesReconsideration UnitSelf-Insured DefendantEdwin D. ReesChevron U.S.A.
References
Case No. ADJ8657415
Regular
Oct 06, 2017

Oliver Boutte IV (Deceased) vs. U.S. XPRESS ENTERPRISES, LIBERTY MUTUAL INSURANCE COMPANY

This Workers' Compensation Appeals Board case involved a petition for reconsideration filed by U.S. Xpress Enterprises and Liberty Mutual Insurance Company. The defendants argued that the medical report relied upon by the Workers' Compensation Judge (WCJ) was not substantial evidence, specifically regarding the timing of the employee's death from a pulmonary embolus. The Board denied the petition, adopting the WCJ's report which found the physician's opinion to be substantial medical evidence based on adequate examination and reasoning. The Board concluded the WCJ properly found this opinion more persuasive than the opposing medical opinion.

Oliver Boutte IVU.S. Xpress EnterprisesLiberty Mutual Insurance CompanyADJ8657415Petition for ReconsiderationWorkers' Compensation Appeals Boardsubstantial evidencemedical opinionpulmonary embolusreasonable medical probability
References
Case No. ADJ1482040 (SFO 508301)
Regular
Jan 05, 2009

GEORGINA HENSON vs. TRA PAC, U.S. FIDELITY AND GUARANTEE INSURANCE COMPANY

The Appeals Board denied applicant's petition and granted defendant's petition to dismiss Signal Mutual Insurance Company and identify U.S. Fidelity and Guaranty Insurance Company as the insurer.

Workers' Compensation Appeals BoardIndustrial InjuryLongshoremanTemporary Total DisabilityTimely DenialPresumption of Industrial InjuryReconsiderationPetition for ReconsiderationU.S. Fidelity and Guaranty Insurance CompanySignal Mutual Insurance Company
References
Case No. ADJ2800291 (LAO 0746233)
Regular
Jan 17, 2014

JORGE FLORAN GARCIA vs. S & S FASHION, INC., STATE COMPENSATION INSURANCE FUND

In *Garcia v. S & S Fashion, Inc.*, the applicant sought reconsideration of an order dismissing his workers' compensation case for lack of prosecution. The administrative law judge (WCJ) initially issued a notice of intention to dismiss after the applicant's claim had been inactive. However, the applicant subsequently filed a declaration of readiness to proceed and the matter was taken off calendar by joint agreement. The WCAB granted reconsideration, rescinded the dismissal order, and returned the case to the trial level for further proceedings, agreeing that dismissal was inappropriate if the applicant was ready to prosecute.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder of DismissalLack of ProsecutionNotice of Intention to DismissIndustrial InjuryFabric CutterNeck InjuryShoulder InjuryArm Injury
References
Case No. ADJ564696
Regular
Mar 01, 2010

JESSE MILES (Deceased) vs. CALIFORNIA STATE DEPARTMENT OF CORRECTIONS, SCIF STATE EMPLOYEES COMMERCE

The Appeals Board denied the applicant's petition for reconsideration, which sought to retroactively change the permanent and stationary (P&S) date from October 16, 2006, to March 25, 2003, based on an industrial orthopedic injury. The Board affirmed the prior finding that the P&S date was October 16, 2006, as stipulated by the parties, and that the applicant was adequately compensated for temporary disability. While the applicant died before the reconsideration, Labor Code section 4700 does not mandate changing the P&S date for accrued benefits. Therefore, the Board found no good cause to disturb the stipulation regarding the P&S date.

Workers Compensation Appeals BoardJesse MilesCalifornia State Department of CorrectionsSCIF State Employees CommerceOpinion and Order Denying Petition for ReconsiderationPermanent Disability AwardPulmonary EmbolismNon-IndustrialPermanent and Stationary (P&S) DateIndustrial Orthopedic Injury
References
Case No. LAO 0811779, LAO 0811780
Regular
Mar 06, 2008

ELENA BLANKEVOORT vs. HUNTINGTON MEMORIAL HOSPITAL, S&B SURGERY CENTER

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a trial judge's order disallowing a lien claim from S&B Surgery Center. The WCAB found that while S&B Surgery Center did have a required "surgical clinic" license, it failed to prove compliance with fictitious business name filing requirements. However, the WCAB returned the case to the trial level for further proceedings, allowing S&B Surgery Center an opportunity to correct this procedural defect to recover on its lien.

Fictitious business nameLien claimantSurgical clinic licenseBusiness and Professions Code section 17910Medical BoardDepartment of Health ServicesBurden of proofReconsiderationWorkers' Compensation Appeals BoardOutpatient setting
References
Case No. ADJ2337190 (LAO 0829672) ADJ3193895 (LAO 0829673) ADJ187762 (LAO 0829674)
Regular
Jul 13, 2009

OLIVIA HUERTA vs. GMP LABORATORIES OF AMERICA, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant sought to disallow Dr. Konstat's medical-legal reports, arguing they were unreasonable due to a settled psyche claim under *Thomas v. Sports Chalet* and failed to meet specific reporting requirements. The Board found that the settlement agreement implicitly acknowledged the value of Dr. Konstat's reports, and the cited statutes and regulations did not preclude their reimbursement as reasonable medical-legal expenses. Furthermore, the Board noted Dr. Konstat's reports were admitted into evidence without objection.

Workers' Compensation Appeals BoardState Compensation Insurance FundPetition for ReconsiderationOpinion and OrderMedical-Legal ExpenseLien ClaimantElena Konstat Ph.D.Psyche ClaimThomas FindingLabor Code section 4061.5
References
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