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

Case No. ADJ7232076
En Banc
Sep 26, 2011

Tsegay Messele vs. Pitco Foods, Inc.; California Insurance Company

The Appeals Board holds that the 10-day period for agreeing on an AME under Labor Code § 4062.2(b) is extended by five days when the initial proposal is served by mail, and clarifies the method for calculating this time period, finding both parties' panel requests premature.

Workers' Compensation Appeals BoardTsegay MesselePitco FoodsInc.California Insurance CompanyADJ7232076Opinion and Decision After ReconsiderationOrder Granting RemovalDecision After RemovalEn Banc
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. ADJ9625407
Regular
Sep 12, 2018

KEITH FIELD vs. CITY OF PINOLE

This case involves a firefighter who sustained bilateral carpal tunnel syndrome after retirement. The Appeals Board reversed the trial judge, holding that Labor Code section 4458.5 applies, entitling the applicant to permanent disability benefits calculated at the maximum indemnity rate. This applies regardless of the applicant's actual earnings or the fact that carpal tunnel syndrome is not a specifically enumerated presumptive injury. The case is remanded for determination of the precise date of injury to calculate the benefit rate.

Workers' Compensation Appeals BoardKeith FieldCity of PinolePermissibly Self-InsuredMunicipal Pooling AuthorityADJ9625407Opinion and Decision After Reconsiderationindustrial injuryfirefighterbilateral upper extremities
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. LBO 0330943
Regular
Aug 25, 2008

BETTY BELL vs. SOUTHERN CALIFORNIA EDISON; Permissibly Self-Insured

Defendant's petition for reconsideration is dismissed because it is not taken from any "final order, decision, or award" subject to reconsideration, and removal is denied.

Workers' Compensation Appeals Boardpetition for reconsiderationpetition for removallien claimantsubstitution of attorneyfinal orderinterlocutory orderprocedural ordersubstantive issueLabor Code § 5900
References
Case No. ADJ8381652
Regular
Feb 07, 2014

CARLOS CABRERA RAZO vs. LAS POSAS COUNTRY CLUB, HARTFORD INSURANCE CO.

This case concerns the timeliness of an applicant's strike from a Qualified Medical Evaluator (QME) panel. The Appeals Board vacated its previous grant of reconsideration, dismissed the defendant's Petition for Reconsideration, and denied their Petition for Removal. The Board determined that Labor Code section 4062.2, as amended by SB 863 effective January 1, 2013, applies to pending matters, including this case with a 2012 date of injury. Applying the amended statute and Code of Civil Procedure section 1013(a), the applicant had 15 days from the Administrative Director's assignment of the QME panel to strike a name. The applicant's strike on the 12th day was therefore timely, affirming the Workers' Compensation Judge's decision.

Workers' Compensation Appeals BoardQualified Medical EvaluatorPetition for ReconsiderationPetition for RemovalLabor Code Section 4062.2(c)Senate Bill 863Administrative DirectorCumulative Trauma InjuryQME Panel AssignmentCode of Civil Procedure 1013
References
Case No. ADJ3682964 (ANA 0393581) ADJ2308886 (ANA 0399397)
Regular
Dec 12, 2008

KARLA ORNELAZ vs. ALBERTSON'S INC., Permissibly Selfinsured, Administered by SPECIALTY RISK SERVICES, INC.

The Workers' Compensation Appeals Board granted reconsideration, finding that the employer's offer of modified work was timely. The Board ruled that the 60-day period to offer work under Labor Code § 4658(d) begins when the employer is served with notice of the employee's permanent and stationary status. Furthermore, the Board held that the five-day mailing extension under Code of Civil Procedure § 1013 applies to this notice, thus entitling the employer to a 15% decrease in permanent disability indemnity.

Workers' Compensation Appeals BoardAlbertson's Inc.Specialty Risk ServicesInc.Karla OrnelazLabor Code §4658(d)(2)Labor Code §4658(d)(3)(A)permanent and stationarymodified workalternative work
References
Case No. ADJ10021120 ADJ8949346
Regular
Apr 14, 2017

ANTHONY BERNARD EDWARDS (Dec'd), CANDACE EDWARDS (Widow), ASHLEY EDWARDS (Daughter), ANTHONY EDWARDS, JR. (Son) vs. CITY OF LOS ANGELES; LOS ANGELES WORLD AIRPORTS, Permissibly Self-Insured

This case involves a workers' compensation death benefit claim for Anthony Bernard Edwards, who died in the course of his employment. The dependents seek death benefits and burial expenses, which were initially awarded by the WCJ. The employer, City of Los Angeles, sought reconsideration, arguing it should receive credit for a third-party settlement the dependents obtained from Kaiser Permanente. The Board agreed to reconsider the issue of credit, specifically whether Civil Code section 3333.1 bars such credit. The Board ultimately deferred the credit issue, affirming the death benefit award and returning the matter for further proceedings to determine the applicability of Civil Code section 3333.1 and potential employer negligence.

Workers' Compensation Appeals BoardADJ10021120ADJ8949346death benefitsLabor Code section 4702burial expensesCivil Code section 3333.1Medical Injury Compensation Reform ActMICRAthird-party settlement
References
Case No. ADJ1191428 (LBO 0310118)
Regular
Aug 09, 2010

RUBEN GOMEZ-SOTO vs. NMI, INC.

Here's a summary of the case for a lawyer in four sentences: The Appeals Board granted removal, modifying the WCJ's order to require the defendant to produce *all* medical reports in its possession to the lien claimant, not just those intended for reliance, pursuant to CCR $\S 10608$. The Board struck the WCJ's provision requiring the lien claimant to prove market rate for interpreters, finding the issue was not properly before the judge. While the lien claimant alleged WCJ bias, the Board found no sufficient evidence of enmity or prejudice based on the record. The case was returned to the trial level for further proceedings consistent with the Appeals Board's decision.

RemovalLien ClaimantWCJ OrderMedical ReportsMarket RateInterpreter FeesBiasDisqualification8 Cal. Code Reg. 10608Labor Code 5710
References
Case No. SAC 0361364
Regular
Jul 11, 2008

AMBER DeFAZIO vs. RESORT AT SQUAW CREEK, ZURICH NORTH AMERICA INSURANCE COMPANY

This case involves sanctions against defense counsel for filing improperly documented petitions and a response without permission. The Appeals Board rescinded the WCJ's award of temporary total disability, remanding the case to determine the precise commencement date of indemnity payments for accurate application of Labor Code section 4656. The Board also upheld the WCJ's exclusion of the employer's modified work offer exhibit as irrelevant.

Workers' Compensation Appeals BoardSanctionsLabor Code § 5813Cal. Code Regs.tit. 8§ 10842Cal. Code Regs.tit. 8§ 10848Incomplete Verification
References
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