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

Case No. ADJ2021542 (LAO 0874590)
Regular
Feb 03, 2010

RAUL MURILLO vs. PARAGON SCHMID BUILDING PRODUCTS; TRAVELERS

This case involves an applicant's cumulative trauma claim where the defendant insurer, Travelers, sought to join Liberty Insurance Corporation and Insurance Company of the State of Pennsylvania as parties. The administrative law judge initially denied joinder due to an EAMS registration issue with the proposed carriers. The Appeals Board granted removal, rescinded the denial, and joined Liberty as a party defendant, finding its coverage period necessary for adjudication. However, Pennsylvania was not joined due to insufficient evidence regarding its necessity and potential coverage overlap.

RemovalOrder Denying JoinderPetition for Order Joining Party DefendantCumulative TraumaEAMSWCIRBNecessary PartyAdjudicationAdministrative ConvenienceLiberty Insurance Corporation
References
Case No. ADJ1930275 (LAO 0856552)
Regular
Aug 19, 2019

Juan Ledesma vs. Nelson Martinez, Amador Estrada, Sara Montenegro

This case concerns Applicant Juan Ledesma's workers' compensation claim for injuries sustained on December 4, 2004, while working as a drywall installer. The initial decision denied benefits, finding intoxication barred recovery under Labor Code section 3600(a)(4). The Appeals Board granted reconsideration, rescinding the prior order and finding that Applicant did sustain injury to multiple body parts. The Board determined the defendants failed to prove Applicant's intoxication was a substantial or proximate cause of his injury, therefore section 3600(a)(4) did not bar recovery, deferring other issues.

Labor Code section 3600(a)(4)Petition for ReconsiderationFindings and Orderintoxication defenseproximate causesubstantial factoraffirmative defensepre-ponderance of the evidencesubstantial evidenceAOE/COE
References
Case No. ADJ9871891
Regular
Jun 13, 2019

MICHAEL SANABRIA vs. PERFORMANCE PLUS INSTALLATION, ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board denied a petition for removal filed by the defendant. Removal is an extraordinary remedy only granted upon a showing of substantial prejudice or irreparable harm, which the petitioner failed to demonstrate. The Board also noted that reconsideration would be an adequate remedy if an adverse decision is ultimately issued. Additionally, the defendant's attorneys were admonished for improperly attaching documents to the petition.

RemovalPetition for RemovalWorkers' Compensation Appeals BoardSubstantial PrejudiceIrreparable HarmReconsiderationAdjudication FileEvidentiary RecordWCJ ReportExtraordinary Remedy
References
Case No. ADJ3959447 (AHM 0138619) ADJ3200673 (AHM 0135036)
Regular
Sep 26, 2019

RICHARD DILLON vs. GENERAL INSTALLATION COMPANY, QBE SPECIALTY INSURANCE, ADMINISTERED BY SEDGWICK CMS

The Workers' Compensation Appeals Board denied the Petition for Removal in the case of Richard Dillon v. General Installation Company. Removal is an extraordinary remedy granted only when substantial prejudice or irreparable harm will occur, and reconsideration is insufficient. The Board found that the petitioner failed to demonstrate these grounds, based on the WCJ's report on the merits of the arguments. Therefore, the petition was denied.

Petition for RemovalWorkers' Compensation Appeals BoardSubstantial PrejudiceIrreparable HarmReconsiderationAdministrative Law JudgeExtraordinary RemedyAdverse DecisionCalifornia Workers' CompensationCase Number ADJ3959447
References
Case No. ADJ9016280
Regular
Jan 28, 2015

WALTER FLORES vs. R \u0026 D CUBICLE INSTALLATION, NATIONAL FIRE INSURANCE COMPANY OF HARTFORD, CNA CLAIMPLUS, INC.

In *Flores v. R & D Cubicle Installation*, the Workers' Compensation Appeals Board (WCAB) dismissed the applicant's petition for reconsideration as untimely. The WCAB found that the petition was filed on December 3, 2014, which was more than 25 days after the Workers' Compensation Judge's decision was served on November 4, 2014. California law strictly enforces the jurisdictional deadline of 20 days for filing a petition for reconsideration, with a potential five-day extension for mailing. The WCAB reiterated that the timely filing of such a petition is a jurisdictional requirement, and untimely petitions cannot be granted.

Petition for ReconsiderationUntimelyDismissalLabor Code section 5903Filing DeadlineJurisdictionalAppeals BoardWCJ's DecisionServiceMailing Extension
References
Case No. ADJ4011315 (ANA 0396860)
Regular
Oct 25, 2010

Jong H. Choi vs. BEST BUY COMPANY, Administered By GALLAGHER BASSETT

The Appeals Board granted reconsideration, affirming the 6% permanent disability award but rescinding a 15% reduction in indemnity. The reduction was improperly applied because the employer failed to offer modified/alternative work within the statutory 60-day window after the applicant reached permanent and stationary status. The Board upheld the WCJ's reliance on the treating physician's report over the QME's for determining the disability level. The employer's offer of work was untimely, thus disqualifying them from the statutory reduction.

Workers' Compensation Appeals BoardPermanent DisabilityQualified Medical ExaminerPrimary Treating PhysicianLabor Code Section 4658(d)(3)(A)Modified WorkAlternative WorkSubstantial Medical EvidenceFindings and AwardReconsideration
References
Case No. ADJ4471499 (ANA 0388511)
Regular
Feb 09, 2009

JOSHUA FALLER vs. UNITED STATES CAR STEREO, INC. dba RACE N' ROCK, UNINSURED EMPLOYERS BENEFIT TRUST FUND

This case involves an applicant who claims industrial injury to his back, leg, and psyche. The defendant sought reconsideration of an award of temporary disability benefits from July 28, 2008, and continuing, arguing insufficient medical evidence. The Appeals Board granted reconsideration, finding that the applicant's testimony alone was insufficient to support ongoing temporary disability. The Board deferred the issue of temporary disability after November 1, 2005, and ordered the record to be further developed with medical evidence.

Workers' Compensation Appeals BoardReconsiderationTemporary DisabilityMedical EvidenceSubstantial JusticeFurther Development of RecordFindings of FactOrderAwardInstallation Manager
References
Case No. SJO 0245781
En Banc

Michael A. Willette vs. AU Electric Corporation, State Compensation Insurance Fund

The Workers' Compensation Appeals Board dismisses the applicant's petition for reconsideration, ruling that it was not filed against a final order since the case had been remanded for further proceedings.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissalEn Banc OpinionIndustrial InjuryLow Back InjuryTailbone InjuryAlarm InstallerUtilization ReviewQualified Medical Examiner
References
Case No. ADJ2041680 (MON 0361210)
Regular
Aug 03, 2009

RAYMOND ORTEGA (Deceased) ELIZABETH ORTEGA (Widow) NOAH ORTEGA and ANDREA ORTEGA (Minors) vs. CALTRANS; Legally Uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

This case involves a deceased Caltrans employee whose widow and child sought death benefits. The Workers' Compensation Appeals Board (WCAB) affirmed the finding that the employee's death was industrially related, overturning the defendant's argument that it was not substantial evidence. The WCAB also amended the original award to defer the specific amounts for death benefits and attorney fees, returning the case to the trial level for clarification on payment methods. This amendment addresses a clerical error regarding earnings and clarifies that accrued death benefits should be paid at the stipulated temporary disability rate, divided between dependents, not as separate full rates.

Workers' Compensation Appeals BoardCaltransLegally UninsuredState Compensation Insurance FundOpinion and Decision After ReconsiderationStipulationIndustrial InjuriesDependantsBurial ExpensesAttorney Fees
References
Case No. ADJ3855987 (OAK 0344425)
Regular
Aug 22, 2012

FRANCIS CRUZ vs. UNIVERSITY ELECTRIC COMPANY, INC., AMTRUST NORTH AMERICA

The Workers' Compensation Appeals Board granted reconsideration of an order allowing an Employment Development Department lien claim. The Board rescinded the original order, finding that the parties had reached a new stipulation based on a mutual mistake regarding the application of a time-off-work cap to the lien. The case is returned to the trial level for further proceedings to approve the replacement stipulation or for the judge to re-issue the original order if the new stipulation is not approved. The Petition for Removal was dismissed as reconsideration was deemed an adequate remedy.

Workers Compensation Appeals BoardPetition for RemovalPetition for ReconsiderationOrder Allowing Lien ClaimEmployment Development DepartmentMutual Mistake of FactTTD CapCompromise and ReleaseStipulationWCJ
References
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