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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
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. ADJ9180631
Regular
Jan 15, 2015

JUAN CARLOS DONATO RUIZ vs. AMERICAN CABLE, INC.; CALIFORNIA INSURANCE COMPANY c/o APPLIED RISK SERVICES

This case involves a petition for reconsideration that was dismissed by the Workers' Compensation Appeals Board (WCAB). The WCAB found that the petition was not taken from a "final" order that determined substantive rights or liabilities. Furthermore, the WCAB denied the petition's request for removal, adopting the reasoning of the administrative law judge. The applicant did not demonstrate substantial prejudice or irreparable harm from the denial of removal.

Petition for ReconsiderationFinal OrderSubstantive RightLiabilityInterlocutory OrderProcedural DecisionEvidentiary DecisionRemovalSubstantial PrejudiceIrreparable Harm
References
Case No. ADJ4629950
Regular
Dec 21, 2012

JOHNNY BETTENCOURT vs. DONALD WILLIAMS, SAFECO INSURANCE COMPANY, UNINSURED EMPLOYERS' BENEFIT TRUST FUND DEPARTMENT OF INDUSTRIAL RELATIONS

The Uninsured Employers' Benefit Trust Fund (UEBTF) sought reconsideration, arguing Safeco's policy covered the applicant's injury. The Arbitrator previously ruled Safeco had no liability as its policy with Donald Williams did not include "comprehensive personal liability" insurance as required by Insurance Code section 11590. The Appeals Board affirmed this decision, finding the Safeco policy explicitly limited coverage to premises liability and lacked the necessary language for comprehensive personal liability coverage. Therefore, Safeco was correctly found not liable for the applicant's injury.

Uninsured Employers' Benefit Trust Fundcomprehensive personal liability insuranceLabor Code section 3351(d)Labor Code section 3352(h)Insurance Code section 11590premises liability insuranceSafeco Insurance CompanyDonald WilliamsJohnny Bettencourtworker's compensation coverage
References
Case No. ADJ2497883 (SFO 0450940) ADJ3261393 (SFO 0504693)
Regular
Apr 30, 2010

JANETTE HARDIN vs. COUNTY OF ALAMEDA, SEDGWICK CLAIMS MANAGEMENT SERVICES, CHARTIS INSURANCE, TRISTAR RISK MANAGEMENT

This case involves Chartis Insurance seeking reconsideration of an arbitrator's decision setting the date of cumulative trauma injury for Janette Hardin's breast cancer as May 28, 1997, not the previously stipulated date of May 16, 2001. Chartis argued the stipulated date was res judicata and could not be altered, especially in a contribution proceeding. The Workers' Compensation Appeals Board denied the petition, affirming that contribution proceedings allow for a relitigation of liability and the determination of the true date of injury based on facts, not prior stipulations between the applicant and one defendant. The Board reasoned that findings of liability in the primary case are not binding in supplemental contribution proceedings.

Cumulative traumaDate of injuryContribution proceedingsRes judicataStipulated awardLabor Code section 5500.5Apportionment of liabilityCase-in-chiefSupplemental proceedingsGreenwald v. Carey Distribution Company
References
Case No. ADJ6925626
Regular
Jun 21, 2010

Nicholas Barragan vs. DPR Construction, National Union Fire Insurance

The applicant claimed an industrial injury on October 31, 2006, but the employer denied liability on January 4, 2007. Despite this denial, the applicant did not file an Application for Adjudication of Claim until September 10, 2009. The Board found the petition for reconsideration timely as it was filed within fifteen days of the defendant receiving the Findings and Award. Ultimately, the claim was dismissed as barred by the statute of limitations under Labor Code section 5405 because no benefits were provided after the denial and the application was filed more than one year after the denial.

Workers' Compensation Appeals BoardReconsiderationStatute of LimitationsLabor Code Section 5405Denial of LiabilityApplication for Adjudication of ClaimTimelinessFindings and AwardPetition for ReconsiderationIndustrial Injury
References
Case No. ADJ3174060 (POM 0298614) ADJ1144360 (POM 0298615) ADJ4338662 (POM 0298616)
Regular
Jan 17, 2014

ALEJANDRO BRAVO vs. A. W. COULTER, INC.; NATIONAL INTERSTATE INSURANCE

The Workers' Compensation Appeals Board (WCAB) dismissed Applicant's Petition for Reconsideration because it was not taken from a "final" order that determined substantive rights or liabilities. The WCAB also denied the petition for removal, finding no showing of substantial prejudice or irreparable harm. The decision to dismiss the reconsideration petition is based on established legal definitions of final orders in workers' compensation cases. The denial of removal adopts the reasoning of the administrative law judge.

Petition for ReconsiderationDenial of RemovalFinal OrderInterlocutory OrderSubstantive RightLiabilityNon-Final OrderProcedural DecisionEvidentiary DecisionAdministrative Law Judge
References
Case No. ADJ1747488
Regular
Dec 19, 2011

ADRIENNE BOYLAN vs. NEW COVENANT CARE GROUP, STATE COMPENSATION INSURANCE FUND

This case concerns the defendant's petition for reconsideration of a prior Board decision. The Board previously affirmed the dates of temporary disability for the applicant but amended the original award to grant the full value of temporary disability indemnity, rather than an apportioned percentage. The defendant argued against this full award, but the Board found that while liability for indemnity can be apportioned between defendants, an employee's entitlement to temporary disability indemnity cannot be apportioned. The Board denied the petition for reconsideration, reaffirming that the defendant is solely liable for the full value of temporary disability indemnity.

Temporary Disability IndemnityCumulative Trauma InjuryApportionment of LiabilityExclusive LiabilityLabor Code Section 3208.2FibreboardGranadoWCAB OpinionPetition for ReconsiderationSpecific Injury
References
Case No. ADJ1293553 (VNO 0460149)
Regular
Dec 14, 2018

CHARLES HOLDER vs. TROY CHRISTIAN dba ADVENTURE LIMOUSINE, THE HARTFORD INSURANCE COMPANY

This case concerns a lien claimant's challenge to a WCJ's decision limiting fees to the Official Medical Fee Schedule. The Appeals Board dismissed the petition for removal, finding it improperly filed as the WCJ's order was a final determination of substantive liability. The Board treated the filing as a petition for reconsideration, which was subsequently denied. The claimant's attempt to seek removal was improper because reconsideration was the adequate remedy.

Workers' Compensation Appeals BoardPetition for RemovalPetition for ReconsiderationWCJ reportOfficial Medical Fee ScheduleLien claimantSubstantive rightLiabilityThreshold issueFinal order
References
Case No. ADJ3220762 (ANA 0379828), ADJ795332 (LBO 0347836)
Regular
Nov 06, 2013

MARIA REYES vs. WESTERN MEMORIAL SERVICE CORPORATION, ZENITH INSURANCE

This case involves a petition for reconsideration and removal related to Workers' Compensation Appeals Board Case Nos. ADJ3220762 and ADJ795332. The Appeals Board dismissed the petition for reconsideration because it was not taken from a "final" order that determined a substantive right or liability. The Board also denied removal, finding no showing of substantial prejudice or irreparable harm required for this extraordinary remedy. Therefore, the petition was dismissed and removal was denied.

Petition for ReconsiderationFinal OrderInterlocutory OrderSubstantive RightLiabilityExtraordinary RemedySubstantial PrejudiceIrreparable InjuryWorkers' Compensation Appeals BoardRemoval
References
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