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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. ADJ9942080 ADJ10381122 ADJ10260028
Regular
Apr 07, 2017

MARIO PADILLA vs. RIO FARMS, LLC, NATIONAL UNION FIRE INS. CO.

The Workers' Compensation Appeals Board granted reconsideration to address whether the defendant was entitled to a credit for $11,020 in permanent disability advances. The applicant argued against the credit, citing that the Compromise and Release explicitly stated "0.00" permanent disability indemnity paid and did not include any deductions for such advances. The Board found the defendant's interpretation of the addendum ambiguous and against the explicit language of the settlement agreement. Therefore, the Board amended the award to permit credit only for permanent disability advances made *after* the date of the Compromise and Release.

Permanent disability advancesCompromise and ReleasePetition for ReconsiderationJoint Findings and Awardcreditaddendumsettlement negotiationscontract interpretationmutual intentionWCJ
References
Case No. AHM 96265
Regular
Jul 21, 2008

PHIL ULLOA vs. COUNTY OF LOS ANGELES FIRE DEPARTMENT, INTERCARE INSURANCE SERVICES

The defendant sought reconsideration of a Stipulated Findings and Award, arguing for credit of overpaid indemnity benefits. The Workers' Compensation Appeals Board dismissed the petition, finding the defendant was not aggrieved as the award already included provisions for asserting credit for permanent disability advances and TTD overpayments. The Board adopted the WCJ's report, which concluded the existing stipulations and award authorized the claimed credit.

Petition for ReconsiderationStipulated Findings and AwardPermanent DisabilityTemporary Total Disability OverpaymentCredit for AdvancesWCJ ReportAggrieved PartyWorkers' Compensation Appeals BoardIndustrial InjurySupervisor Fire Dispatcher
References
Case No. ADJ7111686
Regular
Apr 14, 2010

DANIEL AVENDANO, JR. vs. RAYDON, INC., ENDURANCE INS. CO., FIRSTCOMP.

The defendant sought reconsideration of an approved Compromise and Release agreement, arguing the WCJ erred by not allowing a credit for permanent disability advances due to mutual mistake. The agreement settled the applicant's industrial injuries for $\$12,797.50$. However, the Compromise and Release form contained an ambiguous clause regarding permanent disability advances, with blanks left unfilled by the defendant. Because the defendant drafted the agreement and the applicant was unrepresented, any ambiguity is construed against the defendant. Therefore, the petition for reconsideration was denied, and the defendant is not entitled to a credit for permanent disability advances.

Permanent disability advancesCompromise and ReleaseMutual mistake of factWCABLabor Code section 5003AmbiguityUnrepresented applicantContract interpretationCreditIndustrial injury
References
Case No. ADJ2552389 (OAK 0301853), ADJ2702419 (OAK 0301854), ADJ350772 (OAK 0301856), ADJ3854894 (OAK 0321466)
Regular
Mar 26, 2012

BARBARA LIGE-DIXON vs. A.C. TRANSIT, SEDGWICK CMS, INC.

The defendant, AC Transit, sought reconsideration of an award finding four industrial injuries and three awards of permanent disability for Barbara Lige-Dixon. The primary dispute concerned whether the defendant could credit permanent disability advances made in one case (resulting in zero disability) against its liability in other cases. The Appeals Board granted reconsideration, finding equitable considerations supported allowing the credit across all cases due to overlapping injuries and evolving medical apportionment. The Board amended the award to permit the $12,930 advance credit, while deferring the issue of attorney fees against third-party recovery for further trial-level proceedings.

Workers' Compensation Appeals BoardPermissibly Self-InsuredJoint Findings Award and OrdersPermanent DisabilityPermanent Disability AdvancesCreditThird Party RecoveryEquitable ConsiderationsApportionmentAgreed Medical Examiner
References
Case No. ADJ9615369, ADJ9615370, ADJ10928806
Regular
Jun 19, 2018

CATALINA REYES QUINTANILLA vs. TARZANA FIVE-FOUR CORNERS INVESTMENT, PUBLIC SERVICE MUTUAL INSURANCE COMPANY, CORVEL CORPORATION

This case concerns Defendant's petition for reconsideration of an order approving a $50,000 settlement for Applicant's workers' compensation claims. Defendant argued the order incorrectly failed to credit $5,913.87 in permanent disability advances paid to Applicant. However, the Compromise and Release agreement clearly indicated zero permanent disability advances and explicitly settled that issue. The Appeals Board found no evidence of mutual mistake and denied reconsideration, ruling that Defendant's failure to ensure the credit was included in the agreement constituted a unilateral mistake due to their own neglect.

Compromise and ReleasePermanent Disability AdvancesPetition for ReconsiderationOrder ApprovingWCJUnilateral MistakeMutual MistakeNeglect of Legal DutyContract InterpretationWaiver of Reimbursement
References
Case No. ADJ2852888 (AHM 079739) ADJ6775021
Regular
Dec 11, 2010

PAUL BUTELO vs. LEIGHTON AND ASSOCIATES, AMERICAN MOTORISTS INSURANCE COMPANY

This case concerns a dispute over a defendant's credit for long-term disability (LTD) payments received by the applicant. The Appeals Board granted reconsideration to correct an error where the trial judge erroneously denied a credit for a $102,237.77 third-party recovery. However, the Board affirmed the judge's denial of credit for the LTD payments because the defendant failed to prove the payments were intended as an advance on workers' compensation benefits. The case was returned to the trial level for further proceedings consistent with this decision.

Long Term DisabilityThird Party RecoveryCreditWCJReconsiderationTemporary Disability IndemnityPetition for ReconsiderationEAMSInvited ErrorDue Process
References
Case No. ANA 0341847
Regular
Jun 02, 2008

FLAVIO AMEZCUA-NAVARRO vs. GRISWOLD INDUSTRIES, ARROWPOINT CAPITAL CORPORATION, ROYAL & SUNALLIANCE, DYNAMIC CLAIMS SERVICES

This case concerns a dispute over the amount of credit an employer is entitled to for permanent disability advances against a $70,000 settlement. The applicant argues that the compromise and release agreement limits the credit to $19,180, while the defendant deducted $35,049.36. The Appeals Board granted reconsideration, finding that the WCJ erred in interpreting the agreement based on her subjective understanding rather than the explicit terms. The case is returned to the trial level to determine the parties' agreed-upon credit amount based on the contract language.

Compromise and releasepermanent disability advancescreditlump sum settlementreconsiderationfindings and orderworkers' compensation administrative law judgemandatory settlement conferencecontract interpretationmutual intention
References
Case No. ADJ124002
Regular
Apr 21, 2011

RAMON RUIZ vs. DOLE FRESH VEGETABLES, SPECIALTY RISK SERVICES

The Appeals Board granted reconsideration and modified a prior award regarding temporary disability overpayments. Defendant sought credit for temporary disability paid during the applicant's off-season and after the permanent and stationary date. The Board denied credit for off-season payments, finding them inequitable. However, credit was allowed for temporary disability paid after the permanent and stationary date, recognizing these payments as advances against permanent disability.

ADJ124002Findings Order AwardPermanent DisabilityTemporary DisabilityCredit for OverpaymentOff-Season EmploymentPermanent and Stationary DateLabor Code 4909Equitable PrinciplesDouble Recovery
References
Case No. ADJ7088465
Regular
Jan 27, 2017

RAUL GARCIA vs. CHULA VISTA ELEMENTARY SCHOOL

This case involves cross-petitions for reconsideration of an administrative law judge's (WCJ) decision regarding a custodian's industrial injury. The WCJ initially found a 31% permanent disability rating but issued contradictory findings on the employer's credit for indemnity advances. The Appeals Board granted reconsideration, increasing the permanent disability rating to 48% and correcting the contradictory findings to allow the employer credit for advances. The Board otherwise affirmed the WCJ's decision, concluding the employer should receive credit for prior payments to avoid double recovery and encourage prompt benefit disbursement.

WCABADJ7088465Chula Vista Elementary Schoolcustodianindustrial injuryleft eyefaceneckthoracic spineteeth
References
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