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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Claim of Bitterman v. Friscos Restaurant, Inc.

The State Insurance Fund appealed decisions by the Workers' Compensation Board concerning the cancellation of an insurance policy. The Board initially found the Fund's cancellation failed to comply with Workers' Compensation Law § 54(5) due to a lack of a return receipt request. An amended decision modified this, citing insufficient proof of a return receipt request. The appellate court affirmed the Board's determination, emphasizing the strict requirement for statutory compliance in policy cancellation and the insufficiency of a mailing manifest without proof of a return receipt request. The court noted the absence of testimony establishing the Fund's office practice for proper mailing.

Workers' CompensationInsurance Policy CancellationCertified MailReturn ReceiptStatutory ComplianceMailing ManifestProof of MailingAppellate ReviewState Insurance FundUninsured Employers' Fund
References
2
Case No. MISSING
Regular Panel Decision
Dec 05, 2008

Claim of Zahm v. National Fuel

The claimant, who worked for the employer for 31 years, filed a claim in August 2007 alleging occupational hearing loss due to long-term noise exposure from telephone use. A Workers’ Compensation Law Judge found a 20.4% schedule loss of use for binaural hearing loss, which the Workers’ Compensation Board affirmed. The employer appealed, arguing insufficient proof of injurious noise exposure and a lack of causal connection between the employment and the hearing loss. The appellate court agreed with the employer, finding the claimant's description of noise levels too vague and the medical testimony, specifically from treating otolaryngologist Robin Lazar-Miller, to be based on erroneous assumptions and not adequately refuting the employer's expert, Joel Bernstein. Consequently, the Board's decision was reversed, and the claim was dismissed due to insufficient proof of causation.

References
2
Case No. ADJ13057590; ADJ13058223
Regular
Aug 25, 2025

HEATHER RAMOS vs. PIH HEALTH, ATHENS ADMINISTRATORS

Applicant Heather Ramos sought reconsideration of a WCJ's Findings of Fact and Orders (F&O) which found defendant PIH Health and Athens Administrators had provided proof of service for a supplemental job displacement voucher (SJDV). The WCJ applied the presumption of timely mailing and receipt, finding applicant failed to rebut it and was not entitled to a penalty. Applicant contended there was no valid proof of service, and defendant did not meet the burden to invoke the presumption, thus entitling her to a penalty and attorney's fees. The Appeals Board upheld the WCJ's decision, concluding that the defendant's proof of service was valid, and applicant's evidence was insufficient to overcome the mailing presumption, therefore denying reconsideration.

Supplemental Job Displacement VoucherPresumption of ReceiptMailbox RuleProof of ServiceRebuttal EvidenceWCABPetition for ReconsiderationPenaltiesAttorney's FeesLabor Code Section 5814
References
13
Case No. ADJ2212288
Regular
Mar 09, 2011

GUILLERMO GOMEZ vs. BRINDERSON CONSTRUCTORS, INC., TRAVELERS INSURANCE COMPANY

This case involves lien claimants seeking reconsideration of an order dismissing their lien claims. The Workers' Compensation Appeals Board granted the petitions for reconsideration because the case file lacked proof of service for the notice of the lien trial. The Board has ordered the defendant to provide proof of service within 15 days. This action is intended to allow for a proper review of the facts and law regarding the dismissed liens.

Lien Claim DismissalPetition for ReconsiderationProof of ServiceMinutes of HearingLien TrialWorkers' Compensation Appeals BoardWCJBrinderson ConstructorsTravelers InsuranceWestside Health-Chiropractic
References
0
Case No. 192-1049-352
Regular Panel Decision

Goodman v. Mr. Goodbuys of New York Corp. (In Re Mr. Goodbuys of New York Corp.)

Howard P. Goodman, a former Chief Financial Officer for Mr. Goodbuys of New York Corp., Inc., filed an adversary proceeding seeking severance pay and damages under the Worker Adjustment and Retraining Notification Act (WARN) and to recover under his Proof of Claim No. 833. The Debtors-Defendants moved to dismiss the complaint and expunge the claim. The court found that Goodman was terminated on September 27, 1991, which was more than 90 days prior to the mass layoffs at Mr. Goodbuys in January/February 1992. Therefore, Goodman did not qualify as an "affected employee" under WARN, and his pleadings failed to state a claim for relief. Consequently, the court granted the Debtors-Defendants' motion, dismissing Goodman's complaint with prejudice and expunging his Proof of Claim No. 833.

BankruptcyMotion to DismissWARN ActEmployment TerminationSeverance PayProof of ClaimAdversary ProceedingChapter 11Pro Se LitigantMass Layoff
References
29
Case No. MISSING
Regular Panel Decision

In Re St. James Mechanical, Inc.

ITT Sheraton Corporation (ITT) moved to extend its time to file a proof of claim or to have the notice of appointment of the Creditors Committee deemed an informal claim in the Chapter 11 bankruptcy case of St. James Mechanical, Inc. (the Debtor). The Court denied both aspects of ITT's motion. The Court ruled that ITT no longer possessed a pre-petition claim against the Debtor because it was discharged upon the confirmation of the reorganization plan, thus making Rule 9006(b) for extending claim filing time inapplicable. Additionally, the Court found that the Notice of Appointment did not constitute a valid informal proof of claim as it was not filed by ITT and lacked sufficient intent. However, the Court determined that despite ITT's failure to file a timely claim, it is still entitled to the treatment outlined in the confirmed plan, as the plan's provisions are binding on all parties, acting as res judicata, even if they contained legal errors in ITT's inclusion.

BankruptcyChapter 11Proof of ClaimExcusable NeglectPlan ConfirmationDischargeDue ProcessRes JudicataInformal ClaimCreditors Committee
References
33
Case No. SAC 304435
Regular
Oct 09, 2007

Raymond Phillips vs. California Department of Health Services, STATE COMPENSATION INSURANCE FUND

This case involves a workers' compensation applicant seeking reconsideration of a $50\%$ permanent disability award, arguing for $100\%$ due to insufficient proof of overlap with a prior injury. The defendant also sought reconsideration, contesting the disability rating and dollar amount of the award. The Appeals Board granted reconsideration to correct the dollar amount, affirming the $50\%$ apportionment, the $15\%$ attorney fee, and the defendant's burden of proof for apportionment.

ApportionmentPermanent DisabilityReconsiderationFindings and AwardQualified Medical EvaluatorsLabor Code section 4664Permanent partial disabilityAttorney feesComplex Regional Pain SyndromePeroneal nerve
References
1
Case No. ADJ7985491
Regular
Nov 09, 2016

GEORGE GORDON vs. CITY OF LOS ANGELES, P.S.I., administered by ACME administrators, Inc.

The Workers' Compensation Appeals Board dismissed the Petition for Reconsideration because it was untimely filed. The petition was submitted after the 25-day deadline following the original August 1, 2016, decision, which disallowed the lien claimant's claim for insufficient evidence. The Board clarified that filing proof of mailing is insufficient, and the petition must be *received* by the WCAB within the statutory period. Even if timely, the petition would have been denied on the merits, as lien claimants bear the burden of proving the reasonableness of their services.

Petition for ReconsiderationUntimely FilingLabor CodeCalifornia Code of RegulationsJurisdictional Time LimitFindings of Fact & OrdersLien ClaimantBurden of ProofPreponderance of the EvidenceMedical Treatment
References
9
Case No. STK 0187467
Regular
Sep 26, 2007

HASINA SINGH vs. MARINA VILLAGE WEST, ZENITH INSURANCE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a WCJ's decision, affirming the disallowance of a lien claimant's claim for medical-legal costs due to insufficient proof. However, the WCAB reversed the WCJ's imposition of sanctions against the lien claimant, finding that the defendant failed to meet its burden of proof to demonstrate the claimant's non-compliance with WCAB rules regarding availability for settlement discussions. The WCAB rescinded the sanctions order, finding the lien claimant's petition on that issue meritorious.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFindings and OrdersMedical-Legal CostsBad Faith ActionsSanctions OrderCompromise and ReleaseWCAB RulesMandatory Settlement Conference
References
0
Case No. ADJ3562707
Regular
Feb 01, 2010

TRACIE QUINN vs. WALMART ASSOCIATES, INC., AMERICAN HOME ASSURANCE, AVIZENT

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration, rescinding the prior award of temporary disability. The Board found the applicant failed to meet her burden of proof for temporary disability from October 6, 2007, to March 13, 2008. This was due to insufficient evidence, particularly the absence of key medical reports and a lack of proof that the employer was unable to accommodate restrictions. The Board also found the applicant's termination was due to unexcused absences, not an inability to perform modified work.

Petition for ReconsiderationTemporary DisabilityIndustrial InjuryLeft WristLube-Tire TechWal-Mart AssociatesAvizentFindings Award and OrderWCJAgreed Medical Evaluator
References
0
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