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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
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. ADJ1124123 (BGN 0064929) ADJ3374432 (BGN 0061307)
Regular
Oct 22, 2018

MARY BAKER vs. SWEEETHEART CUPS; CIGA by SEDGWICK CMS for FREMONT INSURANCE in liquidation and PORTEOUS FASTENERS/PACIFIC INDEMNITY COMPANY, CHUBB INSURANCE

The Workers' Compensation Appeals Board granted CIGA's petition for reconsideration, reversing the finding that CIGA remained liable for permanent total disability indemnity and medical treatment for the applicant's industrial injuries. The Board found that because the applicant's injuries resulted in a joint and several award with a solvent insurer, Pacific Indemnity, CIGA has no obligation to pay as "other insurance" was available. The decision clarifies that CIGA is absolved of liability for medical treatment jointly caused by both injuries, but remains liable for treatment solely caused by the September 1979 injury. Pacific Indemnity is now solely responsible for all remaining permanent total disability indemnity and medical treatment costs, adjusting for payments already made by CIGA.

CIGASweetheart CupsPorteous FastenersFremont InsurancePacific IndemnityChubb InsuranceWilkinson doctrinejoint and several liabilitycovered claimsother insurance
References
Case No. ADJ4196699 (SDO 0299468) ADJ3821411 (SDO 0299470)
Regular
Jan 07, 2013

JOHN YOUNTS vs. HANSON AGGREGATES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, Through Its Servicing Facility SEDGWICK CMS, for FREMONT COMPENSATION INSURANCE COMPANY, In Liquidation, ZURICH AMERICAN INSURANCE COMPANY

This case concerns CIGA's (California Insurance Guarantee Association) indemnity petition against Zurich. The Workers' Compensation Appeals Board (WCAB) granted CIGA's reconsideration request, finding the prior denial of its indemnity petition was erroneous. The WCAB clarified that CIGA's right to indemnity had not been adjudicated in previous proceedings and rescinded the prior order. The matter is returned to the trial level for further proceedings on CIGA's indemnity petition.

CIGAFremont Compensation Insurance CompanyZurich American Insurance CompanyindemnityreconsiderationPetition for IndemnityFindings and AwardCompromise and Releasecumulative injuryspecific injury
References
Case No. ADJ329334 (OAK 0311178), ADJ2064025 (OAK 0318666)
Regular
Feb 22, 2013

Vilma Ruiz vs. Margaret O'Leary, California Insurance Guarantee Association, for Fremont Indemnity Company, Republic Indemnity Company

The California Workers' Compensation Appeals Board rescinded a prior award finding Republic Indemnity liable for applicant's cumulative injury. The Board ruled that the applicant's compromise and release agreement with Republic barred further claims against them, and that CIGA was not liable because other insurance (Republic) was available. The Board also determined that the applicant's specific injury claim caused no temporary disability, permanent disability, or need for future medical treatment. Consequently, the applicant was awarded no further benefits in either case.

Workers' Compensation Appeals BoardCalifornia Insurance Guarantee AssociationFremont Indemnity CompanyRepublic Indemnity Companycumulative injuryspecific injurycompromise and releaseinsolvent carriercovered claimsother insurance
References
Case No. FRE 191206
Regular
Nov 20, 2007

MARY SEPEDA vs. SEPEDA BROTHERS DAIRY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION on behalf of FREMONT INDEMNITY, in liquidation, REPUBLIC INDEMNITY

This case involves an applicant seeking reconsideration of a workers' compensation award concerning a low back injury sustained through July 13, 1995. The applicant, supported by her treating physician, argued for additional disc replacement surgery at the L4-5 level beyond the previously awarded L5-S1 spinal fusion. The Workers' Compensation Appeals Board granted reconsideration and amended the award to include the L4-5 disc replacement surgery, finding it reasonably required to cure or relieve the applicant's injury based on the treating physician's opinion.

CIGAFremont IndemnityRepublic Indemnitylow back injurypermanent disabilityfurther medical treatmentspinal surgeryL5-S1 fusionL4-5 disc replacementtreating physician
References
Case No. MON 0271251 MON 0271252 MON 0271253
Regular
Jan 09, 2008

CONSUELO AMADOR vs. JIMWAY, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT INDEMNITY INSURANCE COMPANY, in liquidation, by CAMBRIDGE INTEGRATED SERVICES, STATE COMPENSATION INSURANCE FUND

This case concerns liability for an applicant's cumulative trauma injury where both Fremont Indemnity (represented by CIGA) and the State Compensation Insurance Fund (SCIF) provided coverage. The Workers' Compensation Appeals Board reversed an arbitrator's decision, finding that SCIF, as a solvent insurer jointly and severally liable for the injury, constitutes "other insurance." Therefore, under Insurance Code section 1063.1(c)(9), CIGA is not liable for the applicant's cumulative trauma injury.

CIGAFremont IndemnitySCIFcumulative traumajoint and several liabilitycovered claimother insuranceInsolvencyLabor Code section 5500.5Insurance Code section 1063.1(c)(9)
References
Case No. ADJ1449948 (LAO 0777629) ADJ1052896 (LAO 0777628) ADJ1110587 (LAO 0777627) ADJ1924276 (LAO 0777626)
Regular
Jun 16, 2017

JOSE A. AVINA vs. HIGH-TECH SEATING PRODUCTS, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT INDEMNITY COMPANY, in liquidation, CALIFORNIA INDEMNITY INSURANCE administered by GALLAGHER BASSETT SERVICES, THE HARTFORD

The Workers' Compensation Appeals Board granted the Hartford's petition for reconsideration regarding a prior award for applicant Jose Avina's injuries. The Board affirmed the original award with a modification, striking one finding of fact deemed unnecessary. The Hartford's main contention was its liability for a specific injury outside its coverage period and an incorrect cumulative trauma end date. The Board's decision emphasizes joint and several liability for medical treatment and temporary disability among successive insurers.

California Workers Compensation Appeals BoardCalifornia Insurance Guarantee AssociationCIGAFremont Indemnity CompanyHigh-Tech Seating ProductsGallagher Bassett ServicesThe HartfordLumbar Spine InjuryPsyche InjurySleep Disorder
References
Case No. ADJ2191262
Regular
Nov 03, 2008

JOY ANN HIGHFILL vs. CLUB DISNEY, HELMSMAN MANAGEMENT SERVICES, INC.

This Workers' Compensation Appeals Board case affirms a prior decision regarding attorney's fees. The Board clarified that attorney fees on temporary disability indemnity are awarded only on indemnity obtained or awarded as a result of the attorney's services. Because the record was insufficient to determine if temporary disability indemnity was voluntarily paid prior to the initial award, the attorney's fee was properly limited to any unpaid temporary disability indemnity thereafter awarded.

WORKERS' COMPENSATION APPEALS BOARDReconsiderationOpinion and DecisionAttorney's FeePermanent Disability IndemnityTemporary Disability IndemnityUnpaid IndemnityPolicy and Procedural ManualPretrial Conference StatementMinutes of Hearing
References
Case No. ADJ1299341 (MON 0210486), ADJ1360926 (MON 0210487), ADJ2178726 (MON 0210488), ADJ3724105 (MON 0213769)
Regular
Oct 10, 2013

CARTIS SPILLMAN vs. MCDONNEL DOUGLAS AIRCRAFT, CALIFORNIA INSURANCE GUARANTEE ASSN., FREMONT INDEMNITY CO

This case involves multiple industrial injuries sustained by the applicant from 1990 to 1993. The Workers' Compensation Appeals Board (WCAB) reconsidered the original award, amending it to remove findings of injury to certain body parts like the left knee and neck due to insufficient evidence. The WCAB affirmed the finding of 100% permanent disability, as the applicant's orthopedic and psychiatric conditions were deemed inextricably intertwined and not reasonably apportionable. The periods for temporary total disability indemnity were adjusted, and the Board deferred to the WCJ's credibility determination regarding the applicant's average weekly wage.

CIGAFremont IndemnitySedgwick ClaimsReconsiderationFindings of FactAward and OrderWCJPermanent DisabilityTemporary DisabilityAgreed Medical Evaluator
References
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