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

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
Case No. STK 182176
Regular
Mar 07, 2008

ShAENA SOUTHARD vs. HALLMARK CARDS/ROYAL SUNALLIANCE, SARA LEE/BROADSPIRE

The Workers' Compensation Appeals Board denied Sara Lee's petition for reconsideration, affirming the WCJ's finding of cumulative injury sustained while working for Sara Lee. The Board relied on the Labor Code § 5402(b) presumption of compensability due to Sara Lee's failure to deny the claim within 90 days of receiving the DWC-1 form. Additionally, the Board found the medical opinion of Dr. Feinberg, which attributed a portion of the injury to Sara Lee's employment, to be credible and substantial evidence.

WCABPetition for ReconsiderationCumulative InjurySara LeeHallmark CardsLabor Code § 5402(b)Presumption of CompensabilityAgreed Medical EvaluatorQualified Medical EvaluatorDr. Steven D. Feinberg
References
Case No. ADJ10485403
Regular
Aug 01, 2018

ALVARO JACKSON vs. LOS ANGELES UNIFIED SCHOOL DISTRICT

This case involves an applicant seeking reconsideration of a Workers' Compensation Appeals Board decision that dismissed his claim. The administrative law judge found the claim barred by the statute of limitations, as it was filed over five years after the alleged date of injury and the last provision of benefits. The applicant's arguments regarding a fraudulent DWC-1 form and doctor's opinions were deemed irrelevant to the statute of limitations issue. The Board dismissed the petition because the applicant failed to demonstrate grounds for reconsideration and did not address the controlling legal issue of the statute of limitations.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactDWC-1 forminadmissiblestatute of limitationsLabor Code section 5405(a)Labor Code section 5405(c)actual knowledgeWCJ
References
Case No. ADJ9066748
Regular
May 23, 2014

RAMATU KABBA vs. DAMERON HOSPITAL ASSOCIATION

Applicant Ramatu Kabba sought reconsideration of a finding that her psychiatric injury claim was not presumed compensable. The applicant argued the 90-day presumption period under Labor Code § 5402(b) began when the employer allegedly failed to provide a claim form promptly after receiving notice of injury. However, the Board denied reconsideration, adhering to the holding in *Honeywell v. Workers' Comp. Appeals Bd.* that the 90-day period runs from the filing of the claim form, not the employer's breach. Absent evidence of the employer misleading the applicant into not filing, the presumption did not arise.

Labor Code section 5402(b)presumption of compensabilitypetition for reconsiderationclaim formdenial of liabilityHoneywell v. Workers' Comp. Appeals Bd. (Wagner)estoppelDWC Form 1industrial injurypsyche
References
Case No. ADJ8079708
Regular
May 06, 2013

JAMES AZBILL vs. FATORS MOTORCYCLES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to amend a prior finding, affirming the claim is not barred by the statute of limitations. However, the Board reversed the finding that the applicant was entitled to the presumption of compensability under Labor Code section 5402(b). This presumption requires the filing of a DWC-1 claim form, which was absent in this case. The Board will return the matter to the trial level for further proceedings on deferred issues.

Workers' Compensation Appeals BoardFators MotorcyclesState Compensation Insurance FundJames AzbillADJ8079708Opinion and OrderReconsiderationFindings and OrderWCJStatute of Limitations
References
Case No. ADJ10962119; ADJ11023301
Regular
Jul 10, 2018

OSCAR RENDEROS vs. SEA BREEZE CONSTRUCTION, WESCO INSURANCE, AMTRUST FINANCIAL SERVICES

The Workers' Compensation Appeals Board denied reconsideration of a decision finding the applicant's claim was not barred by the statute of limitations. The Board deferred to the Administrative Law Judge's (WCJ) credibility determination, finding no substantial evidence to reject it. The employer's letter stating they would "administratively close" the file was not deemed a denial of the claim, thus not triggering the statute of limitations. The WCJ found the employer failed to adequately inform the applicant of his rights after receiving the DWC-1 form.

WCABPetition for ReconsiderationStatute of LimitationsDWC-1 Claim FormAOE/COECredibility DeterminationLabor Code §5405Notice of RightsIndustrial InjuryClaims Administrator
References
Case No. ADJ10049659
Regular
May 29, 2018

JOSE PINA DIAZ vs. SUNBURST CHURCH OF SELF REALIZATION, ILLINOIS MIDWEST INSURANCE AGENCY on behalf of STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration for both the applicant and the defendant regarding the initial Findings of Fact and Award. The Board rescinded the prior award and returned the case to the trial level for further proceedings. Key issues included the applicant's alleged injury to his nervous system and psyche, and whether the statute of limitations tolled due to the employer's failure to provide a DWC-1 claim form. The Board found the WCJ's original decision lacked clarity and sufficient basis on these points.

WCABPetition for ReconsiderationFindings of Fact and AwardDate of InjuryLast Injurious ExposureStatute of LimitationsTolledDWC-1 Claim FormNervous System and PsycheCumulative Trauma Injury
References
Case No. ADJ12550205
Regular
Apr 06, 2020

OLGA PLASCENCIA vs. ADECCO USA, INC

This case involves a dispute over a Qualified Medical Evaluator (QME) panel request. The applicant sought a chiropractic QME panel, while the defendant later denied liability for certain injuries. The Workers' Compensation Appeals Board (WCAB) rescinded the prior ruling and returned the case to the trial judge. This decision was based on the need to further develop the record regarding the applicant's DWC-1 form filing and the effect of the defendant's partial acceptance of liability on the QME panel process. The WCAB emphasized that the validity of the QME panel needs resolution before further proceedings.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderDelay LetterMedical EvaluationQME PanelChiropracticOrthopedicLabor Code Section 4060Causation Dispute
References
Case No. ADJ9297105
Regular
May 20, 2016

GREGORY GRIFFIN vs. COUNTY OF SAN BERNARDINO

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration of a statute of limitations defense. The applicant, a fire captain, sustained cumulative injuries ending March 21, 2012, but his claim was initially barred. The Board rescinded the previous findings and returned the case to trial, directing consideration of whether disability pension payments constitute compensation under Labor Code section 5405(b). The case also requires further development regarding potential tolling of the statute due to the employer's knowledge of the injury and failure to provide a DWC-1 form.

Statute of limitationsPetition for ReconsiderationFindings of FactWCJCumulative injurySkinNeckBackFeetHearing loss
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
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