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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ120949 (LBO 0345949)
Regular
Mar 28, 2011

RON CURTIS vs. C.J. SEGERSTROM & SONS, AMERICAN CLAIMS MANAGEMENT FOR EVEREST NATIONAL INSURANCE, AMERICAN SAFETY CASUALTY COMPANY

This case concerns American Safety Casualty Company's petition for reconsideration of an arbitrator's decision regarding contribution. The arbitrator found that Everest National Insurance Company timely instituted contribution proceedings based on a subsequent Compromise and Release Agreement that redefined the cumulative trauma injury dates. American argued that a prior, rescinded award determining earlier injury dates should control, but the Board affirmed the arbitrator's conclusion that the rescission rendered the prior finding void. The Board clarified that this decision only addresses the timeliness of contribution proceedings, not final liability, allowing for further litigation.

Workers' Compensation Appeals BoardCumulative Trauma ClaimContribution ProceedingsArbitrator's Findings and AwardCompromise and Release AgreementDate of Cumulative Trauma InjuryLabor Code Section 5500.5Rescinded Findings and AwardStatus Quo AntePetition for Reconsideration
References
Case No. WCK 60593
Regular
Mar 28, 2008

SUSANA AGUILAR vs. CUSTOM SENSORS AND TECHNOLOGIES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior dismissal order. The defendant argued they were denied due process because they did not receive notice of intention to dismiss, and the dismissal was improper as the main claim was settled, leaving only a contribution issue. The Board agreed that substantial justice warranted a hearing on the merits, remanding the case for further proceedings.

Petition for ReconsiderationOrder of DismissalApplication for Adjudication of ClaimNotice of Intention to DismissDue ProcessCompromise and ReleaseContribution between defendantsReport and RecommendationProof of serviceDismissal of contribution claim
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. 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. ADJ1009271 (AHM 0055424)
Regular
Apr 27, 2009

MYRNA PEREZ vs. FIDELITY FEDERAL BANK, TIG SPECIALTY INSURANCE CO., REM, LTD, GOLDEN EAGLE

This case concerns a contribution dispute between two insurance carriers, TIG and Golden Eagle, for a cumulative trauma injury claim. Golden Eagle sought reconsideration of an order compelling it to pay over $\$101,000$ in contribution to TIG. Golden Eagle argued it was never properly served with a notice of intention and that Labor Code section 5275 mandates arbitration for contribution disputes. The Appeals Board agreed that mandatory arbitration applies, rescinded the order, and remanded the case for either informal resolution or arbitration.

Workers' Compensation Appeals BoardOrder of ContributionPetition for ReconsiderationLabor Code section 5275mandatory arbitrationContributionCumulative Trauma InjuryCompromise and Release AgreementPetition for ContributionNotice of Intention
References
Case No. ADJ4634338 (MON 0262377)
Regular
Jun 24, 2009

NINA GOODRICH vs. UNILAB/QUEST DIAGNOSTICS, SEDGWICK CLAIMS MANAGEMENT SERVICES, AMERICAN CASUALTY CO. OF READING, PA, CNA CLAIMSPLUS, VALLEY HEALTH SYSTEMS, TRISTAR RISK MANAGEMENT, ZURICH INSURANCE CO.

This case concerns a dispute over contribution claims following a cumulative injury to the applicant. The Workers' Compensation Appeals Board granted reconsideration, rescinded an arbitration finding, and remanded the matter for further proceedings. The Board found that Sedgwick, which paid over $180,000 in benefits, was not required to file a petition for contribution under section 5500.5 because it was not a signatory to the Compromise and Release (C&R). Furthermore, the Board held that even if Sedgwick had been required to file, the co-defendant CNA would be estopped from asserting the statute of limitations due to stipulations in the C&R reserving contribution rights. The Board concluded Sedgwick's claim for reimbursement was not time-barred.

Workers' Compensation Appeals BoardNina GoodrichUnilabQuest DiagnosticsSedgwick Claims Management ServicesAmerican Casualty Co.CNA ClaimsplusValley Health SystemsTristar Risk ManagementZurich Insurance Co.
References
Case No. ADJ1139186 (OAK 0308001) ADJ483865 (OAK 0308002) ADJ6524430
Regular
Jan 06, 2011

PATRICK RECORDS vs. WASTE MANAGEMENT OF ALAMEDA COUNTY AND CIGA, CONVERIUM, ACE, ET AL.

The Workers' Compensation Appeals Board granted reconsideration to address CIGA's claim for contribution against Converium for a cumulative trauma injury ending February 15, 2000. CIGA argued that the statute of limitations was tolled by medical treatment and payments made under a Compromise and Release Agreement. However, the Board found the record insufficient, lacking crucial medical evidence regarding the cumulative trauma injury and benefit payment details. Therefore, the case was returned to the trial level to allow the admission of necessary documents, including the Agreed Medical Examiner's reports and a clear benefit payment printout, to determine the validity of CIGA's contribution claim.

CIGAConverium InsuranceContribution claimCumulative traumaStatute of limitationsCompromise and Release AgreementTollingMedical treatmentAgreed Medical ExaminerApplication for Adjudication of Claim
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. 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
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