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

Case No. ADJ1200873 (OAK 0337904) ADJ479879 (OAK 0337905)
Regular
Apr 06, 2009

CARMEN CHACON vs. NATIONAL UPHOLSTERING CO., NATIONAL LIABILITY & FIRE INS. CO.

The Workers' Compensation Appeals Board (WCAB) rescinded an approved Compromise and Release (C&R) agreement due to potential mutual mistake of fact regarding duplicate payments of Temporary Disability Indemnity (TDI) and Unemployment Insurance (UI). Both the defendant and the Employment Development Department (EDD) sought reconsideration, arguing the original order did not adequately protect their interests regarding these duplicate payments. The WCAB found that EDD's due process rights were violated by a lack of proper notice and service regarding the C&R. The matter was returned to the trial level for a new decision to determine if a mutual mistake occurred and to consider EDD's lien.

Workers' Compensation Appeals BoardCarmen ChaconNational Upholstering Co.National Liability & Fire Ins. Co.Employment Development Department (EDD)Compromise and Release (C&R)Order Approving Compromise and Release (OACR)Mutual Mistake of FactDuplicate PaymentsTemporary Disability Indemnity (TDI)
References
Case No. ADJ6604427, ADJ8192308
Regular
Jul 31, 2014

CHERRICE MORRIS-GAINES vs. AC TRANSIT, SEDGWICK CLAIMS MANAGEMENT SERVICES

In this workers' compensation case, the applicant initially stipulated to a lower average weekly wage, which the Board found to be a final determination that could not be revisited due to lack of good cause and the five-year statute of limitations. The Board affirmed the employer's credit for payments made to the Employment Development Department (EDD) to prevent double recovery. Furthermore, the Board found no unreasonable delay by the employer in payments to EDD, thus denying the applicant's penalty claim. Finally, the Board rescinded the order requiring the applicant's attorney to repay fees voluntarily paid by EDD, as such repayment was not mandated by law.

Workers' Compensation Appeals BoardAC TransitSedgwick Claims Management ServicesADJ6604427ADJ8192308bus drivercumulative traumatemporary disability indemnityLabor Code section 4656(c)(2)mandatory settlement conference
References
Case No. ADJ1167245
Regular
Jun 03, 2013

RONALD THOMPSON vs. BLOCKA CONSTRUCTION, INC., SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to amend an award concerning an electrocution injury. The Board modified the award to have the EDD lien for duplicative payments deducted from the applicant's permanent disability award, rather than reimbursed separately by the defendant, and rescinded the award of interest to EDD. The Board affirmed the WCJ's findings of 100% permanent disability without apportionment and the exclusion of sub rosa video evidence. The matter was returned to the WCJ to recalculate the commutation of the award to incorporate the EDD lien payment.

Electrocution injuryPermanent disabilityApportionmentSub rosa videoEDD lienCommutationDuplicative paymentsVocational rehabilitationMedical evidenceCardiac disability
References
Case No. ADJ8753985; ADJ8753959
Regular
Dec 02, 2015

BOB BORBECK vs. ACE BUILDING MAINTENANCE, ZURICH NORTH AMERICA

This case concerns a dispute over a workers' compensation lien filed by the Employment Development Department (EDD). The defendant, Ace Building Maintenance, settled a workers' compensation claim via Compromise and Release (C&R) with the applicant, Bob Borbeck, while aware of EDD's lien for unemployment benefits that duplicated temporary disability payments. The defendant argues they provided sufficient notice to EDD regarding benefit payments and should not be liable for the lien. However, the Board denied the defendant's petition for reconsideration, finding them liable for EDD's lien because they settled the case without resolving it, thus agreeing to pay any subsequently determined amount.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Findings and OrderCompromise and ReleaseEDD LienUnemployment Compensation BenefitsTemporary Disability BenefitsLabor Code Section 4904Notice of Lien ClaimDuplicate Benefits
References
Case No. VNO 0479500
Regular
Aug 06, 2007

RICHARD GREEN vs. SINCLAIR COMPANY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to address a denied lien claim by the Employment Development Department (EDD). The Board found that the EDD's lien was improperly denied by operation of law, despite the defendant's awareness of it and the applicant potentially receiving duplicate payments. The case is returned to the trial level for further proceedings to determine the merits of the EDD's lien and the issue of duplicate recovery.

EDD lienPetition for ReconsiderationFindings and AwardDuplicate RecoveryLabor Code Section 5815Industrial InjuryTemporary DisabilityPermanent DisabilityUCD BenefitsWCJ Authority
References
Case No. ADJ1241059 (POM 0299949)
Regular
May 14, 2009

Jose Contreras vs. OMEGA EXTRUDING CORP OF CALIFORNIA, GALLAGHER BASSETT CORONA

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior Order Approving Compromise and Release. The applicant sought review, alleging discrimination and inadequacy of the $\$ 17,500$ settlement due to fear and a lack of understanding regarding his legal status. The Board found the record incomplete, specifically noting the absence of medical reports supporting the settlement's adequacy and discrepancies in EDD payment reimbursements. Consequently, the matter was returned to the trial level for further proceedings to obtain necessary documentation and ensure the settlement's fairness.

Workers Compensation Appeals BoardCompromise and ReleaseReconsiderationIn Propria PersonaAgreed Medical ExaminerDuplicative EDD PaymentsMedical ReportsBenefits Payment RecordsTrial LevelScared
References
Case No. ADJ4025440 (VNO 0557895)
Regular
Mar 12, 2012

CHARLES B. HANLON vs. WYLE HOLDINGS, INC., AIG adjusted by CHARTIS CLAIMS, INC.

The Workers' Compensation Appeals Board granted reconsideration to clarify an ambiguous award for temporary disability benefits. The applicant sustained a cumulative injury resulting in temporary and permanent disability. The defendant argued the award was unclear regarding the coordination of temporary disability payments with benefits already paid by the Employment Development Department (EDD). The Board clarified that the applicant is to be compensated for temporary disability, less amounts paid by EDD, with adjustments potentially needed to match the agreed-upon temporary disability rate. Furthermore, the Board clarified that EDD's overpayments of unemployment benefits made after the applicant's permanent and stationary date are to be reimbursed from the applicant's permanent disability benefits.

Cumulative industrial injuryTemporary disability indemnityPermanent disability benefitsPetition for ReconsiderationFindings and AwardAmbiguous awardEDD benefitsLabor Code §4904Agreed Medical ExaminerTemporary total disability
References
Case No. ADJ8307394
Regular
Nov 16, 2015

ROSALIO ESPARZA-SALAS vs. INTERAMERICAN MOTOR CORPORATION, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

This case involves an applicant appealing a decision awarding a lien for the Employment Development Department (EDD). The applicant argued EDD failed to prove its lien was duplicative of permanent disability benefits. The Appeals Board granted reconsideration to further examine the issue. The Board affirmed the original award but deferred the EDD lien, remanding the case for further proceedings to develop evidence on proper notice and potential duplicate payments.

ROSALIO ESPARZA-SALASINTERAMERICAN MOTOR CORPORATIONTRAVELERS PROPERTY CASUALTY COMPANY OF AMERICAADJ8307394OPINION AND DECISION AFTER RECONSIDERATIONEmployment Development Department (EDD)lienpermanent disability awardduplicative benefitsMedical Provider Network
References
Case No. ADJ7917429
Regular
Mar 10, 2014

ROBERTO SALAZAR vs. WTS INTERNATIONAL, INC., TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

This case concerns a dispute over defendant's credit for Employment Development Department (EDD) payments against the applicant's permanent disability award. Initially, the WCJ granted the defendant credit for the entire period EDD paid benefits. Upon reconsideration, the Appeals Board clarified that the defendant is only entitled to credit for EDD payments made from January 2, 2012, to May 10, 2012, as these were effectively permanent disability advances. The Board rescinded the original award and amended the findings to reflect this adjusted credit.

Petition for ReconsiderationStipulated AwardPermanent DisabilityTemporary DisabilityCredit for PaymentsEmployment Development DepartmentEDDState Disability InsuranceSDIReimbursement
References
Case No. VNO 541859
Regular
Jan 03, 2008

FAUSTINO SANDOVAL vs. NUTRITION PLUS, INC., PREFERRED EMPLOYERS INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to amend a Stipulation and Award, allowing defendants credit for EDD payments made to the applicant. The Board affirmed the $\$ 240.00$ temporary disability rate, finding no basis to set aside the stipulation as defendant attempted to rely on a wage statement that was available prior to the agreement. The amendment ensures reimbursement to EDD for benefits paid during the applicant's temporary disability period.

Stipulation and AwardPetition for ReconsiderationAgreed Medical ExaminersMPNTemporary Disability RateCredit for EDD PaymentsWeatherall v. WCABFraudMutual MistakeNewly Discovered Evidence
References
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