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

Case No. ADJ7432904
Regular
Sep 24, 2012

NEDA MOTAVAKEL vs. FANTASTIC SAM'S, TOWER SELECT INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, STAR INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, ENDURANCE WORKERS' COMPENSATION, SOUTHERN INSURANCE CO., FIRSTCOMP OMAHA

This case involves an appeal by Star and Tower Insurance Companies regarding a workers' compensation award. The primary issue is the applicant's average weekly earnings, specifically the inclusion of tip income, which was not adequately substantiated by documentary evidence. The Appeals Board found the initial decision lacked substantial evidence regarding earnings and rescinded the award. The matter is remanded for further proceedings to properly develop the evidentiary record on earnings and insurance coverage dates before a new decision is issued.

Workers' Compensation Appeals BoardNeda MotavakelFantastic Sam'sTower Select Insurance CompanyStar Insurance CompanyIllinois Midwest Insurance AgencyLLEndurance Workers' CompensationSouthern Insurance CompanyFirstComp Omaha
References
Case No. ADJ10232182
Regular
Jul 07, 2017

JOSE SAENZ vs. WILLIAM STOESSER, CLAIRE WERNER, REBECCA B. PISCITELLI 2012 SPECIAL TRUST DATED 12/21/2012, ADAM W. BUCK 2012 SPECIAL TRUST Dated 12/21/2012, BENJAMIN C. BUCK 2012 SPECIAL TRUST Dated 12/21/2012, STATE FARM INSURANCE

This case involves a workers' compensation claim where the applicant, Jose Saenz, was injured on April 10, 2015. State Farm sought reconsideration of an arbitrator's finding that four of its insurance policies provided coverage. The Appeals Board granted reconsideration, finding the arbitrator's coverage determination premature. The Board rescinded the prior order and returned the matter to the trial level for a determination of who constitutes the applicant's employer(s) before insurance coverage issues can be addressed.

Workers Compensation Appeals BoardPetitions for ReconsiderationDecision After ReconsiderationWilliam StoesserClaire WernerRebecca B. Piscitelli 2012 Special TrustAdam W. Buck 2012 Special TrustBenjamin C. Buck 2012 Special TrustState Farm InsuranceHomeowner's Policy
References
Case No. ADJ7785936
Regular
Sep 28, 2012

LISA VALDEZ vs. AH CLEARLAKE HOSPITAL, INC. dba ST.\nHELENA HOSPITAL CLEARLAKE, administered by, ADVENTIST HEALTH

This case involves a petition for reconsideration filed by Lisa Valdez related to a prior decision dated August 22, 2012. The petitioner, Valdez, has since withdrawn their petition. Consequently, the Workers' Compensation Appeals Board has formally dismissed the petition for reconsideration. This dismissal is effective as of September 28, 2012.

Petition for ReconsiderationDismissedWithdrawnWorkers' Compensation Appeals BoardApplicantDefendantADJ7785936Santa Rosa District OfficeAugust 22 2012September 28 2012
References
Case No. ADJ4357722 (SBR 0307145) ADJ5714365
Regular
Jun 06, 2012

ANASTASIA JENKINS vs. NEXT ENTERPRISES, INC.

This case involves Anastasia Jenkins' workers' compensation claim against Next Enterprises and the California Insurance Guarantee Association. The Second Appellate District affirmed the Appeals Board's decision that Pinnacle Lien Services could represent multiple lien claimants. The appellate court remanded the case for further proceedings consistent with its opinion. The Appeals Board is now returning the case to the trial level for the workers' compensation judge to conduct necessary proceedings and issue decisions.

ADJ4357722ADJ5714365Anastacia JenkinsNext Enterprises Inc.California Insurance Guarantee AssociationVillanova Insurance liquidationOracle ImagingN-CareNations Surgery CenterPinnacle Lien Services
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. ADJ7077497, ADJ7984313, ADJ7984335
Regular
Oct 16, 2012

LULA TAVE vs. COUNTY OF LOS ANGELES/DEPARTMENT OF HEALTH SERVICES

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of the prior decision. The WCAB rescinded the Administrative Law Judge's (WCJ) decision from August 2, 2012. The case is now returned to the trial level for further proceedings and a new decision by the WCJ. This order is not a final determination on the merits.

Petition for ReconsiderationGrant ReconsiderationRescind DecisionReturn to Trial LevelFurther ProceedingsDecision After ReconsiderationWCJ ReportWorkers' Compensation Appeals BoardAdministrative Law JudgeADJ7077497
References
Case No. ADJ9022023
Regular
Jul 14, 2014

Katherine Ann Burton vs. MOTEL 6, LIBERTY MUTUAL INSURANCE

The Workers' Compensation Appeals Board granted the defendant's Petition for Reconsideration to amend an award. The original award found temporary total disability from July 22, 2013, to November 6, 2013, but only awarded indemnity benefits through October 4, 2013. The Board, adopting the WCJ's recommendation, amended the award to reflect temporary total disability specifically from July 22, 2013, to October 4, 2013. The issue of benefits after October 4, 2013, was deferred.

Petition for ReconsiderationFindings Award and Ordertemporary total disabilitytemporary disability indemnityworkers' compensation appeals boardWCJLiberty Mutual InsuranceMotel 6Report and Recommendationamended
References
Case No. ADJ6843753
Regular
Jul 03, 2012

REGLO MOLINA vs. WORKFORCE STAFFING dba GENEVA STAFFING and TOWER GROUP COMPANIES (Formerly SPECIALTY UNDERWRITERS ALLIANCE/SUA) Administered By INTERCARE HOLDINGS INSURANCE SERVICES

In *Molina v. Workforce Staffing*, the Workers' Compensation Appeals Board denied a Petition for Removal. The Board adopted and incorporated the administrative law judge's report as the basis for this denial. The specific reasons for the denial are detailed in that incorporated report. The order was served on July 3, 2012.

Petition for RemovalWorkers' Compensation Appeals BoardWorkforce StaffingGeneva StaffingTower Group CompaniesSpecialty Underwriters AllianceSUAIntercare Holdings Insurance ServicesADJ6843753Marina del Rey
References
Case No. ADJ6659926, ADJ6659223
Regular
Feb 10, 2012

MICHELLE JIMENEZ vs. DENCO SALES COMPANY, ACE PROPERTY AND CASUALTY COMPANY, ARGONAUT INSURANCE COMPANY

This case involves a nunc pro tunc order by the Workers' Compensation Appeals Board (WCAB) to correct a clerical error in a prior January 6, 2012 decision. The error was the inclusion of "days" alongside "weeks" when specifying the duration of additional temporary disability indemnity. The WCAB clarified that the award was for up to 35 weeks of temporary disability, not weeks and days. While defendants raised issues about their respective liabilities and payments, the WCAB confirmed that the January 6, 2012 decision only addressed the total amount of temporary disability owed to the applicant and did not resolve inter-defendant contribution claims.

Nunc Pro Tunc OrderClerical ErrorTemporary Disability IndemnityFindings and AwardReconsiderationContributionReimbursementCumulative Trauma InjuryWorkers' Compensation Appeals BoardWCJ
References
Case No. ADJ8231938
Regular
Nov 07, 2016

MARIA RIVERA vs. ERA PRODUCTS, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For ULLICO CASUALTY COMPANY, STAR INSURANCE COMPANY, SUSSEX INSURANCE COMPANY

This case concerns determining the correct date of injury for applicant Maria Rivera's cumulative injury claim. Defendant Sussex Insurance Company sought reconsideration of the administrative law judge's finding that the date of injury was February 17, 2012. Sussex argued for an earlier date, which would shift liability to a prior insurer, Star Insurance. The Workers' Compensation Appeals Board denied reconsideration, finding insufficient evidence that Rivera suffered wage loss or ratable permanent disability before February 17, 2012, as required by Labor Code section 5412. Therefore, Sussex remains liable for the claim.

Labor Code 5412Cumulative InjuryDate of InjuryDisabilityWage LossInsurance Guarantee AssociationReconsiderationFindings of FactOpinion and OrderWorkers' Compensation Appeals Board
References
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