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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Industrial Carving Co. v. Hurst

Lester Hurst, the employee, filed a suit to recover benefits under the Workmen’s Compensation Act after suffering a heart attack in 1968 while employed by Industrial Carving Company. This occurred after a 1957 back injury where he was awarded maximum benefits for permanent total disability from Forest Products Corporation, but subsequently rehabilitated himself. The trial court awarded Hurst 65% permanent partial disability to his body as a whole and medical bills for the 1968 injury. The employer appealed, contending that an employee previously declared 100% disabled could not receive further compensation for a subsequent, unrelated injury. The court affirmed the trial court's judgment, ruling that an employee who rehabilitates and re-enters the workforce should be compensated for the loss of their newly acquired earning capacity due to a subsequent injury, and that maximum benefit limits apply per injury, not for a lifetime.

Workers' CompensationPermanent Partial DisabilitySubsequent InjuryRehabilitationEarning CapacityMedical BenefitsTrial Court AwardAppellate ReviewStatutory InterpretationPrior Disability
References
9
Case No. ADJ6663169
Regular
Jan 27, 2010

RICHARD SHILTS (Deceased), KAAREN GUEST (Widow) vs. BRUNTON ENTERPRISES, INC., SEABRIGHT INSURANCE CO.

This case concerns whether a union's "carve-out" agreement, allowing for alternative dispute resolution under Labor Code § 3201.5, applies to dependent death benefits. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, reversing a prior finding. The WCAB held that "carve-out" agreements, by their plain language, apply only to "employees" and not to dependents' death benefit claims. Because dependents' rights to death benefits are independent of the deceased employee's claim and constitutionally mandated, the WCAB found these claims fall under its exclusive jurisdiction.

carve-out agreementLabor Code section 3201.5death benefitsdependents' claimalternative dispute resolutionWCAB jurisdictioncollective bargaining agreementindustrial injurywidowinsurer
References
5
Case No. ADJ799117 (LBO 0393727)
Regular
Jan 14, 2010

FRANK CRUZ (Deceased), DIANA CRUZ (Widow) vs. KRETSCHMAR & SMITH, INC., STATE COMPENSATION INSURANCE FUND

This case involves a widow's claim for death benefits following her husband's fatal industrial injury. The employer argued the claim was barred by a "carve-out" agreement under Labor Code §3201.5, which allows alternative dispute resolution for unionized employees. The Workers' Compensation Appeals Board rescinded the dismissal, finding that carve-out agreements under §3201.5 apply only to employees, not to dependents' death benefit claims. The Board determined that dependents' death benefits are independent rights, not derived from the employee's claim. The case is returned for further proceedings on the merits of the widow's claim.

Carve-out agreementLabor Code § 3201.5Death benefitsDependentsCollective bargaining agreementWorkers' Compensation Appeals BoardReconsiderationRescinded orderLabor Code § 3202Independent claim
References
3
Case No. ADJ8098049
Regular
Oct 01, 2013

SEZETTE DUBAY, as conservator for CARI PILLO on behalf of JOHN PILLO (deceased) vs. CONTRA COSTA ELECTRIC, INC., insured by AMERICAN CASUALTY COMPANY OF REDDING, PENNSYLVANIA, Adjusted by SEDGWICK CMS, et al.

This case concerns whether a deceased employee's death benefit claim falls under an Alternative Dispute Resolution (ADR) carve-out agreement. The defendant argued that arbitration agreements bind non-signatories and should apply to death benefits, likening them to derivative wrongful death claims. However, the Appeals Board affirmed the WCJ's decision, finding Labor Code section 3201.5 clearly limits ADR to disputes "between employees and employers." The Board reasoned that a dependent's claim for death benefits is an independent statutory right, not a dispute between an employee and employer, thus outside the scope of the ADR carve-out.

ADR carve-outnon-signatorywrongful death claimdependentsemployee definitionLabor Code 3201.5collective bargaining agreementinter vivos benefitsarbitrationWCJ
References
11
Case No. ADJ9317919
Regular
Feb 02, 2016

STEVEN SPALIONE vs. ACCO ENGINEERED SYSTEMS, XL SPECIALTY INS. CO.

The Appeals Board dismissed the applicant's attorney's Petition for Reconsideration, finding it untimely filed and non-compliant with WCAB rules. The attorney was personally served with the Compromise and Release on July 9, 2015, but did not file the petition until August 3, 2015. Furthermore, the petition failed to be served on the arbitrator and did not follow proper procedure for carve-out cases. Even if considered on the merits, the attorney would not have been entitled to fees as they were not involved in procuring the settlement.

Workers Compensation Appeals BoardPetition for ReconsiderationCompromise and ReleaseADRArbitratorAttorney's FeesWCAB Rule 10865TimelinessPersonal ServiceJurisdiction
References
0
Case No. ADJ2501619 (OAK 0286955)
Regular
Nov 10, 2008

JAMES BRADFORD vs. MCMILLAN BROS. ELECTRIC, INC., PACIFIC EAGLE INSURANCE CO./tpa SEABRIGHT INSURANCE CO.

The Workers' Compensation Appeals Board vacated its prior order granting reconsideration and dismissed the defendant's petitions for reconsideration, removal, and stay of execution. The petition for reconsideration was dismissed as untimely because it was filed with the Appeals Board more than 25 days after the arbitrator's decision. The Board also lacked jurisdiction to grant the petition for removal or stay of execution, as these actions are not permitted for an arbitrator's decision in a Labor Code section 3201.5 carve-out case.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalPetition for Stay of ExecutionUntimely FilingLabor Code Section 3201.5Carve-out CaseArbitrator's DecisionJurisdictionAppeals Board Rule 10865
References
4
Case No. ADJ8145474
Regular
Apr 13, 2018

BRUCE HAYES vs. ANDERSON & HOWARD ELECTRIC, TRUCK INSURANCE EXCHANGE

The applicant sought removal of an arbitrator's order concerning discovery and evidence admission in a cumulative trauma claim under Labor Code section 3201.5. The Workers' Compensation Appeals Board dismissed the petition, finding it lacked jurisdiction. This is because the arbitrator's order was an interlocutory, procedural decision, not a "final" order as required for review under section 3201.5(a)(1). The Board noted there is no statutory provision for removal of non-final arbitrator decisions in "carve-out" cases.

Workers' Compensation Appeals BoardPetition for RemovalArbitrator's DecisionCumulative TraumaSpecific InjuryAlternative Dispute ResolutionLabor Code Section 3201.5Carve-out SystemsNECA/IBEW Workers' Compensation TrustFinal Order
References
6
Case No. ADJ7188251 ADJ7188272
Regular
Jan 29, 2010

Raymond Mark vs. City of Los Angeles

The Workers' Compensation Appeals Board granted reconsideration of an Arbitrator's award of temporary partial disability for a sleep disorder. The defendant argued that the case fell under an ADR "carve-out" provision and that the chosen Qualified Medical Evaluator found the sleep disorder non-industrial. The Board rescinded the Arbitrator's decision because the record lacked a proper Minutes of Hearing and Summary of Evidence, which is crucial for meaningful review of ADR cases. The matter was returned to the Arbitrator for further proceedings and a new decision.

ADRCarve-out caseQualified Medical EvaluatorAgreed Medical EvaluatorSleep disorderTemporary partial disabilityArbitrator's DecisionReconsiderationMinutes of Hearing and Summary of EvidenceDue process
References
3
Case No. ADJ7160971
Regular
Jan 12, 2015

JACINTO CATILLO vs. SANTA CLARITA INTERIORS, ZURICH AMERICAN INSURANCE CO

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of the defendant's petition to review an arbitrator's award finding the applicant sustained a lumbar spine injury. The defendant's petition for reconsideration was potentially untimely and filed with the incorrect district office for this ADR carve-out case. The WCAB will issue a notice of intention to dismiss unless the defendant provides proof of timely filing with the correct office. The defendant has 15 days to submit documentation demonstrating the petition was timely filed.

Petition for ReconsiderationArbitrator's Findings and AwardJourneyman CarpenterLumbar SpinePermanent DisabilityApportionmentTemporary Total Disability IndemnityArbitrator's Report and RecommendationElectronic Adjudication Management SystemADR carve-out case
References
2
Case No. ADJ2186877 (VNO 0533117)
Regular
Jun 29, 2010

JODY LATOUF vs. STUMBAUGH & ASSOCIATES, INC., TIG SPECIALTY INSURANCE COMPANY as Administered by RISK ENTERPRISE MANAGEMENT, LTD., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) rescinded an arbitrator's findings due to an incomplete record, specifically the absence of a Minutes of Hearing and Summary of Evidence. TIG Specialty Insurance Company sought reconsideration, arguing the arbitrator erred in asserting WCAB jurisdiction over a mandatory "carve out" program for carpenters. The WCAB remanded the case for the arbitrator to create a proper record and issue a new decision on the coverage dispute. Additionally, the Van Nuys District Office will consider the submitted Compromise and Release Agreement.

Workers' Compensation Appeals BoardIndustrial InjuryStumbaugh & AssociatesInc.TIG Specialty Insurance CompanyRisk Enterprise ManagementState Compensation Insurance FundLabor Code § 3201.5Carve Out ProgramAlternate Dispute Resolution
References
1
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