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

Case No. ADJ7541142
Regular
Jul 02, 2012

MIGUEL OSIO vs. EMBASSY SUITES, FIREMAN'S FUND INSURANCE COMPANY

This case involves a worker's compensation claim where the applicant, Miguel Osio, suffered an industrial injury to his right knee. The defendant insurer, Fireman's Fund, sought reconsideration of a finding that it was estopped from raising the statute of limitations. The Appeals Board denied reconsideration, agreeing that the insurer's February 3, 2004 notice was misleading. Specifically, the notice incorrectly stated the applicant had no permanent limitations and failed to inform him of any time limits to pursue further benefits, thus estopping the insurer from asserting the statute of limitations.

Workers' Compensation Appeals BoardFireman's Fund Insurance CompanyPetition for ReconsiderationFindings and AwardStatute of LimitationsEstoppelPermanent DisabilityRight Knee InjuryWaiterNotice Requirements
References
8
Case No. ADJ11146153
Regular
Feb 19, 2019

MARIA CUNNINGHAM vs. RAMCO ENTERPRISES, LP

The WCAB granted reconsideration, affirming temporary disability for the applicant from April 7, 2018, to August 30, 2018. The Board rejected the defendant's argument that the applicant was estopped from receiving benefits due to refusing modified work, as the offer was only for the 2017 season and no offer existed for 2018. While agreeing the defendant's delays estopped them from challenging temporary disability, the Board limited this to the period until the applicant could be examined by a newly authorized treating physician. The issue of temporary disability after August 30, 2018, was deferred pending further medical reports.

WCABPetition for ReconsiderationTemporary DisabilityModified WorkEstoppelQualified Medical EvaluatorTreating PhysicianSeasonal HarvesterBerry IndustryIndustrial Injury
References
1
Case No. ADJ8270156
Regular
Oct 10, 2014

JORGE PRECIADO vs. ALAMILLO REBAR, INC.; OLD REPUBLIC GENERAL INSURANCE

This case involves an employer seeking reconsideration of an award of temporary disability indemnity to the applicant for an industrial injury. The employer argued that the medical evidence was insufficient and that the applicant was estopped from claiming benefits due to refusing modified work. However, the Workers' Compensation Appeals Board denied the petition, adopting the judge's report which credited the applicant's testimony that he was not offered suitable modified work. The Board emphasized that an applicant may be estopped from receiving benefits only if they refuse suitable modified work without good cause, and the judge's credibility determination was given great weight.

Temporary disability indemnityQualified medical evaluatorSubstantial medical evidenceEstoppelModified workOdd lot doctrineHealing periodCredibility determinationsPetition for reconsiderationFindings of Fact
References
6
Case No. MISSING
Regular Panel Decision

Claim of Illaqua v. Barr-Llewellyn Buick Co.

This case involves an appeal by an employer and its carrier, Unigard Insurance Company, from a Workers’ Compensation Board decision. The Board found that Unigard was estopped from denying further liability under Workers’ Compensation Law section 29, subdivision 5. The claimant sustained work-related injuries in 1970, and his compensation case was closed pending a third-party action against Black Hawk Manufacturing Company. This third-party action was later dismissed in 1976 for failure to prosecute, with Unigard's attorney joining the motion to dismiss. The Board concluded that Unigard had implied knowledge of the discontinuance and was estopped from asserting statutory benefits, a finding supported by the carrier's active involvement in the dismissal of the third-party action. The appellate court affirmed the Board's decision, emphasizing the protective nature of compensation law for workers.

Workers' CompensationEstoppelThird-Party ActionFailure to ProsecuteInsurance Carrier LiabilityDiscontinuanceBoard DecisionAppellate ReviewStatutory InterpretationEmployer Liability
References
5
Case No. MISSING
Regular Panel Decision

Gorman v. Town of Huntington

This case involves Norma and Hugh Gorman suing the Town of Huntington for injuries sustained from a sidewalk trip and fall. The core dispute centers on the Town's defense of lacking prior written notice of the defective sidewalk condition, as required by local ordinances. However, the plaintiffs argued that the Town should be estopped from asserting this defense because a municipal employee instructed a member of the public to send notice to the Department of Engineering Services (DES), which managed sidewalk maintenance and its own record-keeping system. The court affirmed the lower court's denial of the Town's motion for summary judgment, agreeing that the Town was estopped. This decision established a new, narrow exception to strict prior written notice statutes, based on the Town's actions and the public's reliance, and awarded partial summary judgment to the plaintiffs, dismissing the Town's affirmative defenses regarding prior written notice.

Prior Written NoticeMunicipal LiabilitySidewalk DefectEstoppelSummary JudgmentNegligenceTrip and FallDelegation of DutiesGovernmental Immunity ExceptionsPublic Safety
References
66
Case No. 2015 NY Slip Op 08506 [133 AD3d 518]
Regular Panel Decision
Nov 19, 2015

Vega v. Metropolitan Transportation Authority

Plaintiff Raul Vega, a laborer, was injured at a subway station reconstruction site when a coworker operating an excavator dropped concrete debris on him, resulting in a crushed left index finger. Plaintiffs sought partial summary judgment on Labor Law §§ 240 (1) and 241 (6) claims, while defendants cross-moved to collaterally estop plaintiffs from relitigating an issue decided by the Workers' Compensation Board. The Supreme Court denied both motions. The Appellate Division modified the order, granting the defendants' cross-motion to collaterally estop the plaintiffs regarding complex regional pain syndrome, as this issue was previously decided by the Workers' Compensation Board. The Court otherwise affirmed the denial of plaintiffs' motion for summary judgment on the Labor Law claims, citing issues of fact regarding comparative negligence for the § 241 (6) claim and the lack of a malfunctioning safety device for the § 240 (1) claim.

Personal InjuryConstruction AccidentExcavator AccidentConcrete DebrisLabor Law § 240(1)Labor Law § 241(6)Summary JudgmentComparative NegligenceCollateral EstoppelWorkers' Compensation Board
References
8
Case No. ADJ1452726 (RIV 0075376)
Regular
Jul 29, 2009

MARCIAL BOLANOS vs. MERIT MASONRY, STATE COMPENSATION INSURANCE FUND

The appeals board reversed the July 29, 2009 award because the applicant never filed a claim form, and the defendant is not estopped from asserting this.

Workers' Compensation Appeals BoardMerit MasonryState Compensation Insurance FundMarcial BolanosDean H. Shapiro D.C.ADJ1452726RIV 0075376Opinion and Order Granting ReconsiderationFindings and AwardLabor Code section 5401(a)
References
1
Case No. ADJ531686 (LBO 0336423)
Regular
Sep 24, 2008

CARLEEN LOGAN vs. UCLA, permissibly self-insured

The WCAB rescinded the July 1, 2008 order disallowing Dr. Richards' lien claim, finding the record unclear on whether notice was given to the defendant. The matter was returned to the trial level to determine if the defendant is estopped from asserting the time requirement.

Workers' Compensation Appeals Boardlien claimCompromise and ReleaseOrder Approving Compromise and ReleaseLabor Code section 4903.5Labor Code section 4904untimely filedestoppelnoticenature and extent of claim
References
2
Case No. LAO 766181
Regular
Aug 05, 2008

MARIA NAVA vs. NORMAN'S ORCHIDS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

This case concerns a workers' compensation applicant seeking to reopen her award for new and further disability. The defendant argued the petition to reopen was untimely filed. The Appeals Board denied reconsideration, finding the petition was timely filed and that the defendant waived or was estopped from asserting the statute of limitations defense due to its actions.

Workers Compensation Appeals BoardNew and Further DisabilityPetition to ReopenStatute of LimitationsJurisdictionWaiverEstoppelSuperior National Insurance CompanyCalifornia Insurance Guarantee AssociationLabor Code Section 5410
References
16
Case No. ADJ6713391
Regular
Aug 15, 2013

PEDRO TELLO MENDEZ vs. MISSION FOODS GRUMA CORPORATION, TRAVELERS PROPERTY CASUALTY COMPANY

The Workers' Compensation Appeals Board granted reconsideration of the initial May 30, 2013 decision. The Board amended the decision to reflect that the defendant, Mission Foods Gruma Corporation, is estopped from opposing the applicant's petition for costs. Consequently, the applicant's Petition for Costs is now granted. The rest of the original decision remains affirmed.

Petition for ReconsiderationDecision After ReconsiderationEstoppelPetition for CostsWorkers' Compensation Appeals BoardWCJMission Foods Gruma CorporationTravelers Property Casualty CompanyPedro Tello MendezAmended Decision
References
0
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