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

Case No. ADJ7031117
Regular
Feb 27, 2013

JAMIE XELOWSKI, JENNIFER CAMPBELL vs. CITY AND COUNTY OF SAN FRANCISCO, COMMUNITY HEALTH NETWORK

This case concerns dependent benefits for the adult daughter of a deceased employee. The applicant argued that a Social Security Administration (SSA) Notice of Award conclusively presumed her dependency for death benefits under Labor Code section 3501(a). The Appeals Board reversed the WCJ's decision, finding the SSA's disability determination constitutes an administrative finding by a trier of fact that the applicant was incapacitated from earning. This finding, occurring prior to the mother's death, satisfies the statutory requirement for conclusive presumption of dependency.

Workers' Compensation Appeals BoardDependent benefitsLabor Code section 3501(a)Conclusive presumption of dependencyTrier of factSocial Security AdministrationIncapacitated from earningAdult daughterMotor vehicle accidentIndustrial injury
References
Case No. ADJ1224922 (MON 0333643) ADJ2871289 (MON 0333644) ADJ6748036
Regular
Jan 21, 2010

MARIA CUPIDO (DECEASED) vs. HEALTHCARE SERVICES GROUP, INC., ZURICH NORTH AMERICA

This case involves a dispute over the appointment of a guardian ad litem (GAL) for the deceased worker's dependents. The defendant sought removal of an ex parte GAL order obtained by one claimant's counsel while another claimant's GAL petition was pending. The Appeals Board granted removal and rescinded the GAL order, finding it invalid on its face and noting questionable conduct by the petitioner's counsel. The matter is remanded for a proper determination of the appropriate GAL for the dependent.

Petition for removalGuardian ad LitemTrusteeEx parteSubstitution of attorneysApplication for Adjudication of ClaimDeath caseDependentWCJRescinded
References
Case No. ADJ8580851
Regular
Feb 26, 2018

JOSE RODRIGUEZ (Dec'd), MARCELA RODRIGUEZ (Wife), ANDREA RODRIGUEZ (Daughter), ISAAC ESPINOZA (Grandson) vs. KENAN ADVANTAGE GROUP, INC., AMERICAN ZURICH INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration. The Board affirmed the administrative law judge's order requiring the agreed medical evaluator (AME) to interview the deceased employee's spouse and daughter to assess causation for his suicide. The Board found the employer acted in bad faith by obstructing these interviews, warranting sanctions, attorney's fees, and costs. The employer's arguments against the interviews and sanctions lacked legal merit.

Workers' Compensation Appeals BoardAgreed Medical EvaluatorSuicideCompensable ConsequenceLabor Code Section 4062.3SanctionsBad FaithDiscovery ObstructionReconsiderationPetition for Reconsideration
References
Case No. ADJ8641548
Regular
May 11, 2016

MILAGROS ALBANO (Dec'd), JONALYN ALBANO (Daughter), JOE RICHARD ALBANO (Son), JOANNE MAE ALBANO (Daughter) vs. CAL AMP CORPORATION, HARTFORD ACCIDENT \& INDEMNITY COMPANY, STANDARD FIRE INSURANCE COMPANY, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The Workers' Compensation Appeals Board granted the applicants' petition for reconsideration in the case of Milagros Albano (deceased) versus Cal Amp Corporation and its insurers. This decision was made to allow further study of the factual and legal issues. All future correspondence regarding the petition must be filed directly with the Board's Commissioners in San Francisco. Trial level documents not related to the reconsideration petition should continue to be filed as usual.

Workers' Compensation Appeals BoardPetition for ReconsiderationGrant of ReconsiderationStatutory Time ConstraintsFactual and Legal IssuesJust and Reasoned DecisionFurther ProceedingsOffice of the CommissionersSan FranciscoElectronic Adjudication Management System (EAMS)
References
Case No. ADJ9763181
Regular
Oct 08, 2018

JUAN GONZALEZ (Deceased), MARIA RIVAS GONZALEZ (Widow), DIOSELINA GONZALEZ, et al. (Dependents) vs. SOUTH GREEN TRANSPORTATION, MARKEL INSURANCE SERVICES

This case involves a defendant seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision finding the deceased was an employee of South Green Transportation. The defendant argued the decedent was actually employed by his daughter and that finding South Green Transportation as sole employer could lead to public policy violations. The WCAB denied reconsideration, adopting the WCJ's report that found no evidence the daughter was an employer. The Board affirmed that an employee can have multiple employers, and South Green Transportation was liable as the entity directing the decedent's work.

Dual EmploymentSpecial EmployerGeneral EmployerIndustrial InjuryEmployee StatusLabor Code Section 3300Labor Code Section 3351Labor Code Section 3357Joint and Several LiabilityPetition for Reconsideration
References
Case No. ADJ7941094
Regular
Nov 17, 2016

DAVID HIGGINS vs. CITY OF LOS ANGELES

This case concerns the distribution of accrued workers' compensation benefits for the deceased David Higgins. The applicant's daughter, Lisa Higgins, petitioned for reconsideration after the Workers' Compensation Appeals Board (WCAB) awarded benefits equally to her and another individual, Deborah Spirithawk, who was found to be David Higgins' natural daughter. The WCAB denied the petition, upholding the original findings that both women were legal heirs entitled to equal shares, primarily based on the deceased's deposition testimony. The WCAB also noted procedural violations in the petition, including the improper attachment of documents.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ credibility determinationsGarza v. Workmen's Comp. Appeals Bd.WCAB Rule 10842(c)Findings and AwardDavid HigginsCity of Los AngelesLisa HigginsDeborah Spirithawk
References
Case No. ADJ6473555, ADJ7393801
Regular
Sep 18, 2014

Frank Jones (Deceased), Araceli Jones, Mya Jaedyn Jones vs. CDCR KERN VALLEY STATE PRISON, State Compensation Insurance Fund

The Workers' Compensation Appeals Board affirmed a previous award for death benefits to the minor daughter of deceased correctional officer Frank Jones. The WCJ found that the daughter, Mya Jones, was entitled to the special minor's death benefit due to "good cause," as her mother is now a sole provider facing significant financial hardship after the decedent's death. The Board agreed, citing compelling evidence of the mother's financial strain and the minor's ongoing needs. This decision overrides the defendant's contentions that the award was improper and denies credit for prior permanent disability advances.

Workers' Compensation Appeals BoardCalPERSspecial death benefitminor dependentGuardian Ad LitemLabor Code section 4704good causeaverage weekly earningstemporary total disabilitypermanent disability indemnity
References
Case No. ADJ3093587
Regular
Jan 16, 2009

ROBERT BABCOCK vs. CROWN DISPOSAL, STATE COMPENSATION INSURANCE FUND

Lien claimants' reconsideration petition denied for lack of substantial medical evidence showing need for home health care services from 1996-1999.

Lien claimantshome health caremedical treatmentcontemporaneous medical evidencesubstantial medical evidenceapplicant's spouseapplicant's daughterpetition for reconsiderationfindings and orderadministrative law judge
References
Case No. ADJ6790437
Regular
Jun 23, 2010

CHRISTOPHER PECKHAM (Dec'd) LISA FALVO-PECKHAM (Widow) vs. RESOLUTION LAW CORP AND REPUBLIC INDEMNITY CO. OF AMERICA

This case concerns a widow's petition for reconsideration of death benefits for her deceased husband. The applicant argued that death benefits should be annually adjusted based on the State Average Weekly Wage (SAWW), even if the decedent's actual earnings did not increase. The Workers' Compensation Appeals Board denied the petition, affirming the administrative judge's finding. The Board concluded that Labor Code section 4453(a)(10) only sets maximum rates and does not mandate automatic increases for death benefits beyond calculated average weekly earnings.

Workers' Compensation Appeals BoardDeath BenefitsPetition for ReconsiderationLabor Code Section 4453(a)(10)State Average Weekly Wage (SAWW)Earning CapacityStipulated AwardApplicant TestimonyExpert TestimonyFinancial Controller Testimony
References
Case No. ADJ3882013
Regular
Mar 22, 2023

TERESA LARA vs. DAUGHTERS OF MARY AND JOSEPH, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied Dental Trauma Center's petition for reconsideration, upholding the finding that the lien claimant failed to prove applicant sustained industrial injury to the psyche, headaches, or TMJ/mouth/jaw/teeth. The Board adopted the WCJ's reasoning that Dental Trauma Center did not meet its burden of proof as it failed to present substantial medical evidence supporting these claims. Consequently, the burden never shifted to the defendant to provide rebuttal evidence. The Board also addressed and rejected the petitioner's arguments regarding proper referral, lack of incorporation, and the binding nature of the Compromise and Release.

Petition for ReconsiderationWorkers' Compensation Appeals BoardLien ClaimantStatute of LimitationsBurden of ProofSubstantial Medical EvidencePrima Facie CaseRebuttal EvidenceProper ReferralCompromise and Release
References
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