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

Case No. ADJ2789507 (VNO 0455132)
Regular
Jun 15, 2012

JOSE GUADALUPE FLORES vs. HARBOR RAIL TRANSPORTATION, U.S. FIDELITY \u0026 GUARANTY CORPORATION

This Workers' Compensation Appeals Board case, involving applicant Jose Guadalupe Flores against Harbor Rail Transportation and its insurer, is being reconsidered. Both the applicant and defendant petitioned for review of a prior decision. The Board granted reconsideration to allow further study of the factual and legal issues, aiming for a just and reasoned decision. All future communications must be filed in writing with the Board's Office of the Commissioners.

Workers' Compensation Appeals BoardReconsiderationGranting ReconsiderationFactual IssuesLegal IssuesJust DecisionReasoned DecisionFurther ProceedingsCommissionersSan Francisco
References
Case No. ADJ1932035 (ANA 0234626) ADJ2673288 (ANA 0234627) ADJ4019770 (ANA 0234628)
Regular
Jun 15, 2009

Elmer Bourland vs. LONG BEACH MEMORIAL MEDICAL CENTER

The Workers' Compensation Appeals Board denied reconsideration, upholding a prior order for a lifetime annuity of $900 per month. Defendant argued the original compromise and release agreement intended only a 15-year guaranteed payment period, not a lifetime annuity. However, the Board found the 1992 Order approving the settlement explicitly stated "lifetime annuity" and was not timely challenged by defendant. As no good cause such as fraud or mutual mistake was shown, the 1992 Order is now final and binding.

WORKERS' COMPENSATION APPEALS BOARDELMER BOURLANDLONG BEACH MEMORIAL MEDICAL CENTERTRISTAR RISK MANAGEMENTFindings and Orderlifetime annuityCompromise & Releaseindustrial injuryright kneeinternal system
References
Case No. ADJ2219719 (VNO 0499919)
Regular
Jul 02, 2009

ELMER COREAS vs. PEKING NOODLE COMPANY, ZENITH INSURANCE COMPANY

This case involves a petition for reconsideration filed with the Workers' Compensation Appeals Board (WCAB). The petition was dismissed as untimely because it was filed 29 days after the decision was served, exceeding the jurisdictional 20-day limit plus a potential 5-day mailing extension. The WCAB emphasized that filing deadlines are jurisdictional and that the Board lacks the power to grant untimely petitions. Had the petition been timely, it would have been denied on the merits according to the WCJ's report.

WORKERS' COMPENSATION APPEALS BOARDELMER COREASPEKING NOODLE COMPANYZENITH INSURANCE COMPANYADJ2219719VNO 0499919OPINION AND ORDER DISMISSING RECONSIDERATIONpetition for reconsiderationuntimelyLabor Code section 5903
References
Case No. ADJ3726826
Regular
Mar 04, 2010

MARIBEL ESCOBAR vs. YGNACIO VALLEY CARE CENTER, CARE WEST INSURANCE

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, finding it timely filed. The Board affirmed the WCJ's finding that the applicant sustained industrial injuries to her lumbar spine and psyche, with compensable consequential injuries to her gastrointestinal system and a sleep disorder. Substantial medical evidence, including opinions from Dr. Cayton for the sleep disorder and Dr. Noriega for the gastrointestinal issues, supported the award. The Board also found Dr. Walcott's psychiatric opinion constituted substantial evidence, justifying the WCJ's disability findings.

Workers' Compensation Appeals BoardMaribel EscobarYgnacio Valley Care CenterCare West InsurancePegasus Risk ManagementFindings Award and OrderNursing AssistantIndustrial InjuriesLumbar SpinePsyche Injury
References
Case No. ADJ9895504
Regular
Jan 17, 2020

Elmer Umana vs. West Coast Arborists, Inc., Liberty Mutual Insurance Company

This case involves an employer's petition for reconsideration of a workers' compensation award. The employer argued the award was untimely, and that the Qualified Medical Examiner's (QME) reports were inadmissible as they lacked substantial evidence and proper causation analysis. The Appeals Board denied reconsideration, finding that any delay in issuing the award did not invalidate it. The Board also held that the QME's reports were admissible and constituted substantial evidence, as they detailed causation and reasoning for the impairment ratings.

Workers' Compensation Appeals BoardElmer UmanaWest Coast ArboristsInc.Liberty Mutual Insurance CompanyADJ9895504Opinion and Order Denying Petition for ReconsiderationFindings of Fact Award and OrdersAdministrative Law Judge (WCJ)Injury Arising Out of and Occurring in the Course of Employment (AOE/COE)
References
Case No. ADJ7191867
Regular
Mar 23, 2012

ARTURO ESCOBAR vs. HENRY WINE GROUP dba ZEPHYR EXPRESS, ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior decision because the WCJ's imposition of a 20% penalty for delayed payment did not adequately explain the penalty amount based on established legal factors. While a delay in payment was found, the Board remanded the case for the WCJ to re-evaluate penalties and interest by clearly applying factors from relevant case law and justifying the awarded amounts with specific evidence. The original decision also failed to separately address statutory interest owed on the delayed payment. The Board emphasized the need for decisions to articulate the evidentiary basis and reasoning for penalty assessments.

Labor Code section 5814Petition for ReconsiderationFindings and AwardWCJZurich American Insurance CompanyArturo EscobarHenry Wine GroupZephyr ExpressCompromise & Releasepenalty
References
Case No. ADJ7770118
Regular
Jan 20, 2016

Martha Escobar vs. Vista Cove Care Center, Amtrust North America

This order dismisses a Petition for Removal filed by the applicant, Martha Escobar, in relation to a Workers' Compensation Appeals Board decision. The petitioner formally withdrew their removal petition. Consequently, the Board has dismissed the petition as requested.

Petition for RemovalWithdrawn PetitionWorkers' Compensation Appeals BoardDismissed PetitionVista Cove Care CenterAmtrust North AmericaADJ7770118Anaheim District OfficeDeidra E. LoweRonnie G. Caplane
References
Case No. ADJ7784334
Regular
Jul 17, 2013

ESTEBAN ESCOBAR vs. UCLA MEDICAL CENTER

The Appeals Board granted reconsideration and reversed the trial judge's finding of no industrial injury. The Board found that the applicant sustained a cumulative injury to his right upper extremity, supported by the unrebutted medical opinion of a Qualified Medical Examiner. Compensation is not barred by the post-termination defense as the date of injury, per Labor Code Section 5412, occurred after the applicant's termination date. The case is returned to the trial level for further proceedings.

Post-termination defenseLabor Code section 3600(a)(10)Section 5412Cumulative injuryRight upper extremityIndustrial injuryPQMEKenneth ScheffelsM.D.Reconsideration
References
Case No. ADJ4240414 (LAO 0823127), ADJ7197407, ADJ9397956
Regular
Nov 19, 2020

CARLOS ESCOBAR vs. AMERICAN RACING EQUIPMENT, INC.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to review a WCJ's findings on temporary disability, permanent disability, and occupation. Following a settlement conference, the parties agreed to a Compromise and Release (C&R) for $400,000, reserving applicant's right to future medical treatment. The WCAB found the settlement adequate and in the applicant's best interest. Therefore, the prior Findings and Order were rescinded, and the C&R was approved.

WCABReconsiderationCompromise and ReleaseFindings and OrderApplicantDefendantTemporary DisabilityPermanent Partial DisabilityOccupational GroupMedical Treatment
References
Case No. POM 0248864
Regular
Jul 18, 2007

KAREN ESCOBAR vs. CONTINENTAL CASUALTY, CNA INSURANCE

The Workers' Compensation Appeals Board granted reconsideration and modified a prior award, reducing the penalty for unreasonable delays in medical treatment from over $51,000 to $10,000, while deferring the issue of sanctions. The Board affirmed the finding that the defendant unreasonably delayed treatment and erred in attempting to force the applicant into its Medical Provider Network. The applicant was not required to transfer to the defendant's MPN due to a prior stipulation and the defendant's failure to show good cause to be relieved.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardUnreasonable DelayMedical TreatmentPenaltiesSanctionsMedical Provider Network (MPN)Qualified Medical Examiner (QME)Utilization Review
References
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