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

Case No. CV-24-0636
Regular Panel Decision
May 29, 2025

In the Matter of the Claim of Felipe Zamora Ramales

Claimant Felipe Zamora Ramales, a pizzeria kitchen assistant, suffered severe burns after a fall down basement stairs while carrying a large pot of hot tomato sauce. Emergency notes indicated a high blood alcohol content, leading the employer and carrier to argue his injuries were solely due to intoxication and thus not compensable. Initially, a Workers' Compensation Law Judge disallowed the claim, but the Workers' Compensation Board reversed this, establishing the claim and finding that intoxication was not the sole cause, invoking the presumption of compensability under Workers' Compensation Law § 21 (4). The Appellate Division, Third Judicial Department, affirmed the Board's decision, determining that the carrier failed to meet the heavy burden of proof required to rebut the presumption. The court reasoned that navigating a heavy pot down stairs was a contributory factor in the accident, preventing intoxication from being the exclusive cause.

Workers' CompensationIntoxication DefensePresumption of CompensabilityWorkplace AccidentBurn InjuryBlood Alcohol ContentSole CauseContributory FactorAppellate ReviewCredibility Assessment
References
9
Case No. MISSING
Regular Panel Decision
Jul 18, 2008

Felipe v. Target Corp.

The plaintiff, Thelma Felipe, sued Target Corporation and Kingsbridge in New York state court after slipping and falling in a Target store. Target removed the case to federal court based on diversity jurisdiction. Felipe moved to remand the case to state court, arguing that the amount in controversy did not exceed $75,000 and that complete diversity was lacking due to Kingsbridge, a New York corporation, being a co-defendant. The court denied Felipe's motion, finding that the amount in controversy was likely over $75,000, as conceded by plaintiff's counsel. The court also determined that Target's principal place of business is Minnesota, establishing diversity with Felipe (a New York resident), and concluded that Kingsbridge was fraudulently joined, as there was no possibility of recovery against them under New York law because they had no contractual obligation to maintain the interior of the store where the injury occurred.

Diversity JurisdictionRemovalRemandAmount in ControversyComplete DiversityFraudulent JoinderSlip and FallPersonal InjuryCorporate CitizenshipNerve Center Test
References
20
Case No. GOL 0100565
Regular
Oct 15, 2007

Felipe Quezada vs. EXCLUSIVE GERMAN AUTO REPAIR, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding the original finding that his injury claim was barred by Labor Code section 3600(a)(10), the post-termination defense. Despite the applicant's argument that notice and termination were concurrent, the Board gave significant weight to the Workers' Compensation Judge's credibility assessment of the witnesses, who found the defense witnesses more credible. Therefore, the applicant will receive no compensation.

Felipe QuezadaExclusive German Auto RepairState Compensation Insurance FundLabor Code section 3600(a)(10)post-termination defenseconcurrent noticeterminationWCJcredibilitypetition for reconsideration
References
1
Case No. ADJ9097708
Regular
Jun 28, 2016

MARIA QUEZADA DUENAS vs. PRIDE INDUSTRIES, BROADSPIRE

The Workers' Compensation Appeals Board denied Maria Quezada Duenas' Petition for Removal against Pride Industries and Broadspire. The Board adopted the WCJ's report, finding that removal is an extraordinary remedy and the applicant failed to demonstrate substantial prejudice or irreparable harm. Furthermore, the applicant did not show that reconsideration would be an inadequate remedy for any potential adverse decision. The WCJ's report also noted a procedural defect in the verification of the petition.

Petition for RemovalWCABExtraordinary RemedySubstantial PrejudiceIrreparable HarmReconsiderationProcedural DefectVerificationCumulative TraumaPermanent and Stationary
References
4
Case No. ADJ8310177
Regular
Apr 25, 2014

FELIPE HERNANDEZ (DECEASED) vs. SUPERIOR READY MIX CONCRETE, TRISTAR RISK MANAGEMENT

This case involves a Petition for Removal filed by a party in the workers' compensation matter of Felipe Hernandez (deceased) v. Superior Ready Mix Concrete. The petitioner subsequently withdrew the filed petition. Consequently, the Workers' Compensation Appeals Board has issued an order dismissing the petition for removal. No further action will be taken on this withdrawn petition.

Petition for RemovalWithdrawn PetitionDismissed PetitionWorkers' Compensation Appeals BoardSelf-InsuredTristar Risk ManagementDeceased ApplicantADJ8310177San Diego District OfficeOrder Dismissing
References
0
Case No. ADJ8419958
Regular
Jan 16, 2014

FELIPE RAMIREZ vs. D'ARCY & HARTY CONSTRUCTION, INC., OLD REPUBLIC GENERAL INSURANCE CORPORATION

This case involves a worker's compensation applicant, Felipe Ramirez, seeking approval for spinal surgery recommended by his treating physician, Dr. Naraghi. The defendants contested the surgery, and Utilization Review initially denied the request. The Administrative Law Judge (ALJ) awarded the surgery, finding the UR denial invalid as the reviewing doctor lacked crucial medical information. The Appeals Board denied the defendants' petition for reconsideration, affirming the ALJ's decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationDenialSpinal surgeryDr. NaraghiUtilization ReviewNon-certificationDr. DeutschSandhagenLabor Code §4610
References
1
Case No. ADJ6472001
Regular
May 29, 2019

JAIME QUEZADA, JR. vs. NEIL JONES FOOD COMPANY DBA TOMATEK, SAFETY NATIONAL INSURANCE COMPANY

This case involves a workers' compensation claim by Jaime Quezada, Jr. against Neil Jones Food Company (Toma-Tek) and its insurer. The applicant initially received an award for permanent total disability and further medical treatment for back, leg, psyche, and hypertension injuries. Following a petition for reconsideration by the defendant, the parties submitted Stipulations With Request for Award. The Workers' Compensation Appeals Board (WCAB) approved these stipulations, rescinding the prior award and issuing a new award for permanent partial disability (63%) and further medical treatment, resolving lien claims and approving the attorneys' fee.

Workers Compensation Appeals BoardJaime Quezada Jr.Neil Jones Food CompanySafety National Insurance CompanyCannon Cochran ConcordADJ6472001ReconsiderationStipulations With Request for AwardAdministrative Law JudgeHypertension
References
0
Case No. 2025 NY Slip Op 03234 [238 AD3d 1454]
Regular Panel Decision
May 29, 2025

Matter of Ramales v. Frank & Nino's Pizza Corp.

Felipe Zamora Ramales, a pizzeria kitchen assistant, suffered severe burns after falling down stairs while attempting to move a large pot of hot tomato sauce. His employer and its carrier controverted his workers' compensation claim, arguing intoxication was the sole cause of the accident and that he deviated from the scope of his employment. The Workers' Compensation Board reversed a Workers' Compensation Law Judge's disallowance, establishing the claim. The Appellate Division affirmed the Board's decision, finding that the carrier failed to rebut the presumption that intoxication was not the sole cause and that claimant's actions did not constitute a deviation from employment sufficient to preclude benefits.

Workers' CompensationIntoxication DefenseScope of EmploymentPresumption of CompensabilityAppellate ReviewBurn InjuryPizzeria WorkerBlood Alcohol ContentCredibility AssessmentHearsay Evidence
References
8
Case No. ADJ8967361
Regular
Nov 26, 2014

FELIPE GARCIA (DECEASED) GUILLERMINA GARCIA (WIDOW) vs. SALVADOR GAYTAN dba G\&P AG MANAGEMENT CONTRACTORS, INC.; STAR INSURANCE, Adjusted by MEADOWBROOK INSURANCE GROUP

This case involved a petition for reconsideration by the applicant in a workers' compensation matter where the deceased worker, Felipe Garcia, was initially found to be an employee but later deemed an independent contractor by the Appeals Board. The applicant argued the Board erred by disregarding the WCJ's credibility assessment and by not applying Labor Code section 2750.5 to unlicensed contractors. The Board denied the petition, finding no evidence the deceased worker was engaged in activities requiring a contractor's license under Business and Professions Code sections 7000 and 7026. Therefore, Labor Code section 2750.5 was inapplicable, and the prior decision finding the applicant an independent contractor was upheld.

Workers' Compensation Appeals BoardIndependent contractorEmployee statusReconsiderationLabor Code section 2750.5Contractors' State License LawBlew v. HornerGarza v. Worker's Comp. Appeals Bd.Rinaldi v. Workers' Comp. Appeals Bd.Unlicensed contractor
References
4
Case No. 2020 NY Slip Op 01290 [180 AD3d 590]
Regular Panel Decision
Feb 25, 2020

Reyes v. Roman Catholic Church of St. Raymond

The Appellate Division, First Department, unanimously affirmed an order from the Supreme Court, Bronx County. The case involved plaintiff Felipe Reyes, a special employee of The Roman Catholic Church of St. Raymond, whose Labor Law § 240 (1) claim was dismissed based on Workers' Compensation Law § 29 (6). The court also denied summary judgment on St. Raymond's third-party contractual indemnification claim against ABM Janitorial Services-Northeast, Inc., due to an unresolved issue of fact regarding ABM's negligence. The decision concluded that Reyes's claim against St. Raymond was barred due to his special employee status.

Special Employee DoctrineSummary JudgmentLabor Law § 240(1)Workers' Compensation Law § 29(6)Contractual IndemnificationThird-Party ClaimAppellate ReviewWorkplace InjuryPremises LiabilityNegligence
References
2
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