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

Case No. 535140
Regular Panel Decision
Nov 17, 2022

In the Matter of the Claim of Fernando Nunez

Fernando Nunez appealed two decisions from the Workers' Compensation Board. Nunez, a maintenance worker, sustained work-related injuries in July 2018. In March 2019, he experienced further back issues at home and resigned. His workers' compensation claim was initially established for a lower back injury by a WCLJ, who found the March 2019 incident exacerbated his prior injury and awarded benefits. However, the Board modified this, finding insufficient evidence of a causally-related disability after March 2019, and denied authorization for surgery. The Appellate Division affirmed the Board's decisions, noting Nunez's burden to prove continued disability and the Board's authority to assess medical evidence credibility, especially when expert opinions were based on incomplete histories provided by Nunez.

Workers' CompensationCausally Related DisabilityAppellate ReviewMedical Evidence CredibilityBurden of ProofLumbar Spine InjuryHerniated DiscBoard DecisionIndependent Medical ExaminationIncomplete Medical History
References
9
Case No. ADJ7722627
Regular
Jun 01, 2012

FERNANDO FLORES vs. COUNTY OF MONTEREY

The defendant, County of Monterey, withdrew its Petition for Removal after reaching an agreement with the applicant, Fernando Flores, to utilize an agreed medical evaluator. The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's petition as a result of this withdrawal. This order effectively closes the removal process in this case.

Petition for RemovalAgreed Medical EvaluatorFindings and OrderWorkers' Compensation Appeals BoardDismissalIntercare InsuranceCounty of MontereyAdministrative Law JudgeApplicantDefendant
References
0
Case No. MISSING
Regular Panel Decision
Sep 25, 1998

Moses v. Pinazo

Isidore Moses, a laboratory clerk at New York Community Hospital, sustained personal injuries after slipping on glue during a re-tiling project in the Intensive Care Unit, where Fernando Pinazo, through a subcontractor, was performing work. Moses, despite observing the glue, attempted to navigate around it and subsequently fell. The Supreme Court granted summary judgment dismissing his complaint, a decision which was upheld on appeal. The appellate court determined that Moses did not fall within the protected class of workers under Labor Law § 241 (6) for construction-related hazards, as his role was not connected to the construction work. Furthermore, the court found that the glue constituted an integral part of the re-tiling process, not a covered obstruction under Industrial Code 12 NYCRR 23-1.7 (e). The defendant Pinazo was also found to have no common-law duty to warn, as the hazard was readily observable by Moses, who acknowledged seeing the glue prior to his accident.

Personal InjurySummary JudgmentLabor LawPremises LiabilityDuty to WarnReadily Observable HazardConstruction AccidentAppellate ReviewIndustrial CodeWorker Classification
References
4
Case No. ADJ3299590
Regular
Sep 08, 2008

Fernando Pineda vs. Jose Casillas/JOE SNYDER (Deceased), Allied Insurnace, A Nationwide Company

The Appeals Board granted reconsideration and reversed the WCAs decision, finding that the applicant's injury was not covered by the homeowner's insurance policy because the insured was engaged in a farming business at the time of the injury.

Workers' Compensation Appeals BoardAllied InsuranceFernando PinedaJoe Snyderresidential employeefarming pursuit exclusionhomeowner's policydomestic employees endorsementbusiness activitycoverage dispute
References
0
Case No. ADJ13303390
Regular
Feb 15, 2023

JULIO PINEDA vs. CITY OF RANCHO CUCAMONGA, LWP CLAIMS SOLUTIONS, INC.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to review the administrative law judge's (WCJ) finding of a compensable psychiatric injury. The defendant argued the psychiatric Qualified Medical Examiner's (QME) opinion lacked substantial evidence and that a "good faith personnel action" defense applied. The WCAB rescinded the award, finding the WCJ's decision failed to include a detailed analysis of the "good faith personnel action" defense as required by *Rolda v. Pitney Bowes*. The matter is returned to the WCJ to issue a new decision addressing all relevant issues under the preponderance of evidence standard.

Psychiatric injuryGood faith personnel action defenseRolda analysisSubstantial causePredominant causeQualified Medical Examiner (QME)Findings and Award (F&A)RescindReturn to WCJLabor Code section 3208.3
References
2
Case No. ADJ883280 (POM 0291224)
Regular
May 12, 2010

FERNANDO JIMENEZ vs. BEWLEY-ALLEN CADILLAC, HARCO INSURANCE, BROADSPIRE

This case involves Fernando Jimenez's workers' compensation claim against Bewley-Allen Cadillac and its insurer. The Workers' Compensation Appeals Board reviewed Jimenez's Petition for Reconsideration. Citing the administrative law judge's report, the Board dismissed the petition. The final order is the dismissal of the Petition for Reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationReport and RecommendationAdministrative Law JudgeDismissedBewley-Allen CadillacHarco InsuranceBroadspireADJ883280POM 0291224
References
0
Case No. ADJ8926229
Regular
Jul 22, 2016

FERNANDO LOPEZ vs. DELUXE LABORATORIES, ZURICH NORTH AMERICA, ESIS

This case involves applicant Fernando Lopez seeking reconsideration of a Workers' Compensation Appeals Board decision. The Board has granted reconsideration to allow for further study of the factual and legal issues. This is necessary to ensure a complete understanding of the record and to issue a just decision. All future filings related to the petition must be submitted directly to the Appeals Board Commissioners, not the district office, and settlement proposals require prompt notification of the Appeals Board.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationGranting ReconsiderationDecision After ReconsiderationStatutory Time ConstraintsFactual and Legal IssuesJust and Reasoned DecisionFurther ProceedingsOffice of the CommissionersElectronic Adjudication Management System
References
0
Case No. ADJ7860847 & ADJ7860626
Regular
Nov 09, 2011

FERNANDO SARMIENTO vs. BLUE CHIP RECYCLING, WAUSAU UNDERWRITERS INSURANCE CO., LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board has granted reconsideration in the case of Fernando Sarmiento versus Blue Chip Recycling and its insurers. This decision was made due to a petition filed by defendant Wausau Underwriters Insurance Company, necessitating further review of the factual and legal issues. The Board requires additional study of the record to ensure a just and reasoned decision. All future communications in this matter should be directed to the Board's Office of the Commissioners in San Francisco.

Petition for ReconsiderationWorkers' Compensation Appeals BoardWausau UnderwritersLiberty MutualFernando SarmientoBlue Chip RecyclingStatutory time constraintsFactual and legal issuesDecision After ReconsiderationOffice of the Commissioners
References
0
Case No. ADJ7238687
Regular
Apr 18, 2013

Fernando Munoz vs. Kings Hawaiian Bakery West Inc., Zurich American Insurance Co., Gallagher Bassett

The Workers' Compensation Appeals Board (WCAB) affirmed the original findings that Fernando Munoz sustained an injury arising out of and occurring in the course of employment (AOE/COE) to his neck, low back, and left shoulder. The employer argued Munoz failed to prove they had notice of the injury before his termination. However, the WCAB found Dr. Feiwell's medical opinions constituted substantial evidence supporting the industrial nature of the injuries. The WCAB also gave significant weight to the trial judge's credibility findings regarding Munoz's testimony that he reported the injury to his supervisor.

AOE/COELabor Code Section 3600(a)(10)Petition for ReconsiderationOpinion and Decision After ReconsiderationFindings and OrderWCJAgreed Medical Evaluator (AME)Qualified Medical Evaluator (QME)substantial evidencemedical probability
References
4
Case No. RDG 0119112 RDG 0119113
Regular
Jul 30, 2007

CHARLES PINEDA vs. CALIFORNIA STATE UNIVERSITY, BAKERSFIELD, OCTAGON RISK SERVICES, DEPARTMENT OF HEALTH SERVICES, STATE COMPENSATION INSURANCE FUND

This case involves a petition for reconsideration and removal filed by applicant Charles Pineda against his employer and their insurers. The Workers' Compensation Appeals Board dismissed the petition for reconsideration, finding it was improperly filed against interlocutory orders that did not determine substantive rights. The Board also denied the petition for removal, agreeing with the WCJ's report that no substantial prejudice or irreparable harm was demonstrated.

Workers' Compensation Appeals BoardPetition for ReconsiderationFinal OrderSubstantive RightInterlocutory OrderRemovalWCJ Report and RecommendationSubstantial PrejudiceIrreparable HarmInadequate Remedy
References
11
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