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

Case No. ADJ4648769 (RIV0066289)
Regular
Mar 11, 2009

MARLON AGUIRRE vs. JACK IN THE BOX, CNA INSURANCE COMPANY

The Appeals Board granted reconsideration of a prior award finding 41% permanent disability for a left knee injury. The Board rescinded the award because the judge's permanent disability rating was not supported by the evidence, specifically the Agreed Medical Examiner's finding of only 17% whole person impairment. The case was returned to the trial level for further proceedings, including formal DEU rating instructions. Additionally, the Board noted the defendant's argument for a 15% reduction in benefits appears inapplicable to the 2004 injury date.

Workers' Compensation Appeals BoardADJ4648769Marlon AguirreJack in the BoxCNA Insurance CompanyReconsiderationFindings and AwardWorkers' Compensation Judge (WCJ)Industrial InjuryLeft Knee
References
Case No. ADJ7959552 ADJ8162345
Regular
Aug 07, 2014

MARIA CHAVEZ-MARTINEZ vs. RESTAURANT LEADERSHIP GROUP, LLC dba JACK IN THE BOX, CALIFORNIA RESTAURANT MUTUAL BENEFIT CORPORATION

The Workers' Compensation Appeals Board (WCAB) dismissed Maria Chavez-Martinez's petition for removal as untimely, as it was filed over 20 days after personal service of the decision. The WCAB also noted the petition was improperly served on all parties. Even if timely and properly served, the petition would have been denied on the merits due to a lack of demonstrable significant prejudice or irreparable harm. The WCAB concluded reconsideration would be an adequate remedy.

Petition for RemovalUntimely FilingPersonal ServiceWCJ's ReportStrom v. Workers' Comp. Appeals Bd.Significant PrejudiceIrreparable HarmReconsiderationAdequate RemedyWorkers' Compensation Appeals Board
References
Case No. ADJ7598238
Regular
Apr 02, 2013

VICTOR GALVAN vs. CARL'S JR.; TRAVELERS INSURANCE COMPANY; JDC FOODS dba JACK-IN-THE-BOX, permissibly self-insured through CALIFORNIA RESTAURANT MUTUAL BENEFIT CORPORATION; AMERICAN CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board denied Victor Galvan's petition for reconsideration, upholding the Administrative Law Judge's (ALJ) decision. The ALJ found that Galvan failed to meet his burden of proof for industrial causation regarding his alleged injuries. The Board adopted the ALJ's reasoning, which also noted that the petition for reconsideration was untimely filed. Therefore, the Board denied the petition on its merits and on the procedural ground of untimeliness.

Workers Compensation Appeals BoardVictor GalvanCarl's Jr.Travelers Insurance CompanyJDC FoodsJack-in-the-BoxAmerican Claims ManagementPetition for ReconsiderationWCJ reportGarza v. Workers' Comp. Appeals Bd.
References
Case No. SDO 0325072
Regular
Jun 09, 2008

RAYMUNDO RAMIREZ (RAYMUNDO SILVA) vs. JACK IN THE BOX, AMERICAN CASUALTY COMPANY OF READING PENNSYLVANIA, CNA CLAIMS PLUS

In *Ramirez v. Jack in the Box*, the Workers' Compensation Appeals Board denied a Petition for Removal because the petitioners failed to demonstrate substantial prejudice or irreparable harm. The lien claimants sought removal of a stay order preventing them from enforcing their liens while issues of authorization and potential consolidation were addressed. The Board found the stay necessary to resolve complex issues of representation and licensing for the lien claimants.

RemovalPetition for RemovalWorkers' Compensation Appeals BoardWCABRemoval DeniedSubstantial PrejudiceIrreparable HarmLien ClaimantsPetition for ConsolidationStay of Proceedings
References
Case No. STK 100401, STK 102758, STK 151721
Regular
May 01, 2007

JACK LITTLE vs. TRI-VALLEY GROWERS, NATIONAL UNION FIRE INSURANCE COMPANY

Applicant Jack Little sustained admitted industrial injuries to his knees and back, resulting in permanent disability and a need for ongoing medical treatment, including for his hypertension. The Appeals Board denied reconsideration of the finding that applicant's erectile dysfunction is not a compensable consequence of the industrial injuries, as both medical evaluators concluded it was not caused by the work injuries. However, a dissenting commissioner argued for reconsideration to further develop the record regarding whether the industrially-caused hypertension and its medications contribute to the erectile dysfunction.

Workers' Compensation Appeals BoardTri-Valley GrowersNational Union Fire Insurance CompanyJack Littleindustrial injurieskneesbackmaintenance mechanicpermanent disabilitymedical treatment
References
Case No. ADJ2747954 (LAO 0820830) ADJ1942372 (LAO 0822123) ADJ2627431 (LAO 0820831)
Regular
Aug 15, 2016

ROSARIO GUTIERREZ vs. ADVANCE PAPER BOX, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The Workers' Compensation Appeals Board (WCAB) has dismissed a petition for reconsideration in the case of Rosario Gutierrez versus Advance Paper Box and its insurer, the California Insurance Guarantee Association. The dismissal is due to the petitioner voluntarily withdrawing their request for reconsideration of the June 3, 2016 decision. This administrative order formally closes the reconsideration process as requested.

Petition for ReconsiderationDismissedWithdrawnWorkers' Compensation Appeals BoardAdvance Paper BoxCalifornia Insurance Guarantee AssociationSedgwickUS Fidelity & GuaranteeLiquidationCase Numbers
References
Case No. ADJ7218172
Regular
Feb 26, 2012

ROBERTA BINGHAM vs. JACK COOPER TRANSP.; and ZURICH AMERICAN INSURANCE COMPANY

This case involves a petition for removal filed by the defendant, Jack Cooper Transport and Zurich American Insurance Company. The Workers' Compensation Appeals Board (WCAB) denied this petition, adopting the reasoning of the workers' compensation administrative law judge. The WCAB specifically noted that the defendant's vocational rehabilitation expert's direct testimony may be restricted at trial under Labor Code section 5703(j) unless good cause is shown. Therefore, the matter remains set for hearing.

Petition for RemovalVocational Rehabilitation ExpertLabor Code Section 5703(j)Direct ExaminationGood CauseWCJ ReportWorkers' Compensation Appeals BoardApplicantDefendantZurich American Insurance Company
References
Case No. ADJ9119397
Regular
Apr 03, 2019

Jesse Lazoya, Jr. vs. IE Rental Homes doing business as Pama Management, Insurance Company of the West

This case involves a lien claimant, Javlin Three, seeking reconsideration of a prior finding that they lacked standing. The Workers' Compensation Appeals Board denied reconsideration, adopting the Judge's report that found no valid assignment, thus precluding Javlin Three from raising issues. The Board noted that the underlying issue of a potential stay on ResHealth Medical Group's lien has not yet been decided and may be consolidated with other related cases. Therefore, Javlin Three's petition for reconsideration is denied.

Petition for ReconsiderationLien ClaimantStandingValid AssignmentLabor Code 4615StayWCJ ReportMaster FileOrder of ConsolidationDesignation of Master File
References
Case No. ADJ2456257 (LAO 0856958)
Regular
Nov 07, 2013

JAVIER BANUELOS vs. JACK'S RESTAURANTS, STATE COMPENSATION INSURANCE FUND

This case involves a defendant seeking reconsideration of an award for 8 hours of daily home care services for the applicant, Javier Banuelos, based on an Agreed Medical Examiner's opinion. The defendant argued the award was improper due to a waived issue regarding a Utilization Review denial and improper reliance on the AME's reports. The Board denied reconsideration, finding the defendant waived the UR denial issue by raising it post-trial, and failed to argue against the substantial evidence provided by the AME. Therefore, the original Findings and Award for home care services were upheld.

Workers' Compensation Appeals BoardJavier BanuelosJack's RestaurantsState Compensation Insurance FundFindings and AwardHome Care ServicesAgreed Medical Examiner (AME)Dr. Rodney BluestoneUtilization Review (UR)Prescription Denial
References
Case No. ADJ2155279 (RIV 0040729)
Regular
Nov 28, 2012

JACK RAMSEY vs. CALIFORNIA PAVEMENT MAINTENANCE, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, Sedgwick CMS, LEGION INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) amended a previous award to defer the issue of attorney fees for enforcing an award of Labor Code section 5710 fees. The WCAB affirmed the remainder of the award, including a $100 penalty for unreasonable delay in authorizing medical treatment, finding the 100-day delay in authorizing treatment with the applicant's chosen physician was unreasonable. The Board also affirmed the award of attorney fees under Labor Code section 5814.5 for enforcing the medical treatment award. The case was returned to the trial level for further proceedings regarding the amount of section 5814.5 fees, with a dissenting opinion arguing for further proceedings on the unreasonable delay issue due to insufficient evidence.

Workers' Compensation Appeals BoardCIGALegion Insurance CompanySedgwick CMSJack RamseyLabor Code section 5814Labor Code section 5814.5Labor Code section 5710Medical Provider NetworkMPN
References
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