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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ3605789 (GOL 0101314) ADJ2387995 (GOL 0101316) ADJ460036 (GOL 0101615)
Regular
Dec 12, 2011

JORGE VIVANCO vs. NEVERLAND VALLEY RANCH, ESTATE OF MICHAEL JACKSON, MJJ PRODUCTIONS, TRAVELERS INDEMNITY, UNITED STAFFING ASSOCIATES, AMERICAN HOME ASSURANCE COMPANY, MONARCH CONSULTING dba PES PAYROLL, STATE COMPENSATION INSURANCE FUND

This case involves a workers' compensation applicant claiming injuries while employed as a zookeeper for Neverland Valley Ranch and other entities. The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior findings, and returned the case for further proceedings. The Board found that the trial judge erred by excluding evidence related to employment agreements under the parol evidence rule, which is relevant to determining employer status. Further development of the record is required to properly address the applicant's employment relationships with the defendant entities.

Workers' Compensation Appeals BoardJorge VivancoNeverland Valley RanchMichael JacksonMJJ ProductionsTravelers IndemnityUnited Staffing AssociatesAmerican Home Assurance CompanyMonarch ConsultingPES Payroll
References
Case No. ADJ10009703 ADJ10043837
Regular
Feb 19, 2019

ZULAY DAVILA vs. EMPLOYERS RESOURCE GROUP, VENSURE HR, INC., LCF LIBERTY JR, LLC/SECURITY NATIONAL INSURANCE COMPANY, AMTRUST NORTH AMERICA, PROPORTION FOODS, LLC/REDWOOD FIRE AND CASUALTY INSURANCE COMPANY, BERKSHIRE HATHAWAY HOMESTATE COMPANIES

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the WCJ's decision due to a due process violation. The WCJ had determined employment by ERG without providing ERG notice and an opportunity to be heard. The WCAB returned the case to the trial level for further proceedings to determine employment status. Issues of insurance coverage will be subject to mandatory arbitration once employment is established.

Workers' Compensation Appeals BoardVENSURE HRSecurity National Insurance CompanyProportion FoodsLLCREDWOOD FIRE AND CASUALTY INSURANCE COMPANYBERKSHIRE HATHAWAY HOMESTATE COMPANIESAMTRUST NORTH AMERICAEMPLOYMENT RESOURCES GROUPINC.
References
Case No. SBR 309137
Regular
Aug 28, 2007

JOSE CARMONA vs. ARROW EMPLOYMENT SERVICES dba ARROW STAFFING SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for LEGION INSURANCE COMPANY, in liquidation, by CAMBRIDGE INTEGRATED SERVICES, KELLY PRODUCTIONS, INC., FARMDALE CREAMERY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board is reconsidering a prior award due to CIGA's contention that the applicant's claim is not a "covered claim" because other insurance was available. The central issue is whether the special employer's (Farmdale Creamery) workers' compensation policy with SCIF constitutes "other insurance" under Insurance Code section 1063.1(c)(9), which would exclude the claim from CIGA's coverage. The case is remanded for further proceedings to definitively determine the availability of this "other insurance" and its impact on CIGA's liability.

CIGALegion Insurance CompanyArrow Employment ServicesFarmdale CreameryState Compensation Insurance Fundcovered claimother insuranceInsurance Code section 1063.1(c)(9)general employerspecial employer
References
Case No. ADJ265314 (LAO 0790236)
Regular
May 21, 2009

VICTORIA RODRIGUEZ vs. THIBIANT INTERNATIONAL, INC., FIREMAN'S FUND INSURANCE COMPANY, SELECT PERSONNEL SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCATION, LEGION INSURANCE CO.

This case involves a workers' compensation applicant injured while working for a special employer, Thibiant International, insured by Fireman's Fund. The applicant was hired by a general employer, Select Personnel, whose insurer, Legion Insurance, became insolvent. The California Insurance Guarantee Association (CIGA) paid benefits but argued its coverage was excluded by Fireman's Fund being "other insurance." The Appeals Board affirmed Fireman's Fund's liability as the special employer's insurer and reversed CIGA's dismissal, finding Fireman's Fund owed CIGA reimbursement for benefits paid. The Board also deemed Fireman's Fund's challenge to the reimbursement amount waived due to failure to raise it at trial.

Workers' Compensation Appeals BoardVictoria RodriguezThibiant InternationalInc.Fireman's Fund Insurance CompanySelect Personnel ServicesCalifornia Insurance Guarantee AssociationCIGALegion Insurance Companyliquidation
References
Case No. ADJ2081826 (VNO 0525965)
Regular
Jun 09, 2011

JANET TANZMAN vs. WARNER PACIFIC INSURANCE, EMPLOYER'S COMPENSATION INSURANCE COMPANY, FREMONT COMPENSATION INSURANCE COMPANY

This case involves a cumulative trauma injury where the applicant disputes the workers' compensation judge's findings on the injury's ending date and the responsible insurance carrier. The Appeals Board granted reconsideration due to an incomplete record and unclear stipulations regarding the injury period and specific body parts affected. The Board rescinded the prior decision, returning the matter for further proceedings to clarify these crucial issues, including the date of injury under Labor Code section 5412 and potential carrier liability under section 5500.5. Issues of insurance coverage disputes are subject to mandatory arbitration.

Cumulative traumaDate of injuryInsurance coverage disputeCIGAFremont Compensation Insurance CompanyEmployers Compensation Insurance CompanyStipulationsLabor Code section 5412Labor Code section 5500.5Mandatory arbitration
References
Case No. STK 0142666
Regular
Jan 17, 2008

DAVID SOTO vs. ADVANCED PACKING & DISTRIBUTION, STATE COMPENSATION INSURANCE FUND, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION On Behalf Of RELIANCE INSURANCE COMPANY, In Liquidation

This case involves a workers' compensation claim where the applicant sustained an injury while employed by both a general employer (Remedy) and a special employer (Advanced). Remedy's insurer, Reliance, became insolvent, leading CIGA to assume potential liability. The WCJ found that Advanced's insurer, SCIF, provided "other insurance" under Insurance Code § 1063.1(c)(9), thus relieving CIGA of responsibility. The Appeals Board denied SCIF's reconsideration, affirming that SCIF's policy constituted "other insurance" and that CIGA is a last resort insurer.

Workers Compensation Appeals BoardCIGAReliance Insurance Companyliquidationspecial employergeneral employerother insuranceInsurance Code section 1063.1(c)(9)covered claimsjoint and several liability
References
Case No. GOL 86641, GOL 99800
Regular
Aug 07, 2008

MIGUEL TORRES vs. HENDRY TELEPHONE PRODUCTS, CONNECTICUT INDEMNITY/ROYAL & SUNALLIANCE INSURANCE, HR3 STAFFING SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, LEGION INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to correct errors in the original award, specifically the misidentification of employers and their insurers. The WCAB rescinded the prior award and returned the case for further proceedings to determine the existence of a cumulative injury and clarify employer liability. The Board also noted that Connecticut Indemnity's policy likely constitutes "other insurance," thus precluding CIGA's involvement.

Workers' Compensation Appeals BoardJoint Findings and AwardReconsiderationIndustrial InjuryNeckRight Upper ExtremityCarpal Tunnel SyndromeCubital Tunnel SyndromeHeadachesDizziness
References
Case No. ADJ7989476 ADJ9983597 ADJ9983898
Regular
Jun 18, 2018

MARIA MIRANDA vs. KOOSHAREM dba SELECT STAFFING dba SELECT FOCUS, EVANS MANUFACTURING, ACE AMERICAN INSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE (CIGA) Adjusted by SEDGWICK for ULLICO CASUALTY, in liquidation, TRUCK INSURANCE EXCHANGE

This case involves a dispute over workers' compensation insurance liability for injuries sustained by applicant Maria Miranda in 2011 while employed by Select Staffing (general employer) and Evans Manufacturing (special employer). The Workers' Compensation Appeals Board (WCAB) rescinded the arbitrator's decision because the evidence, particularly insurance policy endorsements, was not adequately identified and admitted. The WCAB found the record insufficient to determine which insurer, ACE American Insurance Company or Truck Insurance Exchange, is primarily liable for benefits. The matter is returned to the arbitrator to establish a complete and proper record for a new decision, addressing the specific requirements for insurance endorsements limiting coverage.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderInsurance LiabilityGeneral EmployerSpecial EmployerACE American Insurance CompanyTruck Insurance ExchangeCalifornia Insurance Guarantee AssociationCIGA
References
Case No. ADJ2480026
Regular
Aug 26, 2011

CHAD IMES vs. SCENARIO DESIGNS, INC., EVEREST NATIONAL INSURANCE COMPANY, POWER PAYROLL, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for LEGION INSURANCE COMPANY

The Workers' Compensation Appeals Board reversed a prior ruling and ordered Everest National Insurance Company to reimburse CIGA for benefits paid to the applicant. The Board found that Everest was "other insurance" available under Insurance Code section 1063.1(c)(9) because its insured, Scenario Designs, Inc., employed the applicant on the date of injury. This decision clarifies that reimbursement to CIGA does not alter the original award and aligns with statutory limitations on CIGA's liability. Everest is now obligated to reimburse CIGA and administer future benefits.

CIGAEverest National Insurance CompanyLegion Insurance CompanyScenario DesignsPower PayrollInc.other insurancereimbursementdate of injurygeneral-special employment
References
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