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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. ADJ7109517
Regular
May 05, 2011

DWAYNE RUDD vs. OAKLAND RAIDERS AND ACE/USA, Administered by ESIS, TAMPA BAY BUCCANEERS, Permissibly Self-Insured, Administered by NOVA PRO RISK SOLUTIONS

The Workers' Compensation Appeals Board granted reconsideration to reverse a prior decision and found applicant Dwayne Rudd's claim barred by the statute of limitations. Despite the WCJ finding defendants estopped to assert the defense due to notice violations, the Board determined Rudd possessed actual knowledge of his workers' compensation rights. This knowledge was evidenced by his signing of a DWC-1 form and retaining multiple law firms to pursue prior, dismissed claims for the same cumulative trauma injury. Therefore, the Board concluded there was no prejudice from the lack of notice, and the claim was untimely.

Workers' Compensation Appeals BoardDwayne RuddOakland RaidersACE/USATampa Bay BuccaneersNova Pro Risk Solutionsindustrial cumulative traumaprofessional football playerstatute of limitationsestoppel
References
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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ3445477
Regular
Jan 16, 2009

Deborah Newell vs. Ford Construction Company

The WCJ found that Dennis Newell's death was caused by Ford's failure to provide a safe workplace. Both the applicant and Ford sought reconsideration, which was denied.

Workers' Compensation Appeals BoardSerious and Willful MisconductLabor Code sections 6400 et seq8 Cal. Code Regs. 50428 Cal. Code Regs. 5002ForemanIndustrial InjuryDeath BenefitSafe Place to WorkExecutive Knowledge
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. 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. 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. ADJ8739571
Regular
Dec 11, 2015

MARVIN BENARD vs. SAN FRANCISCO GIANTS, ACE INSURANCE COMPANY, U.S. FIDELITY AND GUARANTY INSURANCE COMPANY

In this workers' compensation case, the Appeals Board reversed the WCJ's decision, finding the applicant's claim was not barred by the statute of limitations. The Board determined the defendant failed to meet its burden of proving the applicant had actual knowledge of his workers' compensation rights more than one year before filing his claim. Crucially, the defendant did not provide notice of these rights, and the applicant's knowledge of his injury's industrial cause did not equate to knowledge of his rights to benefits. Therefore, the case was returned for further proceedings.

Cumulative traumaStatute of limitationsDate of injuryKnowledge of rightsTollingAffirmative defenseReconsiderationBurden of proofProfessional athleteNotice of rights
References
Case No. ADJ10425864, ADJ7159539
Regular
Dec 24, 2018

GHASSAN MOSRIE vs. CHURCH OF THE CHIMES, GUIDEONE INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration, rescinding a prior finding that the applicant's 2008 injury claim was barred by the statute of limitations. The Board determined that imputed knowledge from the applicant's attorney does not constitute actual knowledge for tolling purposes. The employer's failure to provide statutory notice of rights, coupled with the applicant's lack of actual knowledge, prejudiced the applicant. Therefore, the Board found the applicant's claim for the November 8, 2008 injury is not barred by the statute of limitations, deferring other issues.

Workers' Compensation Appeals BoardPetition for ReconsiderationStatute of LimitationsTollingClaim FormNotice of Potential EligibilityWaiverMandatory Settlement ConferenceAffirmative DefenseActual Knowledge
References
Case No. ADJ6937263
Regular
Sep 09, 2014

PAUL ESCUDERO vs. CISCO SYSTEMS, INC., ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Cisco Systems' petition for reconsideration, upholding the finding that the applicant's claim was not barred by the statute of limitations. The Board adopted the WCJ's reasoning that Cisco failed to prove the applicant had actual knowledge of his workers' compensation rights. Specifically, the employer did not provide legally required notices, and the applicant's vague consultation with a civil attorney did not constitute sufficient actual knowledge to start the statute of limitations. The Board also noted that actual knowledge cannot be imputed solely by an employee's representation by counsel.

Statute of limitationsTollingActual knowledgeWorkers' compensation rightsEmployer noticeCivil attorneyImputed knowledgePetition for ReconsiderationWorkers' Compensation Appeals BoardAdministrative law judge
References
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