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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. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. AHM 98231
Regular
Sep 24, 2007

MYLINH WHITMAN vs. CINGULAR WIRELESS, SEDGWICK CLAIMS MANAGEMENT

The Appeals Board is reconsidering whether the defendant, Cingular Wireless, is entitled to a credit for salary continuation benefits paid to the applicant. The key issue is whether these benefits were of the "same general character" as workers' compensation, which would permit integration and a credit. The case is returned to the trial level for further evidence development on this specific point, rescinding the prior award of a credit.

Workers' Compensation Appeals BoardCreditSalary continuation planWage loss planMetropolitan Life Short Term Disability PolicyHealth and Welfare Benefits PlanSummary plan descriptionEmployer policyTaxable benefitsPermanent disability indemnity
References
Case No. ADJ1298520
Regular
Dec 24, 2010

CLUSEGUN AFOLAYAN (DECEASED), OLUWASEUN AFOLAYAN, et al vs. STATE OF CALIFORNIA CDCR, CALIFORNIA REHABILITATION CENTER, Legally Uninsured, SCIF/STATE CONTRACTS

In this workers' compensation case, the Appeals Board reconsidered a WCJ's award of dependency benefits to three adult children of a deceased worker. The WCJ had awarded $192,000 total, based on the children being total dependents despite the widow electing CalPERS benefits which typically bar other death benefits. The Board agreed that the adult children are entitled to benefits under Labor Code section 4702, as the widow's CalPERS election does not necessarily exclude other dependents with good cause. However, the Board disagreed with the WCJ's calculation method and remanded the case for a new decision, directing the adult children to divide the difference between the maximum benefit for a widow with dependents and the benefit for a widow without dependents.

Workers' Compensation Appeals BoardDependency benefitsLabor Code Section 4702Adult childrenDeath benefitsLabor Code Section 4707CalPERS special death benefitGood causeTotal dependentsWidow's benefits
References
Case No. ADJ5836855
Regular
Dec 11, 2012

Malory Wheat vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) rescinded a prior award allowing a lien for living expenses claimed by the CCPOA Benefits Trust Fund. The WCAB held that liens in workers' compensation are strictly statutory and the CCPOA's claim for reimbursement of benefits advanced did not fit within the specific provisions of Labor Code sections 4903 or 4903.1 for "living expenses" or benefits provided by a "self-insured employee welfare benefit plan." The Board clarified that liens for living expenses are intended for those who loan money or extend credit, not for contractual obligations of insurance or benefit plans.

Workers' Compensation Appeals BoardMalory WheatState Compensation Insurance FundCCPOA Benefits Trust Fundlien claimantLabor Code section 4903(c)Labor Code section 4903.1(a)(1)Labor Code section 4903.1(a)(2)Labor Code section 4903.1(a)(3)living expenses
References
Case No. ADJ6473555, ADJ7393801
Regular
Sep 18, 2014

Frank Jones (Deceased), Araceli Jones, Mya Jaedyn Jones vs. CDCR KERN VALLEY STATE PRISON, State Compensation Insurance Fund

The Workers' Compensation Appeals Board affirmed a previous award for death benefits to the minor daughter of deceased correctional officer Frank Jones. The WCJ found that the daughter, Mya Jones, was entitled to the special minor's death benefit due to "good cause," as her mother is now a sole provider facing significant financial hardship after the decedent's death. The Board agreed, citing compelling evidence of the mother's financial strain and the minor's ongoing needs. This decision overrides the defendant's contentions that the award was improper and denies credit for prior permanent disability advances.

Workers' Compensation Appeals BoardCalPERSspecial death benefitminor dependentGuardian Ad LitemLabor Code section 4704good causeaverage weekly earningstemporary total disabilitypermanent disability indemnity
References
Case No. GOL 0087934, GOL 0087935, GOL 0087936
Significant
Feb 13, 2002

Alonso Navarro vs. A&A Farming, Western Growers Insurance Co.

The Board held that an employee's claim of discrimination under Labor Code section 132a, based on an employer's termination of contributions to an ERISA group health plan due to the employee's extended disability leave, is preempted by the federal Employee Retirement Income Security Act (ERISA).

Labor Code section 132aERISA preemptiongroup health benefitsdiscriminationtemporary disabilityworkers' compensationadverse actionemployer policyfederal lawstate law
References
Case No. ADJ9091836
Regular
May 09, 2018

CHRISTOPHER DOUGLAS (Deceased), AMY DOUGLAS (Surviving Spouse Guardian Ad Litem) vs. CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION, CALIFORNIA PUBLIC EMPLOYEES RETIREMENT SYSTEM, STATE COMPENSATION INSURANCE FUND (Claims Administrator)

This case involves a dispute over workers' compensation death benefits for the dependents of a deceased CalFIRE engineer/paramedic. The appeals board is reconsidering a prior decision that awarded benefits but ordered coordination with CalPERS special death benefits. The central issue is whether workers' compensation death benefits should be awarded to the decedent's children, considering they already receive CalPERS benefits, and how to properly coordinate these two types of benefits. The Board rescinded the prior decision and returned the case for further proceedings, emphasizing the need for proper joinder of CalPERS and a careful consideration of coordination rules.

WCABCalFIRESCIFCalPERSDeath BenefitsSpecial Death BenefitAntrimThompsonCoordination of BenefitsGuardian Ad Litem
References
Case No. ADJ9100288
Regular
May 17, 2018

GILBERT CORTEZ (Deceased), NOHEMA CORTEZ (Surviving Spouse & Guardian Ad Litem), et al. vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, Legally Uninsured, CALIFORNIA PUBLIC EMPLOYEES RETIREMENT SYSTEM, STATE COMPENSATION INSURANCE FUND (Claims Administrator)

The Workers' Compensation Appeals Board (WCAB) rescinded a prior decision concerning death benefits for the deceased employee's children, Andres and Marisa Cortez. The WCAB remanded the case to the administrative law judge to properly join the California Public Employees' Retirement System (CalPERS) and determine the entitlement to and coordination of workers' compensation death benefits with CalPERS special death benefits. The WCAB clarified that the "good cause" standard under *Antrim* applies and that CalPERS benefits may offset workers' compensation benefits to avoid duplicate payments. Further proceedings are required to consider the specific claims of dependency and the impact of CalPERS payments.

Workers' Compensation Appeals BoardCDCRSCIFCalPERSdeath benefitsdependent childrenspecial death benefitsoffsetAntrim standardLabor Code section 4707
References
Case No. ADJ9351345
Regular
Jul 05, 2016

WILLIAM YONEMITSU vs. PACIFIC BELL TELPHONE COMPANY, OLD REPUBLIC INSURANCE COMPANY

Defendant Pacific Bell sought reconsideration of a decision awarding applicant cumulative injury benefits and denying the employer's claim for "excess credit." The defendant argued it was entitled to credit for payments made under a disability plan, citing relevant case law. However, the Workers' Compensation Appeals Board denied reconsideration, agreeing with the trial judge that the defendant failed to meet its burden of proof. This failure was primarily due to not presenting the disability plan itself or evidence of its funding and the parties' intent at trial. The Board also noted that ERISA preemption was raised for the first time on reconsideration, without an evidentiary hearing.

Workers' Compensation Appeals BoardPacific Bell Telephone CompanyOld Republic Insurance CompanyWilliam Yonemitsucumulative injurykneeslow backcable splicing techexcess creditPetition for Reconsideration
References
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