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

Case No. ADJ7017513
Regular
May 14, 2014

ARTURO JACOBO vs. DUCOMMUN AERO STRUCTURES, TRAVELERS INSURANCE COMPANY

In case ADJ7017513, the Workers' Compensation Appeals Board (WCAB) denied Arturo Jacobo's Petition for Reconsideration. The WCAB adopted and incorporated the reasoning of the administrative law judge's report. The Board considered the applicant's response to the report before issuing its denial. Therefore, the petition for reconsideration was officially denied by the WCAB.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law Judge ReportCal. Code Regs. tit. 8 § 10848WCAB Rules of Practice and ProcedureDenying PetitionDucommun Aero StructuresTravelers Insurance CompanyArturo JacoboADJ7017513
References
Case No. OAK 328137
Regular
Aug 20, 2007

AARON DE MATTEO vs. JOINERY STRUCTURES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration, upholding the liability of Joinery Structures and State Compensation Insurance Fund for the applicant's vocational expert costs. The Board affirmed that vocational expert fees are recoverable expenses under Labor Code Section 5811, as such testimony is relevant to determining permanent disability and aligns with the mandate for expeditious and inexpensive resolution. The denial also addressed the defendants' arguments regarding the timing of the expert's report and its compliance with specific Labor Code sections, finding them unpersuasive.

WORKERS' COMPENSATION APPEALS BOARDReconsiderationApplicantDefendantJOINERY STRUCTURESSTATE COMPENSATION INSURANCE FUNDWCJvocational expertloss of future earning capacity1997 Guidelines
References
Case No. ADJ10574278
Regular
Oct 08, 2018

SERGIO GUTIERREZ vs. STRUCTURAL ALTERNATIVE SOLUTION CONCEPTS, NATIONAL UNION FIRE INSURANCE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration, rescinded the previous decision, and returned the case for further development of the record. The WCAB found the prior judge erred in solely attributing the applicant's temporary disability to the defendant, Structural Alternative Solution Concepts. Medical evidence suggests the applicant may have sustained multiple cumulative injuries during subsequent employment. The WCAB mandates a review of potential consolidation of cases and requires medical evaluators to provide an analysis regarding the number and causation of injuries.

Cumulative injuryPetition for reconsiderationAgreed medical evaluatorTemporary disabilityCausationIndustrial injuryLeft elbowLeft bicep tendonLeft shoulderLow back
References
Case No. ADJ3357383 (LAO 0845427)
Regular
Nov 26, 2013

LARRY ALVES vs. PANELIZED STRUCTURES, STATE COMPENSATION INSURANCE FUND

This case concerns Larry Alves' claim for psychiatric injury following a physical injury sustained while employed for less than six months. The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior ruling favoring the applicant. The WCAB found the psychiatric claim barred under Labor Code § 3208.3(d) because the applicant's employment was too short and the injury was not caused by a "sudden and extraordinary" employment condition. The Board concluded that an injury from a falling truss, though unfortunate, is not extraordinary in construction work.

Labor Code section 3208.3(d)psychiatric injurysudden and extraordinary employment conditionsix-month employment requirementfalling trusscarpenterconstruction workerpanelized structuresState Compensation Insurance FundWorkers' Compensation Appeals Board
References
Case No. ADJ2199065 (POM 0234343)
Regular
Apr 13, 2011

JAMES NORTHCUTT vs. PANELIZED STRUCTURES, CIGA by SEDGWICK CMS for CALIFORNIA COMPENSATION, STATE COMPENSATION INSURANCE FUND

This case involves a petition for reconsideration by the California Insurance Guarantee Association (CIGA) regarding a workers' compensation award. CIGA argued the administrative law judge erred in denying a cumulative trauma injury claim contrary to medical evaluator findings, and in awarding excessive funds to a lien claimant, the County of San Diego. The Workers' Compensation Appeals Board granted reconsideration, adopting the judge's report recommending an amendment to the award. The award will be amended to pay the County of San Diego $25,682.50.

CIGAPanelized StructuresIndustrial injuryCumulative injuryAgreed Medical EvaluatorLien claimantCounty of San DiegoNew moneyAttorney's feesPermanent disability advances
References
Case No. ADJ9405272
Regular
Feb 03, 2015

JACQUELINE LOTT vs. UNIVERSITY OF CALIFORNIA LOS ANGELES

The Workers' Compensation Appeals Board granted reconsideration, overturning a prior decision that barred the applicant's claim under the going and coming rule. The Board found the applicant sustained an industrial injury on March 19, 2014, while employed as an administrative assistant. The injury occurred as she slipped and fell in a parking structure while on an unpaid lunch break, on the shortest route from her office to a snack bar. The Board determined this incident fell within the "reasonable margin of time and space" for ingress and egress from the employer's premises.

going and coming ruleindustrial injuryworkers' compensationadministrative assistantoffice complexparking structureunpaid lunch breakingress and egresspremises line rulecompensable
References
Case No. ADJ164815 (SAL 0049263)
Regular
Apr 01, 2020

Pamela McGowne Willoughby vs. Hoge, Fenton, Jones \u0026 Appel, American Home Assurance

The Workers' Compensation Appeals Board (WCAB) reconsidered an administrative law judge's (ALJ) disapproval of a Compromise and Release (C&R). The ALJ found the C&R unlawful due to an alleged assignment of liability, citing Labor Code section 4900. The WCAB clarified that while an injured worker cannot assign their claim, a structured settlement where a third party pays the insurer's obligation with the worker's consent is permissible. After reviewing the financial stability of the annuity provider, the WCAB found the settlement adequate and in the applicant's best interest, thus rescinding the disapproval and approving the C&R.

Compromise and ReleaseMedicare Set AsideStructured SettlementAssignment of LiabilityLabor Code Section 4900Matthews v. Liberty Assignment Corp.WCAB Rule 10700Financially SoundPeriodic PaymentsAnnuity
References
Case No. ADJ9721385
Regular
Jun 07, 2016

JUAN PABLO BELTRAN vs. STRUCTURAL STEEL FABRICATORS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, overturning a WCJ's order that disallowed settlement of a Supplemental Job Displacement Benefit (SJDB) voucher. The Board held that parties can settle an SJDB voucher claim in a Compromise and Release Agreement if a good faith dispute exists that could defeat the applicant's entitlement to all workers' compensation benefits. In this case, the applicant's failure to report the injury before termination constituted such a good faith dispute, allowing the settlement of the SJDB voucher. The Board therefore approved the parties' original Compromise and Release Agreement, including the settlement of the SJDB voucher.

Supplemental Job Displacement BenefitCompromise and ReleaseGood Faith DisputeSB863Vocational RehabilitationLabor Code Section 4658.7Petition for ReconsiderationWorkers' Compensation Appeals BoardAffirmative DefenseAOE/COE
References
Case No. ADJ3705074
Regular
Nov 18, 2015

DIANA BADYRKA vs. REGENTS OF THE UNIVERSITY OF CALIFORNIA SAN DIEGO

This case involves a worker's compensation claim by Diana Badyrka against the Regents of the University of California San Diego for bilateral foot and ankle injuries. The applicant sought reconsideration of the Workers' Compensation Judge's (WCJ) decision regarding apportionment of her permanent disability. The WCJ found that 50% of the applicant's impairment was due to a congenital foot structure, a position supported by medical evaluations from both the Qualified Medical Evaluator and the applicant's treating physician. The WCAB adopted the WCJ's report, denying the petition for reconsideration.

WCABPetition for ReconsiderationdeniedRegents of the University of California San DiegoSedgwick CMSnursebilateral feet and anklesapportionmentpermanent disabilityQualified Medical Evaluator (PQME)
References
Case No. ADJ3767421 (SFO 0438615)
Regular
Aug 02, 2010

MICHELLE ROUTSON vs. JOHN EVANS, D.D.S., ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision that found it lacked jurisdiction over a petition to transfer structured settlement payment rights. The WCAB rescinded the prior decision, holding that the five-year limitation under Labor Code section 5804 does not apply to commutations of compensation payments. Instead, such matters are governed by Labor Code section 5100, which allows the WCAB to commute payments at any time if certain conditions are met. The case is returned to the trial level for the WCJ to determine if the proposed transfer satisfies section 5100 and related Insurance Code provisions.

Structured settlement transferPetition for ApprovalInsurance Code §10134Labor Code §5804commutationWorkers' Compensation Appeals Boardjurisdictionrescindedfive-year limitationLabor Code §5100
References
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