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

Case No. ADJ10298988
Regular
Jan 31, 2018

BRIAN BERRY vs. HOSPICE OF THE FOOTHILLS, ALPHA FUND

The Appeals Board rescinded the prior decision and returned the case to the trial level for further proceedings. The Board found that the record was insufficient to determine if the applicant voluntarily retired or was constructively terminated from his employment. Further development of evidence is needed to establish whether the applicant intended to permanently leave the labor force or if his industrial injury prevented him from continuing to work. This determination is crucial for assessing his entitlement to additional temporary disability benefits and potentially permanent disability benefits.

Workers' Compensation Appeals Boardindustrial injuryright shouldertemporary disability indemnityvoluntarily retiredlabor forcedue processself-representedadmission of evidenceexclusion of evidence
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ5836855
Regular
Dec 11, 2012

Malory Wheat vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) rescinded a prior award allowing a lien for living expenses claimed by the CCPOA Benefits Trust Fund. The WCAB held that liens in workers' compensation are strictly statutory and the CCPOA's claim for reimbursement of benefits advanced did not fit within the specific provisions of Labor Code sections 4903 or 4903.1 for "living expenses" or benefits provided by a "self-insured employee welfare benefit plan." The Board clarified that liens for living expenses are intended for those who loan money or extend credit, not for contractual obligations of insurance or benefit plans.

Workers' Compensation Appeals BoardMalory WheatState Compensation Insurance FundCCPOA Benefits Trust Fundlien claimantLabor Code section 4903(c)Labor Code section 4903.1(a)(1)Labor Code section 4903.1(a)(2)Labor Code section 4903.1(a)(3)living expenses
References
Case No. ADJ11184438
Regular
Oct 02, 2019

Ricardo Villanueva vs. Golden Labor Services, LLC, Security National Insurance Company

The applicant sought reconsideration of a WCJ's denial of temporary disability benefits from February 1, 2018, to January 9, 2019, for a left shoulder injury. The Appeals Board granted reconsideration, affirming denial of benefits from June 5, 2018, due to refusal of modified work but deferring the issue of benefits from February 1, 2018, to June 4, 2018. This deferral is due to the WCJ's inability to locate critical medical reports, which appear to have been physically filed but not properly scanned into the electronic system through no fault of the applicant. Further proceedings are required to properly rescan and consider these exhibits.

Petition for ReconsiderationTemporary Disability IndemnityModified WorkLabor Code Section 4658.1Electronic Adjudication FileTreating Physician ReportsAmended Petition for PenaltiesSeparate Time-StampDocument Separator SheetScanned Exhibits
References
Case No. ADJ4221124 (SFO 0508133)
Regular
Jun 19, 2012

THEMAS OLSON (Deceased); VICTORIA OLSON (Widow) vs. CITY OF VACAVILLE

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration of an intermediate discovery order, finding it was not a final order. The Board granted the defendant's petition for removal solely to address potential sanctions against their counsel, George Fögy, and his firm, Stockwell, Harris, Woolverton & Muehl. This notice of intent to sanction stems from alleged misrepresentations within the defendant's petition regarding the origin of Exhibit 1 and the explanation for settlement discrepancies. The Board is giving Fögy and his firm an opportunity to show cause why sanctions up to $2,500 should not be imposed.

WCABPetition for ReconsiderationPetition for RemovalSanctionsLabor Code § 5813Civil Asbestos SettlementExhibit 1In Camera ReviewWork ProductPrivilege Waiver
References
Case No. ADJ8944426, ADJ8942895
Regular
Dec 22, 2014

DAVID POSHOGLYAN vs. HOLLIDAY ROCK COMPANY, INC., INSURANCE COMPANY OF THE WEST, XL SPECIALTY INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of a decision finding applicant sustained injury arising out of and in the course of employment. Defendants argued certain exhibits were improperly admitted due to lack of service and that the decision was vague. The Board adopted the WCJ's report, which found the exhibits were properly admitted or any error was harmless, and that the decision adequately addressed the stipulated facts. The WCJ's report detailed why the exhibits were admissible despite service issues and explained that further clarification on body parts or liability was not required at this stage of the proceedings.

ADJ8944426ADJ8942895PoshoglyanHolliday Rock CompanyInsurance Company of the WestXL Specialty Insurance CompanySedgwickPetition for ReconsiderationDeniedWCJ Report
References
Case No. ADJ7159838 ADJ7550047
Regular
Jul 29, 2014

ALMA PELAYO vs. ASSOCIATED LIEN SERVICES

Applicant Alma Pelayo sought reconsideration of a prior decision that found no violation of Labor Code section 132(a) and ordered her to take nothing further. Pelayo argued the judge erred in this finding and in failing to rule on the admissibility of her Exhibit 15. The Appeals Board granted reconsideration solely to admit Pelayo's Exhibit 15 and defendant's Exhibits A1, A2, and A3. The Board otherwise affirmed the original decision, meaning Pelayo still takes nothing further.

Workers' Compensation Appeals BoardLabor Code section 132(a)Findings and OrderPetition for ReconsiderationWCJApplicant's Exhibit 15Defendant's Exhibits A1A2A3admissible evidence
References
Case No. ADJ10443669
Regular
Oct 04, 2017

Donna Carter vs. Rose International Group, OneBeacon Insurance Group

The Appeals Board affirmed the Workers' Compensation Judge's finding that Donna Carter sustained an industrial injury to her right knee and left wrist on May 18, 2016. Despite inconsistencies in the applicant's testimony regarding a slip and fall incident, her account was corroborated by a witness who found her on the floor. Medical records from the day of the incident also supported the applicant's claim, establishing a clear mechanism of injury. The Board found that the common sense nature of a slip and fall does not require expert medical opinion to establish industrial causation for the incident itself.

ADJ10443669Rose International GroupOneBeacon Insurance GroupDonna CarterWorkers' Compensation Appeals BoardOpinion and Decision After Reconsiderationslip and fallindustrial injuryright kneeleft wrist
References
Case No. ADJ7555409
Regular
Mar 04, 2014

JESUS ESCANUELA vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted the defendant's Petition for Reconsideration and dismissed the applicant's untimely petition. The WCAB found that the Agreed Medical Examiner's (AME) opinion regarding psychiatric permanent disability was not supported by substantial evidence, as it did not properly address causation under the current PDRS. Consequently, the case is remanded to the trial level for further development of the record concerning psychiatric permanent disability. The WCAB deferred the issue of permanent disability and attorney's fees pending this further development.

Workers' Compensation Appeals BoardJesus EscanuelaCalifornia Department of Correctionslegally uninsuredState Compensation Insurance FundADJ7555409Fresno District OfficeOpinion and OrderPetition for ReconsiderationFindings and Award
References
Case No. ADJ7212946
Regular
Dec 13, 2012

JOSE QUINTERO vs. CORPORATE PERSONNEL NETWORK, NEW HAMPSHIRE INSURANCE CO., administered by CHARTIS

The Appeals Board granted reconsideration to address the admissibility of Dr. Konstat's psychiatric evaluation. The Board found Dr. Konstat's report inadmissible because it was a medical-legal evaluation obtained in violation of statutory procedures for represented employees, bypassing the requirement for an Agreed Medical Evaluator or Qualified Medical Evaluator. Consequently, the Board amended the prior award to exclude industrial injury to the psyche due to lack of substantial medical evidence. The applicant's award for orthopedic injuries and medical treatment was affirmed.

Workers' Compensation Appeals BoardJose QuinteroCorporate Personnel NetworkNew Hampshire Insurance Co.ChartisAmended Findings and Awardindustrial injuryleft shoulderneckback
References
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