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

Case No. ADJ10132416
Regular
Sep 04, 2019

What Happened in Felix vs. Weber Metals Reconsideration?

This case concerns the determination of the cumulative trauma injury date and the corresponding liability period for a workers' compensation claim. The Appeals Board clarified that the date of injury under Labor Code section 5412 is July 30, 2005, through September 30, 2015, based on when the applicant should have reasonably recognized his disability as work-related, evidenced by his attorney filing a claim. Crucially, the Board distinguished this from the liability period under Labor Code section 5500.5, which was established as July 30, 2014, through July 30, 2015, the applicant's last day of work. This revised liability period confirmed that Starr Indemnity & Liability Company was within coverage for the claim.

Labor Code Section 5412Labor Code Section 5500.5cumulative trauma perioddate of injuryinjurious exposureknowledge of disabilityApplication for Adjudication of Claimpetition to dismisscoverageamended findings
References
3
Case No. MISSING
Regular Panel Decision

How Did the WCAB Rule in Hardgrove vs. Intercon Security?

J. H. Williams, an employee, sustained an injury in September 1924 while working for American Construction Company, an insured employer under the Texas Employers’ Liability Act. He initially received weekly compensation payments from Employers’ Liability Assurance Corporation, Limited. After payments ceased, Williams sought a lump sum award from the Industrial Accident Board, which was granted in June 1925. The assurance corporation subsequently sued in the district court of Galveston county to set aside this award. Williams cross-petitioned for total and permanent disability and a lump sum payment due to manifest hardship. A jury found Williams totally and permanently disabled, and the court sided with Williams, awarding him and his attorneys, Morris, Sewell & Morris, a lump sum of $6,032.15. The assurance corporation appealed this judgment, contesting the finding of total permanent disability and the lump sum award. The appellate court affirmed the lower court's decision, finding sufficient evidence to support the jury's findings and noting the appellant's failure to follow legal procedures regarding a surgical operation demand.

Workers' CompensationTotal Permanent DisabilityLump Sum SettlementIndustrial Accident BoardAppellate ReviewMedical Expert TestimonyJury FindingsEmployer LiabilitySurgical InterventionManifest Hardship
References
6
Case No. MISSING
Regular Panel Decision

What Did the WCAB Decide in Cuadra vs. Community Home Care?

The intervenors, former employees of North American Royalties, Inc. (NAR), appealed a decision regarding the liability of surety companies that issued bonds to NAR, a self-insured employer. NAR ceased paying workers' compensation claims and filed for bankruptcy, prompting the State of Tennessee to seek payment from the sureties. The core dispute was whether the sureties' liability was cumulative for each year a bond was in effect or limited to the penal amount on the face of the bonds. The trial court and Court of Appeals ruled in favor of the sureties, limiting their liability. The Tennessee Supreme Court affirmed, interpreting Tennessee Code Annotated section 50-6-405(b) to mean that the bonds were continuous, single-term obligations, thus capping liability at the penal sum, and found no statutory or contractual basis for cumulative liability.

Surety BondsSelf-Insured EmployersWorkers' Compensation LiabilityStatutory InterpretationCumulative LiabilityPenal AmountAppellate ProcedureTennessee LawInsurance LawBankruptcy Claims
References
19
Case No. AHM 0118316 AHM 0118317 AHM 0118318
Regular
Jun 13, 2008

How Were Death Benefits Handled in Bocanegra vs. Sun-Gro Commodities?

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded prior findings because the WCJ failed to properly determine the date of cumulative injury and ensuing liability. The Board remanded the case for further proceedings to establish the date of injury under Labor Code section 5412 and then determine insurer liability under section 5500.5. This allows for proper joinder of parties and clarification of coverage periods, which are essential for apportioning liability in cumulative trauma cases.

Workers' Compensation Appeals BoardDouglas DeesSouth Coast Plaza SecurityEverest National Insurance CompanyAmerican Safety Casualty CompanyAHM 0118316AHM 0118317AHM 0118318reconsiderationFindings and Orders
References
0
Case No. ADJ3640816 (SBR 0317873) ADJ1343688 (SBR 0317874)
Regular
Apr 10, 2009

Can a WCJ Be Disqualified for Appearance of Bias?

This case concerns a workers' compensation claim for cumulative injury where the liability period for employer Everest National Insurance Company (ENIC) was at issue. The Appeals Board granted reconsideration, amending the previous order to establish the cumulative injury ended on March 6, 2003, aligning with the applicant's first date of disability. Consequently, ENIC is now ordered to reimburse Mid-Century Insurance Company for 61% of benefits paid during the preceding one-year liability period. The Board affirmed the finding of a single cumulative injury, distinguishing it from prior cases with separate periods of disability and continued medical treatment.

Labor Code § 5500.5cumulative injuryspecific injurycompromise and releasetemporary total disabilitypermanent disability advancedate of injurylast day of workemployer liabilityapportionment
References
6
Case No. MISSING
Regular Panel Decision

What Were the Key Rulings in Torrez vs. SuperShuttle?

This worker's compensation case involves an appeal by Esther Anzaldua against American Guarantee & Liability Insurance Company, the compensation carrier. Anzaldua was injured on the job and sued after rejecting an award from the Texas Industrial Accident Board. A jury awarded her damages for partial incapacity and medical expenses, but Anzaldua appealed, alleging the medical award was insufficient, that certain medical reports were improperly admitted due to hearsay, and that a supplemental jury charge was coercive. The court affirmed the lower court's judgment, finding the jury's verdict supported by evidence, the medical reports properly admitted, and the supplemental charge not coercive.

Workers' CompensationMedical ExpensesJury VerdictEvidence AdmissibilitySupplemental Jury ChargeCoercionIncapacityAppealTexas LawInsurance
References
7
Case No. MISSING
Regular Panel Decision

Why Was Removal Denied in Rush vs. California Correctional Institution?

Loblaw, Inc., a self-insured retail chain, sued its excess insurer, Employers’ Liability Assurance Corporation, for reimbursement under a workers’ compensation policy. The dispute centered on whether Loblaw timely notified Employers’ of an employee's escalating injury claim. Loblaw initially believed the claim would not exceed its $25,000 self-retention, delaying notice until June 1972, despite warnings from its agent and mounting costs. The Supreme Court, Erie County, initially sided with Loblaw, but the Appellate Division reversed, ruling Loblaw had an ongoing obligation to notify the insurer and was derelict by May 1969. This court affirmed the Appellate Division's dismissal of Loblaw's complaint, holding that the notice given in June 1972 was too late as a matter of law, given the claim had exceeded $21,000 by December 1970.

Insurance policy interpretationWorkers' compensationExcess insuranceNotice provisionSelf-insurerTimely noticeAppellate reviewContract constructionObjective standardSubjective judgment
References
22
Case No. MISSING
Regular Panel Decision

What Did the WCAB Clarify in Ontiveros vs. Savers Stores?

Electric Mutual Liability Insurance Company appealed a worker’s compensation judgment concerning Ira Gillis White, who sustained a back injury. A jury found White totally incapacitated for three months and permanently partially incapacitated thereafter, establishing his weekly earning capacity at $150 during the partial incapacity period. Electric Mutual contended that the trial court erred in excluding evidence of White’s pre-injury wages and that the jury’s finding on earning capacity was unsupported or against the evidence. The appellate court affirmed the trial court’s decision, explaining that worker’s compensation aims to compensate for loss of earning capacity, not just actual wages, and that post-injury earnings do not conclusively prove capacity. The court found sufficient evidence to support the jury's assessment of White's diminished earning capacity, considering his pain and physical limitations despite continued employment.

Worker's CompensationIncapacityEarning CapacityBack InjuryHerniated DiscMedical EvidenceWage ExclusionJury FindingsAppellate ReviewTexas Law
References
7
Case No. MISSING
Regular Panel Decision
Jul 21, 1990

Why Was Reconsideration Denied in Gomez vs. Dorothy Stevens?

This is an appeal in a worker's compensation case. The plaintiff, Lucille Fullenwider, alleged she developed industrial asthma while working for Motorola, Inc., leading to total and permanent incapacity. The jury found she did not suffer an occupational injury, and the trial court rendered judgment in favor of the defendant, American Guarantee & Liability Insurance Company. The sole issue on appeal was whether the trial court erred in permitting two undisclosed expert witnesses to testify when interrogatories requesting their names were not supplemented thirty days prior to trial. The appellate court concluded that while the trial court abused its discretion in admitting the testimony without a finding of good cause, the error was harmless as the plaintiff was not prejudiced, and affirmed the trial court's judgment.

Expert Witness TestimonyDiscovery RulesGood Cause ExceptionTrial Court DiscretionAbuse of DiscretionHarmful ErrorWorker's CompensationIndustrial AsthmaOccupational InjuryUndisclosed Witnesses
References
17
Case No. MISSING
Regular Panel Decision

Why Was Reconsideration Dismissed in Sabino vs. Johnson Pump Company?

Archie Capps appealed a take-nothing judgment, arguing that American Mutual Liability Insurance Company improperly deducted both worker's compensation and social security benefits from his disability insurance payments. Capps, disabled in 1972, received disability policy payments from 1973 and a lump-sum worker's compensation settlement in 1974, which included attorney's fees. He also received monthly social security benefits. The court affirmed the judgment, holding that the insurance policy's anti-duplication clause permitted the deduction of both worker's compensation and social security payments. Furthermore, the court found that attorney's fees awarded in the worker's compensation case were part of the total amounts payable and were properly deducted, and that the calculation of payments was correct.

AppealDisability InsuranceWorker's CompensationSocial Security BenefitsAnti-duplication ClauseAttorney's FeesLump-sum SettlementBenefit DeductionsPolicy InterpretationInsurance Law
References
2
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