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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. 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. 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. FRE 0208997
Regular
Jan 03, 2008

JASON MANTOOTH vs. SAVE MART SUPERMARKETS, PEGASUS RISK MANAGEMENT

The Workers' Compensation Appeals Board denied reconsideration in Mantooth v. Save Mart Supermarkets. The Board affirmed that a defendant is liable for an applicant's attorney fees if they pay out all indemnity without withholding funds for a fee. This liability exists because an attorney's appearance in a case provides sufficient notice that a fee will be claimed against any indemnity due.

Workers' Compensation Appeals BoardAttorney's FeeTemporary Disability IndemnityPermanent Disability IndemnityPetition for ReconsiderationLien ClaimNoticeIndemnity PaymentCumulative TraumaStipulations with Request for Award
References
Case No. SRO 0135735
Regular
Nov 06, 2007

ROBERT ANUSEWICZ vs. JOINT INDUSTRY BOARD OF PLUMBING, dba KONOCTI HARBOR INN AND RESORT, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant's entitlement to temporary disability indemnity beyond the standard 104-week limit. The Appeals Board rescinded the prior award, ruling that the applicant's hip and knee replacement surgeries did not constitute "amputations" as defined by Labor Code section 4656(c)(2)(C). Therefore, the applicant is limited to 104 weeks of temporary disability indemnity from the commencement of payments, precluding indemnity beyond January 31, 2007.

Workers' Compensation Appeals BoardRobert AnusewiczJoint Industry Board of PlumbingKonocti Harbor Inn and ResortState Compensation Insurance FundSRO 0135735Opinion and Decision After Reconsiderationtemporary disability indemnityindustrial injuryleft knee
References
Case No. ADJ7849715 ADJ7851060
Regular
Feb 01, 2019

, Applicant, , AURELIO DAVILA GARCIA vs. T-Y NURSERY, FLORISTS' MUTUAL INSURANCE CO.

The Workers' Compensation Appeals Board granted reconsideration and will defer issues regarding the applicant's entitlement to an adjusted permanent disability indemnity rate and temporary total disability indemnity. The Board affirmed the Finding of Fact that the applicant sustained a 53% permanent disability award. These deferred issues, along with applicant's attorney fee, are returned to the trial level for further proceedings and decision by the administrative law judge.

ADJ7849715ADJ7851060Petition for ReconsiderationFindings and Orderpermanent disability indemnity rateLabor Code section 4658(d)(2)temporary total disability indemnityWCJAppeals BoardBontempo v. Workers' Comp. Appeals Bd.
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. ADJ7275781
Regular
Jun 17, 2013

DAINA ROBERTSON vs. VETERINARY CENTERS OF AMERICA, ZURICH AMERICAN INSURANCE CO.

This case concerns a WCJ's imposition of a 25% penalty for defendant's failure to include a 10% self-imposed penalty under Labor Code section 4650(d) when paying a previous award. The defendant argued no penalty was due as they disputed indemnity periods and paid within fourteen days of the award. The Appeals Board granted reconsideration, rescinded the supplemental award, and returned the matter for further proceedings. This action was taken because the record was unclear regarding whether the defendant's dispute over indemnity payments constituted a genuine dispute that would excuse the 10% increase under section 4650(d).

Labor Code section 4650(d)Supplemental Findings and Awardtemporary total disability indemnitypermanent disability indemnityindustrial injuryleft ankleregistered veterinary technicianAgreed Medical Evaluator (AME)permanent and stationarysurgery
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
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