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

Case No. ADJ7308922
Regular
Apr 22, 2013

ARTURO CARO vs. JAX MARKET 3, FIREMAN'S FUND

The Workers' Compensation Appeals Board granted reconsideration of an order dismissing a lien claim, finding that the lien claimant's representative misrepresented facts regarding payment of a lien activation fee. Despite the claimant's verified petition claiming payment was made and evidence presented, the Board's own search and the WCJ's report confirmed non-payment. Consequently, the Board issued a notice of intention to impose sanctions up to $2,500 against Qualified Billing & Collections and Diego Plasencia for bad-faith actions and false statements.

Lien Activation FeeLabor Code Section 4903.06WCJ Order Dismissing LienPetition for ReconsiderationVerified PetitionMisrepresentation of FactsBad Faith ActionsWCAB Rule 10561Labor Code Section 5813Sanctions
References
0
Case No. ANA 0347858
Regular
Sep 12, 2008

KEYIN L. ROSS vs. SAN DIEGO CHARGERS and LEGION INSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION (CIGA), SAN DIEGO CHARGERS, KANSAS CITY CHIEFS, TIG

The WCA's decision is affirmed for two reasons: Kansas City is wrong in claiming that San Diego was self-insured, and CIGA's statutes preclude Kansas City from recovering from San Diego.

Workers' Compensation Appeals BoardCIGALegion Insurance CompanyKansas City ChiefsSan Diego Chargerscontributioninsolvent insurercovered claimsInsurance Code section 1063.1(c)(5)deductible reimbursement
References
5
Case No. ADJ4357759 (SDO 0267149) ADJ4317475 (SDO 0359844)
Regular
Sep 09, 2010

SUSAN KUJAWA vs. SAN DIEGO UNIFIED SCHOOL DISTRICT, NOVATO UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied San Diego Unified School District's petition for reconsideration regarding apportionment of temporary disability liability. The Board found that jurisdiction was not barred by the five-year statute of limitations, as the issue of temporary disability remained outstanding until settlement approval. The Board upheld its prior decision to apportion 94% of temporary disability to San Diego Unified and 6% to Novato Unified, based on the Agreed Medical Evaluator's opinion and party stipulations. San Diego Unified's arguments regarding jurisdiction and reliance on the AME's medical opinion were found to be without merit.

ApportionmentTemporary DisabilityPetition for ReconsiderationAgreed Medical Evaluator (AME)Stipulations and AwardsJurisdictionStatute of LimitationsContributionMedical OpinionPermanent Disability
References
6
Case No. ADJ8012651; ADJ8008848
Regular
Sep 01, 2015

MARCELA QUIRINO vs. MARMALADE CAFÉ, Permissibly SelfInsured, CALIFORNIA RESTAURANT MUTUAL BENEFIT CORPORATION, AMERICAN CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to review sanctions imposed on lien claimants, specifically Dr. Rubanenko, Qualified Billing & Collections LLC (QBC), and its employee Diego Plasencia. The WCAB affirmed that sanctions and dismissal of lien claims were warranted due to Plasencia's unauthorized abandonment of a trial, which constituted bad faith and caused unnecessary delay. However, the WCAB rescinded sanctions against other lien claimants, finding insufficient evidence of proper notice. Ultimately, the WCAB ordered Dr. Rubanenko, QBC, and Plasencia jointly and severally to pay $2,500 each in sanctions, totaling $7,500, and affirmed the dismissal of the lien claims.

Workers' Compensation Appeals BoardLien claimantsJoint Petition for ReconsiderationJoint Findings and AwardAttorney's feesSanctionsWCJBad faith actionsUnnecessary delayDue process
References
0
Case No. SDO 0249452
Regular
May 12, 2008

GAIL GODFREY vs. COUNTY OF SAN DIEGO, PROFESSIONAL RESOURCE ENTERPRISE, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION by BROADSPIRE for SUPERIOR PACIFIC CASUALTY COMPANY

The California Workers' Compensation Appeals Board found that the County of San Diego was the applicant's special employer, making them jointly and severally liable for her injury. This determination was made despite a contract stating the applicant was not a County employee, as the Board found sufficient evidence of San Diego's control over her work. Consequently, the County is considered "other insurance available" to the applicant, meaning CIGA is not liable for her benefits.

CIGAcovered claimspecial employergeneral employerlabor brokerageindustrial injuryinsolvent insurerother insurancejoint and several liabilitycontractual exclusion
References
14
Case No. ADJ755792
Regular

KIT DAWSON vs. SAN DIEGO TRANSIT

This case involves Kit Dawson's workers' compensation claim against San Diego Transit. The applicant, Dawson, sought reconsideration of a decision by the Workers' Compensation Appeals Board (WCAB). The WCAB reviewed the petition and the judge's report. Ultimately, the WCAB denied reconsideration, adopting the reasoning of the administrative law judge.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgePermit Self-InsuredDenial of ReconsiderationCase ADJ755792Case SDO 0261150
References
0
Case No. ADJ8866375
Regular
Nov 18, 2016

KRISTINA SCOTT vs. COUNTY OF SAN DIEGO

This case before the Workers' Compensation Appeals Board concerns a petition for reconsideration filed by Kristina Scott against the County of San Diego. The WCJ issued a Findings, Award and Order on August 30, 2016. The petition for reconsideration has since been withdrawn by the applicant. Therefore, the Board has issued an order dismissing the petition for reconsideration.

Petition for ReconsiderationWithdrawnDismissedFindings Award and OrderWorkers' Compensation Appeals BoardWCJSan Diego District OfficeApplicantDefendantAdministrative Law Judge
References
0
Case No. ADJ1750055 (SDO0289470); ADJ184723 (SDO0289471)
Regular
Apr 24, 2023

BEDFORD PALMER vs. SAN DIEGO GAS & ELECTRIC/SEMPRA ENERGY

The Workers' Compensation Appeals Board (WCAB) rescinded a prior award and remanded the case for further proceedings. The WCAB found that the applicant's hypertension claim, which was key to his temporary disability claim, had not been formally accepted or denied. Furthermore, the WCAB noted ambiguity regarding whether the applicant retired voluntarily or due to his industrial injuries, impacting his entitlement to temporary disability benefits. The case is returned to the WCJ to develop the record on these crucial issues and issue a new decision.

Workers' Compensation Appeals BoardTemporary Total DisabilityVocational Rehabilitation Temporary DisabilityPetition for ReconsiderationJoint Findings Award and OrderAdministrative Law JudgeInternal System InjuryHypertensionAgreed Medical ExaminerStipulation
References
6
Case No. ADJ3600842
Regular
Sep 21, 2009

THEMAS POULIN vs. COUNTY OF SAN DIEGO

In this Workers' Compensation Appeals Board case, the defendant, County of San Diego, petitioned for reconsideration of a prior decision. The Board has granted the petition to allow for a more thorough review of the factual and legal issues presented. This reconsideration is necessary to ensure a complete understanding of the record and to render a just and reasoned decision. Pending further proceedings, all communications are to be directed to the Board's Office of the Commissioners.

Workers' Compensation Appeals BoardPetition for ReconsiderationGranting ReconsiderationSan Diego CountyPermissibly Self-InsuredJuly 2 2009 decisionStatutory time constraintsFactual and legal issuesJust and reasoned decisionDecision After Reconsideration
References
0
Case No. ADJ10091554
Regular
Jun 24, 2019

GIUSEPPE MORICI vs. COUNTY OF SAN DIEGO

The Workers' Compensation Appeals Board denied the County of San Diego's petition for reconsideration. The Board affirmed the administrative law judge's finding that the applicant sustained a compensable psychiatric injury. The judge determined the injury was predominantly caused by actual employment events, not lawful personnel actions or the applicant's subjective perceptions. The Board deferred to the judge's credibility determinations based on observed demeanor.

Workers' Compensation Appeals BoardGiuseppe MoriciCounty of San Diegopsyche injurycompensablegood faith personnel actionssubjective misperceptionReport and RecommendationWCJ credibility determinationpreponderance of evidence
References
1
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