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

Case No. ADJ1718605 (RIV 0018154)
Regular
May 20, 2011

SASON COHEN vs. MORTON'S STEAKHOUSE, ESIS, Inc.

In this workers' compensation case, the Appeals Board granted reconsideration, striking the award for additional temporary disability indemnity. The Board clarified that while jurisdiction exists to award temporary disability beyond five years from the injury date if a timely reopening petition is filed, this only applies to continuous disability that bridges the five-year mark. A new, non-continuous period of temporary disability arising more than five years after the injury, even with a timely filed petition, falls outside the Board's jurisdiction. The Board otherwise affirmed the original findings and award.

New and further disabilityStatute of limitationsTemporary total disabilityReconsiderationFindings and AwardQualified medical evaluatorSubstantial evidenceLabor Code section 5410Labor Code section 5803Labor Code section 5804
References
16
Case No. 57
Regular
Apr 28, 2011

LAURIE TRINIDAD vs. ALBERTSON'S, PSI, Administered by SPECIALTY RISK SERVICES

This case concerns an applicant's claim for temporary disability benefits beyond five years from the date of injury. The Workers' Compensation Appeals Board (WCAB) affirmed the WCJ's decision that it lacked jurisdiction to award these benefits. The WCAB determined that while the applicant experienced new periods of disability after the five-year mark, no petition to reopen or for new and further disability was filed within the statutory period following a prior order awarding temporary disability. The Board distinguished this case from prior decisions where jurisdiction extended beyond five years due to the absence of any prior award or a continuing award that was improperly terminated.

Workers Compensation Appeals BoardLaurie TrinidadAlbertson'sSpecialty Risk ServicesOpinion and Decision After Reconsiderationtemporary disability benefitsjurisdictiongrocery checkerlumbar spinebilateral shoulders
References
12
Case No. ADJ3519701
Regular
Nov 04, 2013

SHERYL SEIFERT vs. BLOCKBUSTER VIDEO, SEDGWICK RIVERSIDE

The applicant, injured in 2001, sought further temporary disability benefits more than five years after her injury date. While the Workers' Compensation Appeals Board (WCAB) generally retains jurisdiction for benefits beyond five years if no final award has been issued, this case involved a prior stipulated award of temporary disability that was subsequently terminated. Therefore, to seek additional benefits, the applicant was required to file a petition to reopen or for new and further disability within the five-year statutory period. Since no such petition was filed within the timeframe, the WCAB properly denied the applicant's petition for reconsideration, upholding the WCJ's finding of lack of jurisdiction to award further benefits.

Petition for ReconsiderationTemporary Disability BenefitsDate of InjuryJurisdictionAward TerminationPetition to ReopenNew and Further DisabilityInsidious Progressive DiseaseStated ReasonsAdministrative Law Judge
References
11
Case No. ADJ1232764
Regular
Mar 24, 2009

ALEXANDRA CULLEN-WRIGHT vs. CUMMINS & WHITE, LLP, STATE COMPENSATION INSURANCE FUND

Applicant sought reconsideration of a WCAB decision denying jurisdiction to amend a prior award, arguing her RSD constitutes an insidious, progressive disease exempting it from the five-year statute of limitations. The Board denied reconsideration, finding the applicant failed to demonstrate her RSD met the criteria for an insidious, progressive disease as defined in *General Foundry Service v. WCAB*. Furthermore, the Board noted the original decision did not reserve jurisdiction and no timely petition to reopen was filed to address this possibility. Therefore, the WCAB lacked jurisdiction to amend the award over five years post-injury.

Workers' Compensation Appeals BoardLabor Code Section 5804cumulative injurycomplex regional pain syndromeRSDagreed medical examinersubstantial evidencepermanent and stationarysympathetic ganglion blockpetition to set aside
References
8
Case No. MISSING
Regular Panel Decision

MacTaggart v. Gibbs & Cox. Inc.

This appeal concerns the dismissal of an action for failure to prosecute for over five years. The plaintiffs' primary excuse for the delay was their involvement in another litigation concerning similar issues. However, the court found that the issues in the two cases were not identical, and a significant period of a year and a half elapsed after the conclusion of the prior litigation without any further action on the present case. The court also considered the prejudice to the defendant, noting the difficulty and impracticability of recouping extra costs from clients related to contracts completed between February 1944 and December 1945. Consequently, the court affirmed the dismissal of the action.

failure to prosecutedismissal of actionappellate reviewdiscretionary powerprejudice to defendantdelay in litigationstipulationsamended complaintnote of issueextra compensation
References
1
Case No. ADJ3138312 (WCK 0059967)
Regular
Jul 05, 2011

GREGORY McBEE vs. AMERICAN DESIGN ROOFING, CIGA, LEGION INSURANCE COMPANY

The Appeals Board rescinded a prior award of temporary disability benefits because the applicant's period of temporary disability commenced more than five years after his date of injury. The Board found that Labor Code section 5410, which allows for claims of new and further disability within five years of injury, did not apply here. Jurisdiction to award temporary disability beyond five years is limited to continuous disability that began within that timeframe, which was not established. The case was returned for further proceedings on the issue of permanent disability.

Petition to reopennew and further disabilitytemporary disability indemnityjurisdictionfive-year limitationdate of injurystipulated awardAgreed Medical Evaluatorwrit deniedsubstantial medical evidence
References
4
Case No. ADJ394938 (OAK 0328377)
Regular
Dec 16, 2015

LONDON MORROW vs. GOLDEN GATE BRIDGE HIGHWAY AND TRANSPORTATION DISTRICT

This case concerns an applicant who sustained a right shoulder injury in 2003 and was awarded temporary disability indemnity for a new period of disability in 2015. The defendant challenged this award, arguing the Board lacked jurisdiction to grant temporary disability more than five years after the injury date, as the applicant had not been continuously disabled. The majority of the Board denied reconsideration, adopting the WCJ's report. However, a dissenting commissioner argued that Labor Code section 4656 and prior case law preclude jurisdiction for a new temporary disability period initiated more than five years post-injury, especially when disability was not continuous.

Workers' Compensation Appeals BoardPetition for ReconsiderationTemporary Disability IndemnityDate of InjuryJurisdictionLabor Code Section 4656Nickelsberg v. Workers' Comp. Appeals Bd.Continuous DisabilityNew Period of Temporary DisabilityPermanent and Stationary
References
1
Case No. ADJ2378668 (FRE 0197604)
Regular
Nov 21, 2008

DANIEL LOERA vs. BOB JONES PAINTING, LWP CLAIMS SOLUTIONS, Security Insurance Company of Hartford

The Board granted reconsideration to reverse an award of temporary total disability benefits. The WCJ erred in awarding continuing temporary disability as it began more than five years after the date of injury, a period beyond the Board's jurisdictional authority. The decision emphasizes that temporary disability indemnity may not be awarded for a period commencing more than five years from the date of injury, even if surgery was recommended or delayed.

Cumulative traumaTemporary total disabilityFive-year limitationDate of injuryReconsiderationFindings and AwardPetition to reopenContinuing jurisdictionEstoppelSurgical delay
References
6
Case No. 2017 NY Slip Op 04009 [150 AD3d 1507]
Regular Panel Decision
May 18, 2017

Matter of Jie Cao v. Five Star Travel of NY Inc.

Claimant, a bus driver, was involved in a 2007 accident and successfully applied for workers' compensation benefits, naming "Five Stars Travel Bus Inc." as his employer. Five Star Travel of NY Inc. (Five Star) did not appear after being served, leading to a WCLJ finding it liable for awards and assessments. After subsequent awards and medical treatment authorizations, a settlement was approved in 2013. In May 2015, Five Star sought to reopen the claim and challenge the prior decisions and settlement, but the Workers' Compensation Board denied the application due to untimely submission of new material evidence and the non-reviewable nature of an approved waiver agreement. The Appellate Division affirmed the Board's decision.

Workers' CompensationBus AccidentUninsured EmployerClaim ReopeningSettlement AgreementBoard ReviewAppellate DivisionTimelinessContinuing JurisdictionDue Process
References
6
Case No. FRE 0199865
Regular
Feb 04, 2008

CHRYSTI WIMER vs. FRESNO UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board granted reconsideration and rescinded a previous award, holding that the applicant was not entitled to "new and further" temporary disability benefits commencing after the five-year statutory period from her original injury. While the WCAB agreed with the administrative law judge's amended order clarifying the scope of the decision, they found that the claim for temporary disability after the five-year mark lacked jurisdiction. The issue of new and further permanent disability remains deferred.

new and further disabilitypetition to reopentemporary disabilitystipulated awardpermanent disabilitydate of injuryfive-year limitationSarabiAcostaWCAB Rule 10859
References
9
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