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

Case No. ADJ4718149 (GRO 0034104) ADJ708995 (GRO 0034105)
Regular
Jul 03, 2012

ART QUIROS vs. SUPERIOR TANK COMPANY, INC., SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded an earlier order awarding reimbursement to the Employment Development Department (EDD). The Board found that EDD's claim for reimbursement was invalid because EDD failed to provide the defendant with proper written notice of the lien claim and its extent, as required by Labor Code section 4904(a). Although EDD argued oral notice was given at hearings, the Board held that statutory law mandates written notification for a lien to be valid. Therefore, EDD's claim for reimbursement was disallowed.

Workers' Compensation Appeals BoardSuperior Tank CompanySeabright Insurance CompanyEmployment Development Departmentlien claimCompromise and Releasewritten noticeLabor Code section 4904(a)actual or constructive noticetemporary disability benefits
References
0
Case No. ADJ1975641 (SRO 0139288)
Regular
Nov 15, 2010

LETEBRHAN BERHE vs. DLK VENTURES INC. dba HANNA HOUSE, RIDLEY NURSING HOME; VIRGINIA, SURETY INSURANCE COMPANY as, administered by FIRSTCOMP OMAHA

Defendant seeks reconsideration of an award finding applicant sustained a work injury and granted benefits, including reimbursement to EDD from applicant's permanent disability award. The defendant contends the WCJ erred by not ordering applicant to reimburse EDD directly. The Appeals Board granted reconsideration, rescinded the decision, and returned the matter to the trial level. This action was taken to allow the WCJ to determine EDD's entitlement to reimbursement directly from the defendant, given the defendant's failure to notify EDD of permanent disability payments after receiving EDD's lien notice.

WORKERS' COMPENSATION APPEALS BOARDDLK VENTURES INC.HANNA HOUSERIDLEY NURSING HOMEVIRGINIA SURETY INSURANCE COMPANYFIRSTCOMP OMAHAADJ1975641SRO 0139288LETEBRHAN BERHEFindings and Award
References
0
Case No. ADJ9282902
Regular
Oct 10, 2017

JUAN CARRILLO vs. ASKEW INDUSTRIAL CORPORATION, TWIN CITY FIRE INSURANCE COMPANY

The Workers' Compensation Appeals Board dismissed the Employment Development Department's (EDD) petition for reconsideration. The EDD sought interest on reimbursement awarded for disability benefits, but the original Findings and Award did not specify the reimbursement amount or rule on interest. The Board found the EDD was not aggrieved by the initial award, as the parties were instructed to adjust the amount themselves. Therefore, the EDD must first seek a final order on the reimbursement amount before pursuing reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and Awardtemporary disability indemnityreimbursementEmployment Development Department (EDD)lienUnemployment Insurance Code section 2629.1interestadministrative law judge (WCJ)
References
0
Case No. ADJ7176518
Regular
Nov 13, 2013

TRAVIS RIEL vs. STATE OF CALIFORNIA, DEPARTMENT OF FORESTRY, Lawfully Uninsured

This case concerns Travis Riel's workers' compensation claim for a 2007 spinal injury. The Appeals Board dismissed Riel's petition for reconsideration as premature, as it concerned a non-final order regarding EDD reimbursement, and Riel failed to serve EDD. The Board denied the defendant's petition, affirming the finding that Riel sustained new and further permanent disability, and that his claim was not barred by the statute of limitations. The WCJ's conditional order for EDD reimbursement was not a final determination and Riel is not yet liable to reimburse EDD.

New and further disabilityPetition to reopenStatute of limitationsLabor Code section 4656(c)(1)Employment Development Department (EDD)ReimbursementPermanent and stationary dateAggrieved partyFinal orderPetition for reconsideration
References
2
Case No. ADJ8860181
Regular
Jul 16, 2015

GARY GATSON vs. BIMBO BAKERIES USA, INC., ACE AMERICAN INSURANCE COMPANY

This case involves a dispute over the Employment Development Department's (EDD) lien for temporary disability benefits paid to the applicant. The original award found the applicant sustained a cumulative trauma injury and awarded temporary disability benefits, but only allowed partial reimbursement to EDD. Both EDD and the employer sought reconsideration, with EDD arguing for full reimbursement and the employer challenging the EDD lien finding. The Appeals Board granted EDD's petition, denied the employer's, and will allow further proceedings to determine the correct amount of EDD's lien and temporary disability award.

WCABcumulative traumaAchilles tendonpermanent disabilitytemporary disabilityEDD lienreconsiderationsubstantial evidencestandingLabor Code section 4904
References
0
Case No. ADJ9258192
Regular
Aug 03, 2015

Thomas Senczakiewicz vs. Boeing Company, Sedgwick Claims Management Services, Inc.

The Appeals Board granted reconsideration to address the applicant's attorney fee claim under Labor Code § 4903.2, related to EDD lien reimbursement. The Board affirmed the original award of temporary total disability but deferred the issue of attorney fees against the EDD lien. They found the applicant's attorney instrumental in securing EDD's reimbursement, as EDD had notice of hearings but did not participate. The matter is returned to the WCJ for further proceedings on the attorney's fee.

Workers' Compensation Appeals BoardPetition for ReconsiderationAmended Findings Award and OrderAdministrative Law JudgeProduction Operation SpecialistThoracic SpineLumbar SpineRight ShoulderTemporary Total DisabilityPost-Retirement Period
References
0
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
2
Case No. ADJ4305719
Regular
Jun 18, 2015

HELEN BOUGH vs. DANA MANCHESTER, DMD, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendants' petition for reconsideration in this case. The defendants argued the Workers' Compensation Judge erred in ordering the State Compensation Insurance Fund (SCIF) to reimburse the Employment Development Department (EDD). However, SCIF had prior knowledge of EDD's lien for benefits paid to the applicant but still proceeded to pay the full award. The Board found that EDD is entitled to reimbursement from SCIF and that the award does not constitute a double recovery for the applicant.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJSCIFEDDLienReimbursementDouble RecoveryCreditContinuous Trauma
References
1
Case No. AHM 129038
Regular
Jul 19, 2007

FRANCISCO OLIVA vs. LAIDLAW TRANSIT COMPANY, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

This case involves a bus driver, Francisco Oliva, who claimed an industrial injury to his right hand and upper extremity. The defendant, Laidlaw Transit Company, sought reconsideration of the initial award, arguing the injury was personal and not work-related, and challenging reimbursement to the Employment Development Department (EDD). The Appeals Board granted reconsideration, affirmed the finding of industrial injury, but amended the award to remove the reimbursement requirement to the EDD.

Workers Compensation Appeals BoardLaidlaw Transit CompanyInsurance Company of the State of PennsylvaniaFrancisco Olivaindustrial injuryright handupper right extremitybus driverassaultpersonally motivated
References
0
Case No. MISSING
Regular Panel Decision
Oct 26, 2015

Matter of Newbill v. Town of Hempstead

Claimant, a sanitation crew chief, injured his right ankle and foot at work and was awarded disability benefits. His self-insured employer paid his full weekly wages during a period of disability and timely sought reimbursement for these advanced payments. A Workers’ Compensation Law Judge granted the employer's reimbursement request against a 20% schedule loss of use award for the right foot. The Board affirmed this decision, and the claimant appealed, arguing that reimbursement should not cover periods where no compensation awards were initially made. The court affirmed the Board's decision, reiterating that an employer is entitled to full reimbursement from a schedule loss of use award for advanced wages paid during disability, as schedule awards are not allocable to specific periods of lost work.

Schedule Loss of UseReimbursementAdvanced Wage PaymentsDisability BenefitsEmployer RightsAppellate ReviewWorkers’ Compensation BoardStatutory InterpretationPermanent Partial DisabilityTimely Claim
References
10
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