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

Case No. 30 AD3d 876
Regular Panel Decision

Sandra M. v. St. Luke's Roosevelt Hospital Center

The plaintiffs, Sandra M. and her husband, appealed a Supreme Court order granting summary judgment to St. Luke's Roosevelt Hospital Center, dismissing their complaint. Sandra M. was allegedly sexually assaulted by a nursing assistant, Ricardo Cortez, supplied by United Staffing System, Inc., while on suicide watch at the Hospital. The plaintiffs sued the Hospital, United, and Cortez, alleging the Hospital was negligent in its suicide watch policies and its failure to independently evaluate staff provided by United. The Appellate Division dismissed the appeal from the intermediate order and affirmed the judgment dismissing the complaint against the Hospital. The court found the Hospital was not vicariously liable for Cortez's personal tortious acts and had no duty to independently screen employees supplied by United, as it had no prior knowledge of Cortez's propensity for misconduct.

Personal InjurySexual AssaultNegligenceHospital LiabilityVicarious LiabilityIndependent ContractorNegligent HiringSummary JudgmentAppellate ReviewSuicide Watch
References
20
Case No. ADJ8969860
Regular
Jul 28, 2016

Miguel Cortez vs. American Security Force, Inc., The Hartford

This case involves an applicant, Miguel Cortez, who sought workers' compensation benefits for an alleged injury to his left shoulder sustained on May 28, 2013. The Workers' Compensation Appeals Board denied his Petition for Reconsideration, upholding the administrative law judge's finding. The Board found Cortez failed to meet his burden of proof for a compensable injury arising out of and occurring in the course of employment. This decision was based heavily on the judge's credibility determination regarding Cortez's inconsistent testimony about the incident and conflicting accounts of the injury provided to medical providers.

AOE/COEPetition for ReconsiderationCredibility determinationBurden of proofLabor Code § 3600(a)(10)Industrial injuryCompensable injuryWCJ reportWitness demeanorTerminated employee
References
1
Case No. ADJ9843354, ADJ9340113
Regular
Feb 02, 2017

SANDRA CORTEZ vs. EMPLOYMENT RESOURCES GROUP, INC.; CLAIMS R.M.

This case involves an applicant, Sandra Cortez, and defendants Employment Resources Group, Inc. and Claims R.M. The Workers' Compensation Appeals Board dismissed Cortez's petition for reconsideration and denied her petition for removal. The Board found that the WCJ's decision addressed an interlocutory procedural or evidentiary issue, not a final determination of substantive rights or liabilities. Removal was denied because there was no showing of substantial prejudice or irreparable harm, and reconsideration would be an adequate remedy. The Board also clarified that a letter to an AME copied to the applicant's attorney was not an ex parte communication.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFinal OrderSubstantive RightThreshold IssueInterlocutory DecisionProcedural IssueEvidentiary IssueExtraordinary Remedy
References
9
Case No. ADJ9100288
Regular
May 17, 2018

GILBERT CORTEZ (Deceased), NOHEMA CORTEZ (Surviving Spouse & Guardian Ad Litem), et al. vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, Legally Uninsured, CALIFORNIA PUBLIC EMPLOYEES RETIREMENT SYSTEM, STATE COMPENSATION INSURANCE FUND (Claims Administrator)

The Workers' Compensation Appeals Board (WCAB) rescinded a prior decision concerning death benefits for the deceased employee's children, Andres and Marisa Cortez. The WCAB remanded the case to the administrative law judge to properly join the California Public Employees' Retirement System (CalPERS) and determine the entitlement to and coordination of workers' compensation death benefits with CalPERS special death benefits. The WCAB clarified that the "good cause" standard under *Antrim* applies and that CalPERS benefits may offset workers' compensation benefits to avoid duplicate payments. Further proceedings are required to consider the specific claims of dependency and the impact of CalPERS payments.

Workers' Compensation Appeals BoardCDCRSCIFCalPERSdeath benefitsdependent childrenspecial death benefitsoffsetAntrim standardLabor Code section 4707
References
7
Case No. ADJ9428267
Regular
Jul 07, 2018

JOHNNY CORTEZ vs. LES SCHWAB TIRE, INC.

The Appeals Board dismissed Johnny Cortez's untimely petition for reconsideration of a stipulated award, as it was filed more than 25 days after the WCJ's decision. However, the Board granted reconsideration on its own motion within the statutory 60-day period. The Board rescinded the original award and returned the case to the WCJ for further proceedings to determine if the stipulations should be approved. This action was taken to address the applicant's claims regarding incorrect temporary disability payments and improper notification of PQME rights.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeStipulated AwardTemporary Disability IndemnityPanel Qualified Medical EvaluatorPermanent DisabilityTimelinessJurisdictional Time LimitReconsideration on Own Motion
References
2
Case No. ADJ4549941 (OXN 0133428) ADJ1729960 (OXN 0133245)
Regular
Jan 13, 2011

MARIA CORTEZ vs. EL TACO DE MEXICO, SCIF INSURED OXNARD

This case concerns Maria Cortez's workers' compensation claims against El Taco de Mexico and its insurer, SCIF. The Workers' Compensation Appeals Board (WCAB) has issued an order denying reconsideration of a prior decision. The WCAB adopted and incorporated the reasoning of the workers' compensation administrative law judge. Therefore, the petition for reconsideration has been officially denied.

Workers' Compensation Appeals BoardMaria CortezEl Taco de MexicoSCIF Insured OxnardOrder Denying ReconsiderationPetition for ReconsiderationWorkers' compensation administrative law judgeWCJ reportAdopt and incorporateDeidra E. Lowe
References
0
Case No. ADJ6710414
Regular
Dec 02, 2014

JOAQUIN CORTEZ vs. ACTIONS CONTRACTORS, INC., LINCOLN GENERAL INSURANCE COMPANY

This case involves applicant Joaquin Cortez seeking reimbursement for medical expenses incurred with Dr. Elena Konstat and Ames Medical Corporation. Both Dr. Konstat and the defendant, Actions Contractors, Inc., sought reconsideration of a previous WCJ decision. The Board rescinded the prior decision, noting Ames Medical's lien is moot due to withdrawal. The Board found insufficient evidence to determine Dr. Konstat's lien entitlement and returned the case for further proceedings to develop the record regarding MPN notification, treatment denial, and the reasonableness of charges.

Workers' Compensation Appeals BoardMedical Provider NetworkUtilization ReviewLien ClaimantsFindings and AwardCompromise and ReleasePetition for ReconsiderationLabor CodePrimary Treating PhysicianPsychiatric Injury
References
2
Case No. ADJ4299001
Regular
Mar 08, 2010

JOAQUIN CORTEZ vs. FRU-CON CONSTRUCTION CORPORTION, ZURICH NORTH AMERICAN INSURANCE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to review the permanent disability rating of 54% awarded to applicant Joaquin Cortez. The defendant argued the rating was improperly calculated under *Ogilvie II*, which dictates the burden of proof lies with the party rebutting the scheduled rating. The WCAB found the vocational expert's analysis flawed due to contradictory assumptions about the applicant's pre- and post-injury earning capacity. Consequently, the WCAB reversed the 54% award, finding the applicant failed to rebut the scheduled 13% permanent disability rating and issued an award for 13% disability.

Ogilvie IIOgilvie IDFECPermanent DisabilityReconsiderationRebuttalVocational ExpertWhole Person ImpairmentRAND dataLabor Code section 4660
References
3
Case No. ADJ3968322
Regular
Apr 29, 2011

GABRIEL CORTEZ vs. THOMAS WYNN & MIA WYNN, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board granted reconsideration of a prior decision finding applicant Gabriel Cortez was an employee of defendants Thomas and Mia Wynn. The Board rescinded the decision due to an incomplete record, specifically the absence of the WCJ's actual decision. The matter is remanded for further proceedings and a new decision, allowing parties to address a newly raised Labor Code section 3715(b) issue. The defendants' arguments regarding employment status under Labor Code sections 2750.5, 3351(d), and 3352(h) remain to be fully adjudicated.

Labor Code section 2750.5Labor Code section 3351(d)Labor Code section 3352(h)unlicensed drywall installeremployment relationshipPetition for ReconsiderationReport and RecommendationSupplemental Petition for ReconsiderationLabor Code section 3715(d)WCJ decision
References
3
Case No. ADJ8290469
Regular
Jul 02, 2015

Mario Cortez vs. The Regents of the University of California Riverside; permissibly self-insured, administered by Sedgwick Claims Management Services

This case concerns Mario Cortez, a police officer for the University of California-Riverside, who claimed cumulative skin cancer to his face due to sun exposure during his employment. The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration and stay of the award. The Board found substantial evidence supported the finding of industrial causation for basal cell carcinoma, based on medical reports and the applicant's testimony. The Board also affirmed the 25% permanent partial disability rating and the 90% apportionment to industrial causes, deeming the physician's reasoning sound.

Workers' Compensation Appeals Boardcumulative injuryskin cancerbasal cell carcinomapermanent partial disabilityapportionmentindustrial causationAMA GuidesLabor Code Section 3212.1treating physician
References
20
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