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

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. ADJ12315169
Regular
Sep 10, 2019

Gregory Williams vs. Redwood Electric Group, Travelers Property Casualty Company of America

The Appeals Board affirmed an Arbitrator's finding that an electrician's injuries, potentially from electrocution, arose out of employment. Despite the unwitnessed nature of the injury and lack of direct evidence on the precise cause, the Board applied the *Clemmens* doctrine, creating a presumption that the injury occurred in the course of employment when the employee is placed at the location by the employer. Circumstantial evidence, including entry and exit wounds and the active construction site environment, supported the industrial nature of the injury. The defendant's arguments regarding the neutral risk doctrine, burden of proof, and denial of due process were found unpersuasive or waived.

Workers' Compensation Appeals BoardRedwood Electric GroupTravelers Property Casualty Company of AmericaJourneyman Electricianupper and lower extremitiesbody systemskinkidneysheartbrain
References
Case No. ADJ473373 (ANA 0406381)
Regular
Feb 10, 2012

FERNANDO GUTIERREZ vs. SOCAL FRAMING aka BMHC; ACE AMERICAN INSURANCE, administered by ESIS, INC.

This case concerns applicant's claim for extended temporary disability (TD) benefits beyond 104 weeks due to a left eye injury. The Appeals Board affirmed the WCJ's denial of the "amputation" exception, ruling that the surgical removal of an eye does not fit the statutory definition. However, the Board remanded the case for further development of the record on the "high-velocity eye injury" exception, as the velocity and force of the object that struck the applicant's eye were unclear. The applicant's Petition for Removal was dismissed as reconsideration was the appropriate remedy.

Workers' Compensation Appeals BoardFernando GutierrezSoCal FramingBMHCACE American InsuranceESISInc.ADJ473373ANA 0406381Opinion and Decision
References
Case No. ADJ6655702
Regular
Mar 18, 2010

GERICK CATUGDA vs. WINKLEBLACK CONSTRUCTION, CALIFORNIA INSURANCE COMPANY c/o APPLIED RISK SERVICES

This case concerns whether the "going and coming rule" bars applicant's workers' compensation claim for injuries sustained during his commute. The defendant argued the rule applied, but the Workers' Compensation Appeals Board denied their petition for reconsideration. The Board adopted the WCJ's finding that the applicant's employment required him to have transportation for multiple job sites, creating an exception to the rule. This decision aligns with established precedent, where transportation necessity for the employer's benefit removes the commute from the rule's exclusion.

Going and coming ruleindustrial injuryconstruction laborerhead injurybrain injurypsyche injuryspine injuryribs injurypelvis injuryarms injury
References
Case No. ADJ4359205
Regular
Aug 07, 2013

HECTOR GONZALEZ vs. DIMAS ERNESTO RAMOS, BZZZ CONSTRUCTION, STATE COMPENSATION INSURANCE FUND, PACIFIC SPECIALTY INSURANCE COMPANY, TRISTAR RISK MANAGEMENT

This case concerns a petition for reconsideration in a workers' compensation matter where the applicant, Hector Gonzalez, claimed injury while working on a construction project. The defendant, Dimas Ernesto Ramos, contested that he was the employer, arguing Gonzalez was an independent contractor or a residential employee. The Administrative Law Judge found Ramos to be the employer based on extensive contradictions in Ramos's testimony and the credible testimony of others, establishing an employer-employee relationship. The Workers' Compensation Appeals Board denied the petition for reconsideration, upholding the WCJ's findings and giving them great weight.

WCABPetition for ReconsiderationWCJ reportcredibility findingGarza v. Workmen's Comp. Appeals Bd.construction projectbuilder-ownerlicensed general contractorBZZZ ConstructionState Compensation Insurance Fund
References
Case No. ADJ11084134, ADJ11084352
Regular
Apr 17, 2023

Denisha Johnson vs. defendant

The Workers' Compensation Appeals Board denied the petitioner's petitions for reconsideration. While accepting supplemental pleadings, the Board noted the petitioner failed to follow proper procedure for filing them. The underlying facts involve an employee injured on a construction site due to a floor collapse, with subsequent medical evaluations and ongoing litigation. Ultimately, the Board upheld the prior determination, denying the request to revisit the decision.

Petitions for ReconsiderationSupplemental PleadingsCal. Code Regs. tit. 8 § 10964Workers' Compensation Appeals BoardDeniedApplicantEmployerConstruction SitesKnee InjuryWrist Injury
References
Case No. ADJ7039301
Regular
Mar 16, 2011

ROBLY HART vs. LA JOLLA PACIFIC/DRR NEFF & ASSOCIATES, OAKS RIVER INSURANCE/BERKSHIRE HATHAWAY HOMESTATE COMPANIES

This case concerns Robly Hart's workers' compensation claim for an injury sustained in a motorcycle accident. The applicant was a construction consultant who used his motorcycle for work, traveling between home, job sites, and interviews. The primary dispute centers on whether the accident occurred during the course and scope of his employment, with conflicting evidence regarding his activities and timeline leading up to the incident. The Workers' Compensation Appeals Board denied reconsideration, adopting the judge's report that found the applicant's testimony lacked credibility due to inconsistent statements and timeline discrepancies.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJGarza v. Workers' Comp. Appeals Bd.Findings and OrderCourse of EmploymentConstruction ConsultantBuilding InspectorMotorcycle TravelJob Sites
References
Case No. ADJ9419247
Regular
Aug 09, 2016

GUADALUPE ALVAREZ vs. CITY WALL CONSTRUCTION, THE HARTFORD INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of a prior order finding the applicant was not an employee of City Wall Construction. The applicant claimed a work injury to his back and foot, but the judge found his testimony regarding employment lacked credibility against the defendant's consistent testimony. The Board also rejected the applicant's request to reopen based on newly discovered evidence, as he failed to demonstrate due diligence in discovering and presenting this information at trial. Therefore, the applicant did not meet his burden of proof to establish an employer-employee relationship.

Workers' Compensation Appeals BoardGuadalupe AlvarezCity Wall ConstructionThe Hartford Insurance CompanyADJ9419247denial of reconsiderationindustrial injuryconstruction workeremployment statusnewly discovered evidence
References
Case No. ADJ7572145
Regular
Aug 09, 2012

ALBERTO CARMONA vs. MEDINA CONCRETE CONSTRUCTION, DELOS INSURANCE COMPANY, RISK ENTERPRISE MANAGEMENT LIMITED

The Workers' Compensation Appeals Board denied reconsideration of a decision that found no industrial injury occurred. The applicant, Alberto Carmona, alleged he fractured his arm in a trench but provided inconsistent accounts of the incident. The Workers' Compensation Judge found the applicant not credible based on contradictory testimony, including evidence that the injury may have occurred from a fall off a ladder inside a house. The Board adopted the Judge's report and reasoning, giving great weight to the credibility findings.

Workers' Compensation Appeals BoardReconsiderationWCJCredibilityIndustrial InjuryFractured HumerusConstruction SiteTrenchLadderMedical Reports
References
Case No. ADJ9099900
Regular
May 04, 2015

JESSEKA BETTS vs. YMCA OF THE EAST VALLEY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, affirming a prior award. The applicant, a YMCA site director, sustained injuries in a car accident while en route to a work-related meeting. The Board found that the "required vehicle exception" to the going and coming rule applied, as the applicant was required to use her personal vehicle for her job duties, for which she was reimbursed mileage. Therefore, her injuries were deemed to have arisen out of and in the course of employment.

Workers' Compensation Appeals Boardgoing and coming defenserequired vehicle exceptionmaterial deviationwork-related meetingmileage reimbursementsplit shiftssite directorcar insurancelicensing inspection
References
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