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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. 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. 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. ADJ1298520
Regular
Dec 24, 2010

CLUSEGUN AFOLAYAN (DECEASED), OLUWASEUN AFOLAYAN, et al vs. STATE OF CALIFORNIA CDCR, CALIFORNIA REHABILITATION CENTER, Legally Uninsured, SCIF/STATE CONTRACTS

In this workers' compensation case, the Appeals Board reconsidered a WCJ's award of dependency benefits to three adult children of a deceased worker. The WCJ had awarded $192,000 total, based on the children being total dependents despite the widow electing CalPERS benefits which typically bar other death benefits. The Board agreed that the adult children are entitled to benefits under Labor Code section 4702, as the widow's CalPERS election does not necessarily exclude other dependents with good cause. However, the Board disagreed with the WCJ's calculation method and remanded the case for a new decision, directing the adult children to divide the difference between the maximum benefit for a widow with dependents and the benefit for a widow without dependents.

Workers' Compensation Appeals BoardDependency benefitsLabor Code Section 4702Adult childrenDeath benefitsLabor Code Section 4707CalPERS special death benefitGood causeTotal dependentsWidow's benefits
References
Case No. ADJ915762 (SFO 0490442)
Regular
Dec 16, 2009

RON NOVACHICK vs. PLANTIUM EQUITY LLC dba NEXTIRAONE, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

The WCAB granted reconsideration and amended the WCJ's decision to defer the issue of EDD's lien because the period for which EDD paid benefits does not overlap any award of temporary or permanent disability benefits.

Workers' Compensation Appeals BoardReconsiderationEDD LienTemporary Disability IndemnityPermanent DisabilityLabor Code 4904Unemployment Compensation Disability BenefitsOverlapAward of CompensationStipulations
References
Case No. ADJ7231381
Regular
Oct 24, 2011

ERIN HEALY vs. WE ARE 6J INCI, FARMERS INSURANCE

The Workers' Compensation Appeals Board granted the Employment Development Department's (EDD) petition for reconsideration. The Board found the original decision failed to properly address EDD's lien for State Disability Indemnity (SDI) benefits paid to the applicant. Specifically, the decision did not provide for EDD's reimbursement when temporary and permanent disability indemnity were awarded for the same periods applicant received SDI. The matter was remanded for further proceedings and a new decision that will satisfy EDD's statutory entitlement to reimbursement.

EDD lienSDI benefitsPetition for ReconsiderationFindings Award and Ordertemporary disability indemnitypermanent disability indemnityLabor Code section 4903(f)Labor Code section 4904(b)defective servicestatutory interest
References
Case No. ADJ2902670 (VNO 0344530)
Regular
Sep 16, 2016

IRMA LARIOS vs. AREA TRADE BINDERY, GALLAGHER BASSETT

The Workers' Compensation Appeals Board granted reconsideration to address the lien claim of the Employment Development Department (EDD). The original award failed to account for EDD's lien for state disability benefits paid to the applicant. The Board found that the defendant is obligated to withhold EDD's lien amount from temporary disability payments once notified. Therefore, the case was returned to the trial level for recalculation of temporary disability benefits, including proper credit for the EDD's lien.

Lien claimantPetition for ReconsiderationFindings and AwardEmployment Development Department (EDD)Temporary disability benefitsIndustrial injuryCervical spineHypertensive heart diseaseGastrointestinalPsyche
References
Case No. ADJ6473555, ADJ7393801
Regular
Sep 18, 2014

Frank Jones (Deceased), Araceli Jones, Mya Jaedyn Jones vs. CDCR KERN VALLEY STATE PRISON, State Compensation Insurance Fund

The Workers' Compensation Appeals Board affirmed a previous award for death benefits to the minor daughter of deceased correctional officer Frank Jones. The WCJ found that the daughter, Mya Jones, was entitled to the special minor's death benefit due to "good cause," as her mother is now a sole provider facing significant financial hardship after the decedent's death. The Board agreed, citing compelling evidence of the mother's financial strain and the minor's ongoing needs. This decision overrides the defendant's contentions that the award was improper and denies credit for prior permanent disability advances.

Workers' Compensation Appeals BoardCalPERSspecial death benefitminor dependentGuardian Ad LitemLabor Code section 4704good causeaverage weekly earningstemporary total disabilitypermanent disability indemnity
References
Case No. AHM 98231
Regular
Sep 24, 2007

MYLINH WHITMAN vs. CINGULAR WIRELESS, SEDGWICK CLAIMS MANAGEMENT

The Appeals Board is reconsidering whether the defendant, Cingular Wireless, is entitled to a credit for salary continuation benefits paid to the applicant. The key issue is whether these benefits were of the "same general character" as workers' compensation, which would permit integration and a credit. The case is returned to the trial level for further evidence development on this specific point, rescinding the prior award of a credit.

Workers' Compensation Appeals BoardCreditSalary continuation planWage loss planMetropolitan Life Short Term Disability PolicyHealth and Welfare Benefits PlanSummary plan descriptionEmployer policyTaxable benefitsPermanent disability indemnity
References
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