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

Case No. ADJ3885285 (FRE 0248529) ADJ3795787 (FRE 0247126)
Regular
Dec 30, 2008

Larry Shores vs. CITY OF MADERA; ACCLAMATION FRESNO

This case concerns a worker's compensation claim for a back and spine injury sustained by Larry Shores. The Board granted reconsideration, rescinded sanctions imposed on the defendant for litigation tactics, and rescinded a penalty for delayed temporary disability payments. However, it otherwise affirmed the finding of industrial injury, awarded penalties for unreasonable delay in medical treatment, and upheld the need for ongoing medical care, including surgery.

Workers' Compensation Appeals BoardLarry ShoresCity of MaderaAcclamation FresnoADJ3885285ADJ3795787Opinion and Order Granting ReconsiderationFindings and AwardWCJIndustrial Injury
References
Case No. ADJ10330377
Regular
Jul 10, 2017

Taylor Baugh vs. Action Holdings, Inc., XL Specialty Insurance

This case concerns a defendant's petition for reconsideration regarding a 10% penalty for underpayment of temporary disability benefits. The Workers' Compensation Appeals Board granted reconsideration and amended the original decision. The penalty was adjusted to apply only to the specific amount of temporary disability that was delayed, not the entire awarded sum, in accordance with Labor Code section 5814.

Labor Code section 5814Petition for ReconsiderationTemporary DisabilityUnderpaymentPenaltyWCJWorkers' Compensation Appeals BoardFindings and AwardDecision After Reconsiderationunreasonable delay
References
Case No. ADJ2464522 (OAK 0338150)
Regular
Feb 19, 2013

CHARLES COWART vs. JACK IN THE BOX, INC.

The Workers' Compensation Appeals Board granted reconsideration, rescinding the prior award of penalties for unreasonable delay in funding an annuity. The Board found that applicant's own delay in providing necessary information was the primary cause of the annuity funding delay, thus not warranting a penalty. However, the Board affirmed a $10,000 penalty for the employer's unreasonable delay in paying applicant's attorney's fees, to be paid to the applicant, not the attorney. Attorney's fees for enforcing the compromise and release were deferred for trial level resolution.

Workers' Compensation Appeals BoardCompromise and ReleaseLabor Code section 5814PenaltyUnreasonable DelayAnnuity FundingAttorney's FeesReconsiderationFindings and AwardDecision After Reconsideration
References
Case No. ADJ2562535 (BAK 0151733)
Regular
Jan 07, 2014

STEVE ADAMS vs. COUNTY OF KERN, Permissibly Self-Insured

The Workers' Compensation Appeals Board reversed a finding that the defendant did not unreasonably delay compensation payments. The applicant sustained an industrial injury to his pulmonary system, and medical evidence confirmed the injury was work-related. The Board found that despite the existence of an agreed medical examiner's report confirming the injury, the defendant's denial of liability persisted for an unreasonable period. Consequently, the defendant was found to have unreasonably delayed payments for temporary disability, permanent disability, and mileage reimbursement, with the penalty amount to be determined.

Industrial InjuryPulmonary SystemCode Compliance OfficerPermanent DisabilityReconsiderationLabor Code 5814Delay PenaltiesAgreed Medical ExaminerPulmonary DiseaseOccupational Asthma
References
Case No. ADJ13332737, ADJ15218980, ADJ12640295
Significant

ABEL HIDALGO, et al. vs. ROMAN CATHOLIC ARCHBISHOP, permissibly self-insured, administered by SEDGWICK, et al.

The Workers' Compensation Appeals Board imposed sanctions totaling $15,000 against attorneys Susan Garrett and Lance Garrett for filing frivolous petitions for reconsideration with the willful intent to disrupt or delay court proceedings.

Labor Code Section 5813SanctionsWillful IntentImproper MotiveIndisputably Without MeritPetitions for ReconsiderationDelay of ProceedingsReasonable ExpensesAttorney's FeesEn Banc Decision
References
Case No. ADJ2529270 (MON0205624)
Regular
Dec 17, 2010

ZOI FOVOS vs. LOS ANGELES UNIFIED SCHOOL DISTRICT permissibly self insured c/o SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration of a prior decision that found an award was paid timely without penalties. Applicant contended the defendant failed to include interest with the award payment, entitling them to penalties and attorney fees. The Board found the WCJ's decision failed to address the timeliness of interest payment and the applicability of penalties under Labor Code sections 5814 and 5814.5. The case is returned to the WCJ for further proceedings and a new decision regarding potential penalties and attorney fees for the delayed interest payment.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings of FactAwardPenaltyAttorney's FeeInterest on AwardLabor Code Section 4650Labor Code Section 5814Labor Code Section 5814.5
References
Case No. ADJ8890109 ADJ8890125
Regular
Jan 09, 2017

ELIZABETH BURGOS vs. IMAGEFIRST HEALTHCARE LAUNDRY SPECIALIST; TRAVELERS

The applicant sought removal from a Workers' Compensation Appeals Board decision finding no denial of care. The applicant argued a 43-day delay in authorizing a change to a new treating physician within the defendant's MPN constituted denial of care. The Board denied removal, finding the applicant did not prove denial of care, as there was no evidence of inability to obtain treatment or refusal by the defendant. Furthermore, the applicant's requested change of physician occurred after the initial 30-day window, thus not falling under Labor Code section 4601(a).

Workers' Compensation Appeals BoardPetition for RemovalJoint Findings and AwardStipulations with Request for AwardPrimary Treating Physician (PTP)Medical Provider Network (MPN)Denial of CareLabor Code section 4601(a)Labor Code section 4600Cal. Code Regs.
References
Case No. SJO 0245865 SJO 0245864 SJO 0245866
Regular
Apr 22, 2008

ANITA REXINGER vs. ELECTROLUX CORPORATION, WAUSAU INSURANCE COMPANIES

The Appeals Board granted reconsideration to clarify vocational rehabilitation temporary disability (VRTD) benefits, holding that earnings from subsequent employment may offset VRTD if the applicant was not concurrently employed at the time of injury. The Board also directed that VRTD benefits should be reduced by unemployment insurance paid for the same period and affirmed the applicant's 1997 W-2 as the basis for calculating average weekly earnings. Finally, the Board rescinded the prior award and returned the matter for further proceedings, including potential reconsideration of the unreasonable delay penalty.

VOCATIONAL REHABILITATIONRECONSIDERATIONSTIPULATIONSPERMANENT DISABILITYREHABILITATION UNITDELAY RATEAVERAGE WEEKLY WAGEATTORNEY FEESCREDIT FOR EARNINGSUNREASONABLE DELAY
References
Case No. ADJ10183558 ADJ10183560
Regular
2020-00-00

MONA BALDWIN vs. FRESH & EASY, LLC, AIG CLAIM SERVICES

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior order, affirming sanctions against applicant's attorney, Joseph M. Roberts, individually, for engaging in tactics causing unreasonable delay and expense. The WCAB found that Roberts knew or should have known his actions regarding attorney's fees were frivolous and unnecessary. However, the WCAB amended the original order to remove sanctions against Roberts' law firm, as proper notice was not provided to the firm. The decision also clarified that the issue of attorney's fees and costs was not barred by res judicata and that the judge had authority to impose sanctions on the individual attorney.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Findings of Fact and OrdersSanctionsAttorney's FeesLabor Code section 5813Res JudicataDue ProcessWCJ AuthorityFrivolous Delay
References
Case No. ADJ2192154
Regular
Feb 22, 2011

IRMA ZAMORA vs. STATE OF CALIFORNIA DEPARTMENT OF AGRICULTURE, Legally Uninsured

This case involves an applicant's petition to reopen for new and further disability following a previous workers' compensation award for back injury. The defendant sought reconsideration, arguing the judge erred by not crediting prior disability payments and by awarding a penalty on the entire new and further disability. The Workers' Compensation Appeals Board denied reconsideration, finding the judge's award implicitly credited prior payments and that a penalty was warranted due to unreasonable delay in payment following receipt of an Agreed Medical Examiner's report indicating increased disability. The Board corrected a clerical error in the award to clarify credit was given.

WORKERS' COMPENSATION APPEALS BOARDLegally UninsuredPetition to Reopennew and further disabilitypermanent disabilitypenaltydelayed paymentStipulated AwardAgreed Medical ExaminerLabor Code §4650
References
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