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

Case No. ADJ2357169 (VNO 0476110) ADJ3613914 (VNO 0476111) ADJ1007900 (VNO 0476112) ADJ3475183 (VNO 0476113) ADJ1139437 (VNO 0476115)
Regular
Jan 05, 2009

LUIZA ZIEGLER vs. FIRST BANK AND TRUST, CHUBB GROUP OF INSURANCE CO.

The Appeals Board dismissed the lien claimant's petition for reconsideration as untimely, filed 26 days after the October 9, 2008, Order of Dismissal.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien ClaimantOrder of DismissalTimelinessJurisdictionalLabor CodeCode of Civil ProcedureCalifornia Code of RegulationsWCJ
References
Case No. ADJ11391724, ADJ11391757
Regular
Oct 03, 2019

PABLO LOPEZ DURAN vs. SOUTH HILLS ACADEMY, CHURCH MUTUAL INSURANCE COMPANY, SECURITY NATIONAL INSURANCE COMPANY, AMTRUST NORTH AMERICA, CRESCENT HOTELS & RESORTS, LLC, CHUBB INSURANCE GROUP, GALLAGHER BASSETT SERVICES, INC.

This Workers' Compensation Appeals Board case involves applicant Pablo Lopez Duran and multiple defendants including South Hills Academy, Church Mutual Insurance Company, Security National Insurance Company, Crescent Hotels & Resorts, LLC, and Chubb Insurance Group. The Board granted a petition for reconsideration and affirmed a prior order regarding sanctions and costs. Specifically, Chubb Insurance Group, administered by Gallagher Bassett Services, Inc., was ordered to pay an additional $395 for attorneys' fees related to a petition for fees, less any credit for prior payments.

WORKERS' COMPENSATION APPEALS BOARDSOUTH HILLS ACADEMYCHURCH MUTUAL INSURANCE COMPANYSECURITY NATIONAL INSURANCE COMPANYAMTRUST NORTH AMERICACRESCENT HOTELS & RESORTSLLCCHUBB INSURANCE GROUPGALLAGHER BASSETT SERVICESINC.
References
Case No. ADJ2109115; ADJ3790194; ADJ4103411
Regular
Aug 01, 2013

LETICIA BENAVIDES vs. BON APPETIT DANISH; MACY'S; CHUBB GROUP OF INSURANCE CO.

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The applicant sought penalties and attorney fees for the late payment of a Compromise and Release (C&R) settlement, alleging Chubb Group failed to make timely and correct payment. The Board found that the delay was due to a single instance of human error involving an incorrect address on the C&R, which was promptly corrected upon discovery. The applicant also contributed to the delay by not notifying Chubb of the non-receipt of payment for over three months. Therefore, the Board concluded there was no unreasonable delay justifying penalties.

Workers Compensation Appeals BoardPetition for ReconsiderationDeniedWCJ ReportDefective VerificationCured VerificationSupplemental PetitionCompromise and ReleaseLate PaymentChubb Group
References
Case No. ADJ8589789
Regular
Jun 05, 2014

ANTONIA GARCIA vs. GOGLANIAN BAKERIES, CHUBB GROUP OF INSURANCE COMPANIES

The Workers' Compensation Appeals Board (WCAB) dismissed Antonia Garcia's Petition for Reconsideration against Goglanian Bakeries and Chubb Group of Insurance Companies. The dismissal was based on the petition's failure to meet the verification requirement of Labor Code section 5902. Even if it had been verified, the WCAB would have denied the petition on its merits, adopting the reasoning of the workers' compensation judge.

Petition for ReconsiderationVerifiedLabor Code section 5902DismissalWorkers' Compensation Appeals BoardAdministrative Law JudgeReport and RecommendationVerified PetitionDenied on MeritsWCJ
References
Case No. ADJ7915283
Regular
Nov 01, 2013

GUILLERMO LEMUS vs. G & K MANAGEMENT, INC., CHUBB INSURANCE GROUP, GALLAGHER BASSETT SERVICES, INC.

This case involves an applicant, Guillermo Lemus, and defendants G & K Management, Inc., and Chubb Insurance Group. The Workers' Compensation Appeals Board (WCAB) issued an order dismissing a Petition for Reconsideration filed in this matter. The WCAB adopted the reasoning of the workers' compensation administrative law judge, noting the petition was skeletal and unverified. Even on the merits, the petition would have been denied based on the WCJ's report.

Petition for ReconsiderationWCABAdministrative Law JudgeLien ClaimantUnverifiedSkeletalDismissalChubb Insurance GroupGallagher Bassett ServicesG&K Management
References
Case No. ADJ10565692
Regular
Nov 08, 2018

BRIAN CLARK vs. LOS RIOS COMMUNITY COLLEGE DISTRICT, YORK RISK SERVICES GROUP

This case involves a sports athletic trainer, Brian Clark, who sustained head and psyche injuries at work. Both the applicant and the defendant sought reconsideration of the initial award. The applicant argued his occupational group was misclassified, while the defendant contended the judge wrongly rejected the medical evaluator's apportionment of permanent disability. The Workers' Compensation Appeals Board denied both petitions, upholding the original findings. The Board found the applicant failed to prove factual error in his occupational group classification and adopted the WCJ's reasoning regarding the apportionment.

WORKERS' COMPENSATION APPEALS BOARDLOS RIOS COMMUNITY COLLEGE DISTRICTYORK RISK SERVICES GROUPFindings and Awardsports athletic traineroccupational group 390occupational group 311permanent disability apportionmentPanel Qualified Medical Evaluator (PQME)substantial evidence
References
Case No. ADJ10443669
Regular
Oct 04, 2017

Donna Carter vs. Rose International Group, OneBeacon Insurance Group

The Appeals Board affirmed the Workers' Compensation Judge's finding that Donna Carter sustained an industrial injury to her right knee and left wrist on May 18, 2016. Despite inconsistencies in the applicant's testimony regarding a slip and fall incident, her account was corroborated by a witness who found her on the floor. Medical records from the day of the incident also supported the applicant's claim, establishing a clear mechanism of injury. The Board found that the common sense nature of a slip and fall does not require expert medical opinion to establish industrial causation for the incident itself.

ADJ10443669Rose International GroupOneBeacon Insurance GroupDonna CarterWorkers' Compensation Appeals BoardOpinion and Decision After Reconsiderationslip and fallindustrial injuryright kneeleft wrist
References
Case No. ADJ10362335
Regular
Mar 06, 2018

WILLIBALDO DURAN ESCANDON vs. VALLEYCREST LANDSCAPING MAINTENANCE, CHUBB GROUP OF INSURANCE, ESIS

The Workers' Compensation Appeals Board denied reconsideration of a Findings and Award, upholding the Administrative Law Judge's decision. The Applicant alleged a left shoulder injury sustained while employed as a landscaper on February 25, 2016. The Board found the WCJ's credibility determinations, based on observing witnesses, to be sound and supported by substantial evidence. The WCJ appropriately admitted an employer letter rebutting testimony about the date of injury and employment. Medical evidence from Dr. McCreesh supported an industrial injury, while Dr. Poon's opinions were deemed speculative and inflammatory.

WILLIBALDO DURAN ESCANDONVALLEYCREST LANDSCAPING MAINTENANCECHUBB GROUP OF INSURANCEESISRECONSIDERATION OF FINDINGS AND AWARDGarza v. Workmen's Comp. Appeals Bd.credibility determinationsADJ10362335Mandtory Settlement Conference (MSC)Pre-Trial Conference Statement
References
Case No. ADJ6766619 (MF) ADJ6766620
Regular
Feb 28, 2018

MARIA DURAN vs. FOREVER 21 RETAIL, INC., CHUBB GROUP

This case involves Maria Duran's request for home health care services, which was initially denied by utilization review (UR) and upheld by Independent Medical Review (IMR). The applicant argued that her need for assistance with household chores and personal hygiene fell outside the scope of the Medical Treatment Utilization Schedule (MTUS) guidelines as applied. While the Board acknowledges that the specific MTUS guideline used in this case was later found to be an invalid regulation in a related case, it affirmed the original decision. This affirmance was based on the finding that the initial request for services was too vague, lacking specific details on the type, frequency, and duration of care, and that a revised request could be made.

Workers' Compensation Appeals BoardMaria DuranForever 21 RetailInc.Chubb GroupOpinion and Decision After ReconsiderationIndependent Medical ReviewIMRUtilization ReviewUR
References
Case No. ADJ9778321 ADJ9778380
Regular
Aug 19, 2015

SHARI HERNANDEZ vs. FREMONT BANK, CHUBB GROUP OF INSURANCE COMPANIES

The Workers' Compensation Appeals Board (WCAB) denied Shari Hernandez's Petition for Removal. Removal is an extraordinary remedy granted only when substantial prejudice or irreparable harm will result and reconsideration will be inadequate. The WCAB found that the applicant did not meet this high burden of proof, adopting the WCJ's reasoning for denial. Therefore, the petition was denied.

Petition for RemovalWorkers' Compensation Appeals BoardSubstantial prejudiceIrreparable harmReconsiderationAdministrative law judgeWCJ reportExtraordinary remedyFremont BankChubb Group
References
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