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

Case No. ADJ8775072, ADJ10425869
Regular
Jul 27, 2016

JACINTO RUEDA vs. BON APPETIT MANAGEMENT, GALLAGHER BASSETT

In this Workers' Compensation Appeals Board case, the applicant, Jacinto Rueda, formally withdrew his Petition for Reconsideration. Consequently, the Board has dismissed the petition. The Board also noted that Rueda requested his attorney be dismissed and directed the Workers' Compensation Judge to address this matter upon the case's return to the trial level. The order officially dismisses the petition as requested by the petitioner.

Petition for ReconsiderationDismissalWithdrawnAttorney of RecordTrial LevelWorkers' Compensation Appeals BoardBon Appetit ManagementGallagher BassettJacinto RuedaSan Jose District Office
References
Case No. ADJ203268 (RIV 0073757)
Regular
Jan 31, 2013

SUSAN LEMERANDE vs. MT. SAN JACINTO COLLEGE DISTRICT

This case concerns Susan Lemerande's claim against Mt. San Jacinto College District for discrimination under Labor Code section 132a. The Workers' Compensation Appeals Board found that Lemerande's claim is not barred by the statute of limitations due to the employer's continuing course of conduct. The Board rescinded the prior award and returned the case to the trial level for further proceedings on the merits of the 132a petition. The central issue is whether the District failed to rehire Lemerande into an available position after her industrial injury, thereby violating anti-discrimination laws.

Labor Code 132adiscriminationstatute of limitationsreconsiderationreemploymentindustrial injuryprima facie caseburden of proofGovernment Claims Actworkers' compensation
References
Case No. ADJ2855195 (MF); ADJ965274
Regular
Jan 23, 2012

MARCELO RUEDA vs. ALL LABOR TIRES, STATE COMPENSATION INSURANCE FUND

The State Compensation Insurance Fund petitioned for reconsideration of awards made to Marcelo Rueda, arguing that Agreed Medical Examiner (AME) reports by Drs. Hyman and Sanders lacked substantial evidence. Specifically, the Fund disputed impairment ratings for hypertension, upper digestive tract issues, and sleep disorders, as well as the carpal tunnel syndrome diagnosis. The judge recommended denying the petition, finding that the AME reports provided reasoned medical opinions supported by the AMA Guides and clinical judgment. The Workers' Compensation Appeals Board granted reconsideration to further review the complex factual and legal issues involved.

Petition for ReconsiderationAgreed Medical ExaminerAMA GuidesPermanent DisabilityHypertensionUpper Digestive Tract ImpairmentSleep DisorderCarpal Tunnel SyndromeSubstantial EvidenceClinical Judgment
References
Case No. SFO 0460461
Regular
Oct 11, 2007

HEIDI RUEDA vs. WESTAMERICA BANCORP., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, FREMONT INSURANCE, LIBERTY MUTUAL FIRE INSURANCE COMANY

This case involves CIGA's claim for reimbursement from Liberty Mutual for benefits paid to applicant Heidi Rueda due to industrial injuries sustained in 1992 and 1998. Liberty Mutual, liable for the 1998 injury, disputes CIGA's entitlement to 100% reimbursement, arguing the 1992 injury also contributed to the disability. The Workers' Compensation Appeals Board denied Liberty Mutual's request for reconsideration, upholding the arbitrator's findings.

Workers' Compensation Appeals BoardCIGAFremont InsuranceLiberty MutualReconsiderationFindings and AwardTemporary DisabilityPermanent DisabilityMedical BenefitsMedical-Legal Expenses
References
Case No. ADJ1723558
Regular
Jul 01, 2013

OMAR JACINTO vs. EXCEL DIRECT, FRYE CLAIMS

The Workers' Compensation Appeals Board (WCAB) denied a lien claimant's petition for reconsideration. The WCAB affirmed the dismissal of the lien claimant's claim because they failed to pay the required lien activation fee prior to the commencement of the lien conference as mandated by Labor Code §4903.06(a)(4) and the en banc decision in *Figueroa v. B.C. Doering Co*. The claimant's argument that they paid the fee during the conference was rejected, as proof of payment must be presented at the scheduled commencement time. The Appeals Board emphasized a bright-line rule regarding the timely payment of this fee.

Lien claimantLien activation fee (LAF)Petition for ReconsiderationWorkers' Compensation Appeals Board (WCAB)Lien conferenceDismissal with prejudiceLabor Code §4903.06(a)(4)Figueroa v. B.C. Doering Co.Proof of paymentCommencement of lien conference
References
Case No. ADJ277813 (SAC 0359011)
Regular
Feb 24, 2011

JACINTO BECERRA vs. JOHN LITZO dba LAKE CHAPALA

The Workers' Compensation Appeals Board granted the applicant's Petition for Removal, overturning a WCJ's order that reopened discovery for an absent, potentially uninsured employer. The Board found that continuing discovery beyond the Mandatory Settlement Conference (MSC) violated Labor Code section 5502(e)(3) absent good cause. The hearing scheduled for March 7, 2011, was redesignated as an MSC, and the case was returned to the trial level. If the employer fails to appear at this new MSC, discovery will close, and any subsequent evidence offered will be inadmissible without a showing of due diligence.

Petition for RemovalMandatory Settlement ConferenceLabor Code section 5502(e)(3)Discovery closingDue process rightsIllegally uninsuredUninsured Employers Benefit Trust FundIndustrial injuryLow backLegs
References
Case No. ADJ8321950
Regular
Apr 30, 2013

JACINTO CORNEJO vs. FOWLER PACKING CO., STAR INSURANCE CO.

The Workers' Compensation Appeals Board denied the defendant's petitions for removal and reconsideration. The Board upheld the finding that the applicant sustained an industrial injury from dehydration, relying on the administrative law judge's credible assessment of the applicant's testimony regarding working conditions and reporting of the injury. The Board agreed that the applicant's testimony was sufficient to trigger a reasonable investigation by the employer, despite the defendant's claims about discovery closure and lack of notice.

Petition for RemovalPetition for ReconsiderationInjurious EventDehydrationAOE/COECredibilityMedical EvidenceDiscovery ClosedBurden of ProofReasonable Investigation
References
Case No. ADJ2855195 (VNO 0550470)
Regular
Feb 06, 2014

MARCELO RUEDA vs. DRIVE SERVICE, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration of a WCJ's decision awarding $7,200 for shockwave therapy to the applicant's elbows. The Board found that the lien claimant failed to establish the medical reasonableness and necessity of the treatment, as the Agreed Medical Examiner's opinion did not specifically endorse shockwave therapy. The WCJ's exclusion of the defendant's utilization review denial letters was also questioned, but the Board reopened the record to allow for further development of evidence regarding the treatment's necessity. Consequently, the matter was returned to the trial level for further proceedings and a new decision.

Utilization Reviewshockwave therapymedical necessityAgreed Medical Examinerdeposition testimonydue processdevelopment of recordlien conferencePetition for ReconsiderationFindings and Award
References
Case No. ADJ2855195 (VNO 0550470) ADJ965274 (VNO 0550466)
Regular
May 30, 2012

MARCELO RUEDA vs. ALL LABOR TIRES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board is issuing a Notice of Intention to impose sanctions on the defendant, State Compensation Insurance Fund, and its attorney. This action stems from the defendant's petition for reconsideration, which improperly cited a medical report not entered into evidence. Such a tactic is considered frivolous and a violation of the Board's Rules of Practice and Procedure. The Board intends to impose a $500 sanction jointly and severally unless good cause is shown to the contrary within fifteen days.

Workers' Compensation Appeals BoardSanctionLabor Code Section 5813Frivolous ConductReconsiderationAgreed Medical ExaminersAMA GuidesWCJPermanent DisabilityIndustrial Injury
References
Case No. ADJ7160971
Regular
Jan 12, 2015

JACINTO CATILLO vs. SANTA CLARITA INTERIORS, ZURICH AMERICAN INSURANCE CO

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of the defendant's petition to review an arbitrator's award finding the applicant sustained a lumbar spine injury. The defendant's petition for reconsideration was potentially untimely and filed with the incorrect district office for this ADR carve-out case. The WCAB will issue a notice of intention to dismiss unless the defendant provides proof of timely filing with the correct office. The defendant has 15 days to submit documentation demonstrating the petition was timely filed.

Petition for ReconsiderationArbitrator's Findings and AwardJourneyman CarpenterLumbar SpinePermanent DisabilityApportionmentTemporary Total Disability IndemnityArbitrator's Report and RecommendationElectronic Adjudication Management SystemADR carve-out case
References
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