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Case Law Database

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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ1282419 (LAO 0846452) ADJ915214 (LAO 0854736)
Regular
Feb 01, 2010

VALERIE VANCE DILLON vs. TJ MAXX, CNA CLAIMS PLUS

This case involves a Compromise and Release agreement between the applicant and defendants. The Board granted reconsideration, rescinded the prior decision, and returned the matter to the trial level. This action is contingent on the workers' compensation administrative law judge approving the settlement. If not approved, the original decision could be reinstated, with the right to seek reconsideration.

Compromise and ReleasePetition for ReconsiderationGrant ReconsiderationRescind DecisionTrial LevelWorkers' Compensation Appeals BoardAdministrative Law JudgeSalvage and ClaimsSalvage and ClaimsSalvage and Claims
References
Case No. ADJ3525697 (LAO 0534774) ADJ2342373 (LAO 0512482) ADJ1310306 (LAO 0568035) ADJ2645702 (LAO 0519888) ADJ1384751 (LAO 0568036) ADJ2871875 (ANA 0235799)
Regular
Feb 03, 2017

ALICE BRYANT vs. REGENTS OF THE UNIVERITY OF CALIFORNIA, permissibly self-insured, UCLA MEDICAL CENTER; SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves applicant Alice Bryant's petition for reconsideration of prior dismissed workers' compensation claims and a Labor Code section 132a retaliation claim. The Workers' Compensation Appeals Board (WCAB) denied reconsideration, upholding the administrative law judge's findings. The WCAB concluded that Bryant's claims were previously dismissed, with some dismissed by her own request and others for failure to prosecute. Furthermore, the WCAB found that Bryant failed to demonstrate extrinsic fraud and lacked the required diligence to reopen these final dismissals, even with newly discovered evidence.

Workers' Compensation Appeals BoardRegents of the University of CaliforniaSedgwick Claims Management ServicesPetition for ReconsiderationFindings and OrdersWorkers' Compensation Administrative Law JudgeLabor Code section 132aRetaliation claimExtrinsic fraudDismissed claims
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ9030735
Regular
Jul 08, 2014

HECTOR CASILLAS vs. XERXES CORPORATION, BROADSPIRE CLAIMS SERVICES

The Workers' Compensation Appeals Board denied Xerxes Corporation's Petition for Removal. The Board found that while the defendant raised legitimate concerns about potential fraud, these issues were not relevant to the applicant's current claim. The Board adopted the administrative law judge's report, concluding that the evidence presented did not support a fraudulent claim and the forum was not appropriate for addressing concerns about running, capping, and steering. Therefore, the petition was denied.

Petition for RemovalWorkers' Compensation Appeals Boardrunningcappingsteeringfraudulent claimadministrative law judge reportADJ9030735Xerxes CorporationBroadspire Claims Services
References
Case No. ADJ10962119; ADJ11023301
Regular
Jul 10, 2018

OSCAR RENDEROS vs. SEA BREEZE CONSTRUCTION, WESCO INSURANCE, AMTRUST FINANCIAL SERVICES

The Workers' Compensation Appeals Board denied reconsideration of a decision finding the applicant's claim was not barred by the statute of limitations. The Board deferred to the Administrative Law Judge's (WCJ) credibility determination, finding no substantial evidence to reject it. The employer's letter stating they would "administratively close" the file was not deemed a denial of the claim, thus not triggering the statute of limitations. The WCJ found the employer failed to adequately inform the applicant of his rights after receiving the DWC-1 form.

WCABPetition for ReconsiderationStatute of LimitationsDWC-1 Claim FormAOE/COECredibility DeterminationLabor Code §5405Notice of RightsIndustrial InjuryClaims Administrator
References
Case No. ADJ10098930, ADJ10438935, ADJ10458721
Regular
Feb 02, 2018

CHRISTINA LILE vs. SOUTHEAST PERSONNEL LEASING, INC., PACKARD CLAIMS ADMINISTRATION, STATE NATIONAL INSURANCE

This case involves a Petition for Removal that the Workers' Compensation Appeals Board (WCAB) denied. The WCAB adopted the Workers' Compensation Judge's (WCJ) reasoning that removal is an extraordinary remedy and the petitioner failed to demonstrate substantial prejudice or irreparable harm. The WCAB also agreed with the WCJ that the applicant's multiple claims should be consolidated for trial. Therefore, the petition was denied as reconsideration would be an adequate remedy if a final adverse decision were issued.

Petition for RemovalWorkers' Compensation Appeals BoardAdministrative Law JudgeSubstantial PrejudiceIrreparable HarmReconsiderationConsolidated ClaimsOverlapping Body PartsSoutheast Personnel LeasingPackard Claims Administration
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. ADJ1444335 (RIV 0017334), ADJ167619 (RIV 0017335), ADJ4158912 (RIV 0046324)
Regular
Sep 08, 2010

CHERYLE HUTCHINSON vs. COMMUNITY HOSPITAL OF SAN BERNARDINO, SEDGWICK CIGA GLENDALE, CHARTIS COSTA MESA, American Home Assurance Company (AHA)

The Appeals Board dismissed American Home Assurance Company's (AHA) Petition for Reconsideration regarding an order for AHA to administer three workers' compensation claims. The Board granted AHA's petition for removal, rescinded the order, and returned administration of the claims to CIGA. The Board found that the Workers' Compensation Judge prematurely ordered AHA to administer the claims, as no findings of liability or "other insurance" had been established, which are prerequisites for shifting administration away from CIGA. Therefore, CIGA will continue administering the claims until a determination of liability and coverage is made.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalClaims AdministrationCalifornia Insurance Guarantee AssociationCIGAOther InsuranceJoinder of DefendantDate of InjuryOverlap of Injuries
References
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