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

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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ8610560
Regular
Sep 19, 2013

William Brown (Deceased), Annette Brown vs. SAVE MART SUPERMARKETS

This case involves a widow's petition for workers' compensation death benefits for her truck driver husband who died in a motorcycle accident after leaving work. The administrative law judge denied the claim, finding it barred by the going and coming rule. The applicant argued the special risk exception applied due to hazardous road conditions and a quantitatively greater risk compared to the general public. The majority of the Appeals Board denied reconsideration, agreeing with the WCJ that the risks were not exclusive to employment.

Going and Coming RuleSpecial Risk ExceptionDeath BenefitsMotor Vehicle AccidentIndustrial InjuryTruck DriverNegligencePublic RoadZone of DangerHazard
References
Case No. ADJ9160815
Regular
Jun 10, 2014

ALMA CEDILLO vs. CEDARS SINAI MEDICAL CENTER, TRISTAR RISK MANAGEMENT

This case involves an applicant, Alma Cedillo, seeking workers' compensation benefits from Cedars Sinai Medical Center and Tristar Risk Management. The Workers' Compensation Appeals Board (WCAB) issued an order denying a Petition for Removal filed in the case. The WCAB adopted the reasoning of the workers' compensation administrative law judge (WCJ) in reaching its decision to deny removal. Therefore, the applicant's request to remove the case from the current process was rejected.

Petition for RemovalWorkers' Compensation Appeals BoardCedars Sinai Medical CenterTristar Risk ManagementAdministrative Law JudgeADJ9160815Van Nuys District OfficeAlma Cedillodenying removalworkers' compensation
References
Case No. ADJ7863081
Regular
Jun 25, 2012

RONNIE BROWN vs. MASTER PLUMBING, RISK ENTERPRISE MANAGEMENT, AMERICAN ALL RISK LOSS

In this workers' compensation case, the defendant sought reconsideration of a prior Board decision that had granted them a Petition for Reconsideration and amended a WCJ's decision to deny the applicant temporary disability indemnity. The defendant argued the Board erred by not finding them entitled to a credit for temporary disability already paid during that period. The Board denied the defendant's petition, stating that the issue of credit for overpayment is discretionary under Labor Code section 4909 and should have been addressed at the trial level by the WCJ. Therefore, the defendant's petition for reconsideration of the denial of the credit was denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationTemporary Disability IndemnityCredit for OverpaymentLabor Code section 4909Findings Award and OrderAdministrative Law JudgeDecision After ReconsiderationMaster PlumbingRisk Enterprise Management
References
Case No. ADJ9014448
Regular
Mar 10, 2020

TIM WAITE vs. COUNTY OF VENTURA permissibly self-insured; administered by SEDGWICK RISK SERVICES (formerly YORK RISK SERVICES)

This case involves a workers' compensation claim where the WCJ initially issued Findings and Awards. Following the applicant's request for reconsideration, the WCJ rescinded the award and set the matter for trial. The defendant then petitioned for reconsideration, but the WCJ issued an amended award *after* the period for such actions under WCAB Rule 10961 had expired, thus losing jurisdiction. The Appeals Board affirmed the WCJ's amended award, holding that despite the jurisdictional issue with the amended award, it was the correct outcome.

WCABReconsiderationFindings and AwardsRescinding OrderJurisdictionWCJAdministrative Law JudgeAppeals BoardPetitionAmended F&A
References
Case No. ADJ7167333; ADJ7167413
Regular
Mar 24, 2015

ROSA LOPEZ vs. SUPERIOR CENTER CONCEPTS, INC., CARE WEST and PEGASUS RISK MANAGEMENT, PATRIOT RISK SERVICES for CIGA

In this workers' compensation case, CIGA sought reconsideration of a decision finding it liable for a portion of medical treatment and legal expenses. CIGA argued that because Care West provided "other insurance," it should not be liable. However, the Board denied CIGA's petition, upholding the original findings. This decision was based on a prior stipulation between Ullico (whose claims CIGA now administers) and Care West, which contractually apportioned liability. The Board found that CIGA is bound by this pre-liquidation stipulation, which supersedes CIGA's statutory exclusion for claims covered by other insurance.

CIGAUllicoCare WestPatriot Risk ServicesPegasus Risk ManagementSuperior Center Concepts Inc.Rosa LopezPetition for ReconsiderationFindings and OrderCompromise and Release
References
Case No. ADJ7166686
Regular
Jul 24, 2012

RICHARD ANDERSON vs. JAGUAR/LANDROVER OF VENTURA, COMPWEST INSURANCE COMPANY

This case involves an applicant who suffered a stroke and subsequent 100% permanent disability following surgery for an industrial shoulder injury. The defendant sought reconsideration, arguing for apportionment to pre-existing conditions and challenging the attorney's fee calculation. The Appeals Board affirmed the 100% permanent disability finding, finding no basis for apportionment as the applicant's pre-existing conditions did not cause the disability itself. However, the Board modified the attorney's fee award, requiring commutation using a specific method and a 3% cost of living adjustment, finding the previously assumed 4.6% to be speculative.

Workers Compensation Appeals BoardRichard AndersonJaguar/Landrover of VenturaCompwest Insurance CompanyADJ7166686ReconsiderationFindings and AwardIndustrial InjuryBrain InjuryNeurological System
References
Case No. ADJ7412203
Regular
Jul 15, 2011

RIGOBERTO GARCIA vs. COLE RANCH, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding that the applicant's industrial injury was caused by a "sudden and extraordinary" event, thereby exempting it from the six-month employment rule for psychiatric injuries under Labor Code section 3208.3(d). The Board corrected a clerical error in the citation of the relevant statute. While the defendant argued the event was an inherent risk of the job, the applicant's uncontradicted testimony provided the only evidence suggesting it was not routine. A dissenting opinion argued that a simple fall from a ladder, without more, should not qualify as extraordinary, especially given the short employment duration and lack of evidence for truly unusual circumstances.

Workers' Compensation Appeals BoardRigoberto GarciaCole RanchState Compensation Insurance FundADJ7412203Opinion and Order Denying Petition for ReconsiderationCorrecting Clerical ErrorFindings and Ordersavocado pickerhigh tree worker
References
Case No. ADJ7987695 ADJ7987686
Regular
May 08, 2014

VANESSA BRUCE vs. VALLEY HEALTH SYSTEM/PHYSICIANS FOR HEALTHY HOSPITALS; CRUM & FORSTER AND TRISTAR RISK MANAGEMENT

The applicant, a licensed vocational nurse, sought workers' compensation for injuries sustained when she fell asleep driving home after working three extra hours off the clock due to a coworker's issue. The Workers' Compensation Appeals Board (WCAB) denied her petition for reconsideration. The WCAB found the injury did not arise out of or occur in the course of employment, as the "going and coming rule" applied and neither the "special mission" nor "special risk" exceptions were met. The applicant's decision to stay late was voluntary, not at the employer's request, and falling asleep while driving is a common risk, not a special employment-related hazard.

Workers' Compensation Appeals BoardLicensed Vocational NurseSpecific InjuryNeck InjuryBack InjuryHeadachesCumulative InjurySleep DisorderGoing and Coming RuleSpecial Mission Exception
References
Case No. ADJ2423806
Regular
Jun 07, 2010

BASIL PERKINS vs. CITY OF LOS ANGELES

In this workers' compensation case, the applicant, Basil Perkins, sought reconsideration after his claim for an industrial injury was denied. Perkins argued he was denied due process and that his injury was compensable under several doctrines, including positional and special risk, while also asserting employment motivation for the assault. The Appeals Board admitted a security bulletin provided by the applicant but found it irrelevant as it described tactics dissimilar to the applicant's shooting and was issued over two years after the injury. Ultimately, the Board affirmed its prior decision denying the applicant's claim.

Workers' Compensation Appeals BoardReconsiderationIndustrial InjuryDue ProcessPositional Risk DoctrineSpecial Risk DoctrineSecurity BulletinAnimal Rights GroupsEmployment-Related AssaultInference of Motivation
References
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