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

Case No. ADJ4609174 (RDG 0041947)
Regular
Oct 27, 2010

DOYLE CANADA vs. REDDING POWER SAWMILL DIVISION, ESIS PORTLAND

In this Workers' Compensation Appeals Board case, Doyle Canada's petition for reconsideration was denied. The Board adopted the findings of the Workers' Compensation Administrative Law Judge, whose report detailed the reasons for the denial. This order, dated October 27, 2010, upholds the original decision and denies further review. The defendants were Redding Power Sawmill Division and ESIS Portland.

WCABPetition for Reconsiderationworkers' compensation administrative law judgereport of the workers' compensation administrative law judgedeny reconsiderationADJ4609174Redding Power Sawmill DivisionESIS PortlandDoyle CanadaADJUDICATION
References
0
Case No. ADJ9527444
Regular
May 23, 2018

, REYES P. HERNANDEZ, vs. , QUALI RUN RANCH; STATE COMPENSATION INSURANCE FUND; OMA OJAI PACIFIC; ZENITH INSURANCE COMPANY; ACE USA INSURANCE COMPANY, Administered By ESIS; MICHAEL AND JODY CROMER, Homeowners; STATE FARM INSURANCE,

The Workers' Compensation Appeals Board granted ESIS's Petition for Removal because the WCJ's order denying ESIS a panel Qualified Medical Evaluator (PQME) evaluation was found to cause significant prejudice and irreparable harm. ESIS was not a party to the original Agreed Medical Examiner (AME) agreement between the applicant and SCIF, and the WCJ's decision unfairly bound ESIS to the AME's findings and effectively closed ESIS's discovery rights. The Board rescinded the WCJ's decision and ordered a PQME evaluation for ESIS, recognizing the denial violated ESIS's due process rights.

Petition for RemovalQualified Medical EvaluatorAgreed Medical ExaminerDue ProcessSignificant PrejudiceIrreparable HarmDiscoveryFindings and OrderWorkers' Compensation Appeals BoardCumulative Trauma
References
6
Case No. ADJ1690383 (LAO 0818718) ADJ253066 (LAO 0811576) ADJ1849347 (LAO 0845486)
Regular
Dec 07, 2010

TRINI RIVERA vs. FREMONT COMPENSATION INSURANCE, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ESIS, INC., ARGONAUT INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration, rescinding an arbitrator's decision that had determined specific injury dates binding for contribution proceedings. The Board ruled that ESIS, Inc. was not bound by its prior stipulation with the applicant regarding injury dates for the purpose of determining contribution from other defendants. The case is remanded for the arbitrator to independently determine the dates of injurious exposure, as required by Labor Code section 5500.5, to properly address ESIS's contribution claim.

Workers' Compensation Appeals BoardReconsiderationContribution ProceedingCumulative Trauma InjuryDates of InjuryStipulated AwardInjurious ExposureLabor Code Section 5500.5De Novo DeterminationApportionment of Liability
References
1
Case No. ADJ3668486 (SBA 0081243) ADJ2866077 (SBA 0073112) ADJ3676183 (SBA 0082815) ADJ3511801 (GOL 0090292) ADJ2318677 (GOL 0095094) ADJ658495 (SBR 0193676)
Regular
Jul 09, 2009

FRANCINE KOBLICK vs. PALM SPRINGS UNIFIED SCHOOL DISTRICT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ACE/ESIS

This case concerns ACE/ESIS seeking reconsideration of a WCJ's decision that CIGA was not responsible for a Blue Cross lien. ACE/ESIS and CIGA had settled the applicant's multiple injury claims via a Compromise and Release agreement which included an addendum obligating both parties to pay 50% of adjusted liens. CIGA argued it was not liable for the Blue Cross lien due to Insurance Code § 1063.1(c) excluding "covered claims" related to insurers, similar to the *Gorgi* case. The Appeals Board granted reconsideration, finding the WCJ erred by distinguishing this case from *Gorgi* due to CIGA's voluntary contractual agreement to pay 50% of liens, making it analogous to the *Carter* case. The Board rescinded the WCJ's finding and returned the matter for further proceedings, holding that CIGA's contractual promise overrides the statutory exclusion for liens.

CIGAACE/ESISCompromise & ReleaseLienBlue CrossInsurance Code § 1063.1(c)Contractual ObligationCovered ClaimReconsiderationWorkers' Compensation Appeals Board
References
2
Case No. ADJ7110968
Regular
Apr 09, 2013

CLAUDIA LARA vs. NORTHGATE MARKET, ESIS

This case involves Claudia Lara, applicant, versus Northgate Market and ESIS, defendants. The Workers' Compensation Appeals Board issued an Order Dismissing Petition for Reconsideration. The dismissal is due to the petitioner having withdrawn their petition for reconsideration of the January 13, 2012 decision. Therefore, the petition has been formally dismissed by the Board.

Petition for ReconsiderationWithdrawn PetitionDismissed OrderWorkers' Compensation Appeals BoardApplicantDefendantNorthgate MarketESISPomona District OfficeJanuary 13 2012 decision
References
0
Case No. ADJ6413644
Regular
Apr 24, 2009

JANICE HOWELL vs. NATIONAL MENTOR HOLDINGS, dba COLE VOCATIONAL SERVICES, administered by ESIS

The Workers' Compensation Appeals Board dismissed the applicant's Petition for Reconsideration because it was not taken from a final order determining substantive rights or liabilities. The petition also sought removal, which was denied as the applicant failed to demonstrate substantial prejudice or irreparable harm. The underlying issues, such as an order compelling medical record production, are interlocutory procedural matters not subject to reconsideration. The Board adopted the WCJ's report and recommendation, denying both reconsideration and removal.

Petition for ReconsiderationFinal OrderInterlocutory OrderSubstantive RightRemovalWCJ Report and RecommendationStipulationsOrder Compelling Production of RecordsDiscovery ProcessPrivacy
References
11
Case No. MISSING
Regular Panel Decision

VANDERWALL, SHANE v. 1255 PORTLAND AVENUE LLC

An individual plaintiff sustained injuries at a construction site in Monroe County when struck by an excavator bucket. The plaintiff initiated an action against 1255 Portland Avenue LLC and Spoleta Construction LLC, alleging violations of Labor Law §§ 200 and 241 (6), alongside common-law negligence. The Supreme Court initially granted defendants' motions for summary judgment, dismissing the complaint. On appeal, the order was modified; the appellate court reinstated the Labor Law § 241 (6) claim, finding a violation of Industrial Code (12 NYCRR) § 23-9.5 (c) because the plaintiff was not part of an “excavation crew” at the time of the accident. However, the court denied the plaintiff's motion for partial summary judgment on liability, reiterating that an Industrial Code violation is only evidence of negligence, not negligence as a matter of law.

Construction Site AccidentExcavator InjuryLabor Law § 241 (6)Industrial Code 23-9.5 (c)Summary JudgmentAppellate ReviewPersonal InjuryWorkplace SafetyNegligenceDesignated Operator
References
7
Case No. ADJ10553566, ADJ10553567
Regular
Apr 04, 2017

HUGO FLOREZ vs. SUPERIOR INDUSTRIES INTERNATIONAL, INC.; ESIS

The Workers' Compensation Appeals Board (WCAB) denied Superior Industries International, Inc. and ESIS's Petition for Removal in the case of Hugo Florez. Removal is an extraordinary remedy granted only when substantial prejudice or irreparable harm would occur, and reconsideration is inadequate. The WCAB found that the defendants failed to demonstrate such prejudice or inadequacy. Therefore, the petition was denied.

Petition for RemovalWorkers' Compensation Appeals BoardDenying RemovalExtraordinary RemedySubstantial PrejudiceIrreparable HarmReconsiderationAdministrative Law JudgeWCJ ReportAdverse Decision
References
2
Case No. ADJ10168186 ADJ10168303
Regular
Mar 17, 2020

JOSEFINA VALDIVIA vs. KING MEAT, INC., ACE/ESIS

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior decision concerning Josefin Valdivia's claims against King Meat, Inc. and ACE/ESIS. While affirming the January 10, 2020 decision, the WCAB amended it to defer specific issues. The determination of whether the injury arose out of and occurred in the course of employment (AOE/COE) is deferred. Furthermore, issues regarding permanent disability and entitlement to future medical treatment are also deferred.

AOE/COEPetition for ReconsiderationWorkers' Compensation Appeals BoardPermanent DisabilityFuture Medical TreatmentWCJ ReportDecision After Reconsideration
References
0
Case No. ADJ8915327
Regular
Apr 22, 2015

MARIA HERNANDEZ vs. WAREHOUSE DEMO SERVICES, INC., ESIS

This case involves a Petition for Reconsideration filed by Warehouse Demo Services, Inc. and ESIS regarding an award of total temporary disability (TTD) to applicant Maria Hernandez. The defendants argued the award was unsupported by evidence regarding Hernandez's ability to drive or perform modified duty while experiencing dizziness. The Workers' Compensation Appeals Board (WCAB) denied the petition, adopting the WCJ's reasoning. The WCAB also admonished defense counsel for improperly citing and attaching an unadmitted deposition. The WCJ found applicant's testimony credible, supported by medical reports indicating dizziness and inability to drive or work safely.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ reportADJ8915327deniedPaul E. ZayatGrancell Standerdeposition10842Lynn Devine
References
0
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