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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ8859169
Regular
Jun 23, 2015

ERNESTO SALAZAR vs. BOONE TRUCKING, INC., STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the applicant, Ernesto Salazar, sought reconsideration of a prior decision that deemed him an independent contractor. The Appeals Board rescinded the prior ruling and found Salazar to be an employee of Boone Trucking, Inc. The Board emphasized Boone Trucking's right to control Salazar's work, including daily instructions on assignments, hours, locations, and pay. Furthermore, Salazar was required to use defendant's equipment and follow specific invoicing protocols, indicating his integral role in the company's regular business.

Independent ContractorEmployeeRight to ControlBorello factorsTruck DriverBoone TruckingWorkers' Compensation Appeals BoardReconsiderationFindings and OrderLabor Code
References
Case No. ADJ3560082 (ANA 0380953)
Regular
Mar 12, 2009

MARGARITA SERRANO vs. 3 DAY BLINDS, STATE COMPENSATION INSURANCE FUND

This case involves a lien claim by Huntington Beach Hospital for medical services rendered to an injured worker. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to reverse a prior finding, determining that contractual agreements between the hospital, Blue Cross, and the defendant insurer (SCIF) constitute an "express agreement" under Labor Code section 5304. This express agreement, which includes binding arbitration provisions, divests the WCAB of jurisdiction over the lien dispute. Therefore, the WCAB rescinded its prior award and ordered the parties to arbitrate the dispute according to the terms of their contract.

Workers' Compensation Appeals BoardState Compensation Insurance FundHuntington Beach HospitalComprehensive Contracting Hospital AgreementWorkers' Compensation Managed Care Service AgreementOther PayorLabor Code Section 5304Labor Code Section 4609Express AgreementBinding Arbitration
References
Case No. ADJ2200226
Regular
Apr 08, 2014

RUDY GALLARDO vs. SOUTHERN CALIFORNIA EDISON

The WCAB reversed a prior decision, finding it lacked jurisdiction over a hospital's lien claim for unpaid services. The Appeals Board held that an "express agreement," as required by Labor Code Section 5304 to divest the WCAB of jurisdiction, existed through a chain of contracts between the hospital, a network administrator (Blue Cross), and the self-insured employer. This chain of agreements fixed the payment amounts, thus precluding the WCAB from adjudicating the fee dispute. Any claims of contract breach or non-compliance with other statutes like Section 4609 must be pursued in a different forum.

WCAB jurisdictionLabor Code Section 5304express agreementchain of contractsHuntington HospitalSouthern California EdisonBlue Cross of CaliforniaOfficial Medical Fee Schedulelien claimfee dispute
References
Case No. ADJ800751 (VNO 0554673)
Regular
May 24, 2012

RUBEN KESHISHIAN vs. PROGRESS RAIL SERVICE/VIC'S TRUCKING, LIBERTY MUTUAL INSURANCE

The Workers' Compensation Appeals Board denied reconsideration of a decision finding Ruben Keshishian was employed as a truck driver by Progress Rail Service on August 30, 2007. This finding was supported by the WCJ's analysis under the *Borello* factors, which the Board adopted. The decision was further supported by cited cases from the California Supreme Court and appellate courts. Therefore, the Petition for Reconsideration was denied.

Workers' Compensation Appeals BoardReconsideration DeniedEmployment StatusTruck DriverS.G. Borello & SonsLiberty Mutual InsuranceProgress Rail ServiceVic's TruckingWCJ OpinionAdministrative Law Judge
References
Case No. ADJ253443 (POM 0286361)
Regular
Jan 17, 2014

JUAN MANUEL RESENDIZ vs. DANNY'S TRIMMING & BINDING CORP., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinding the WCJ's finding that it lacked jurisdiction over a lien dispute between Good Samaritan Hospital and State Fund. The Board found the contracts between State Fund, Blue Cross, and Good Samaritan potentially created an "express agreement" under Labor Code Section 5304, divesting the Board of jurisdiction. However, the Board also noted Good Samaritan failed to meet its initial burden of proof regarding the necessity of its services and that State Fund may not have provided proper notice of its payor status under the contract. The case is returned to the trial level for further evidence development on these issues.

Workers' Compensation Appeals Boardlien claimantPetition for ReconsiderationFindings of FactjurisdictionState Compensation Insurance FundOfficial Medical Fee ScheduleLabor Codeexpress agreementarbitration
References
Case No. ADJ433589 (VNO 0467795)
Regular
Dec 19, 2013

GLADYS GIRON vs. JUDITH LARSON, IDEAL FOODS, INC., UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board denied Gladys Giron's Petition for Reconsideration. The Board admonished applicant's counsel for multiple procedural violations in the petition, including exceeding page limits with improper formatting and appending improperly admitted evidence. Furthermore, the petition's tone bordered on impugning the Workers' Compensation Judge's integrity, which is sanctionable. Finally, an unfiled Response was submitted by applicant's counsel.

Petition for ReconsiderationWCJ ReportApplicant's CounselPage Limit ViolationFont Size ViolationLinespacing ViolationRule 10842(c)Rule 10856Catering Truck and Route AgreementSworn Statement
References
Case No. SAL 95992 SAL 95993 SAL 97616
Regular
Feb 06, 2008

JOSE G. LIZARRAGA (DECEASED) vs. WATSONVILLE PRODUCE, REPUBLIC INDEMNITY COMPANY OF AMERICA

This case concerns whether a binding compromise and release agreement was formed before the applicant's death. The Appeals Board denied reconsideration, finding that the agreement was not "duly executed" as required by statute because the defendant had not signed it, and a Medicare set aside provision was still pending. The majority concluded that a complete meeting of the minds on all material aspects was lacking, making the WCJ's prior finding of a binding agreement erroneous.

Compromise and ReleaseDuly ExecutedMedicare Set AsideBinding AgreementMeeting of the MindsLabor Code Section 5003Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderIndustrial Injury
References
Case No. ADJ8496155
Regular
May 16, 2016

EALWINDER MANN (Deceased) MOHINDER MANN (Widow) vs. DARBARA SINGH, DARBARA SINGH Dba D&G TRANSPORT

This case concerns a deceased truck driver, Balwinder Mann, whose widow, Mohinder Mann, is claiming workers' compensation benefits. The defendant, Darbara Singh, dba D&G Transport, appealed a decision finding Mann was an employee and that the statute of limitations did not bar the claim. The defendant argued Mann was an independent contractor due to an agreement and lack of control, and that the claim was time-barred. The Appeals Board denied reconsideration, affirming the WCJ's findings that Singh retained sufficient control to establish an employer-employee relationship, and that the defendant's failure to provide a claim form tolled the statute of limitations.

AOE/COEIndependent Contractor AgreementEmployee statusStatute of limitationsRight to controlLabor Code Section 3351Labor Code Section 3357Labor Code Section 3353Borello factorsTruck driver
References
Case No. ADJ6540543
Regular
Jun 07, 2013

Christopher Toms vs. Marvin Lee Weatherbee dba BEELINE TRANSPORTATION, illegally uninsured, KIEWIT PACIFIC COMPANY, permissibly self-insured

This case involves Christopher Toms, an applicant injured while employed as a truck driver by Beeline Transportation, an illegally uninsured entity. The Workers' Compensation Appeals Board granted reconsideration of a finding that Kiewit Pacific Company, permissibly self-insured, was a dual employer. The Board rescinded the prior award, finding that Kiewit was a contracting party who engaged Beeline as an independent contractor. No statutory basis existed to deem Toms an employee of Kiewit, therefore Kiewit is not liable for workers' compensation benefits.

Workers Compensation Appeals BoardChristopher TomsMarvin Lee WeatherbeeBeeline TransportationKiewit Pacific Companyillegally uninsuredpermissibly self-insureddual employersultimate hirerjoint and severally liable
References
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