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

Case No. ADJ6722603
Regular
Jun 16, 2010

TONY PEAK vs. REC SOLAR, PRAETORIAN INSURANCE COMPANY c/o AARLA

The Workers' Compensation Appeals Board (WCAB) denied the applicant's Petition for Reconsideration in the case of Tony Peak v. REC Solar and Praetorian Insurance Company. The WCAB adopted and incorporated the reasons provided in the Workers' Compensation Administrative Law Judge's (WCJ) report. This order formally denies the reconsideration of the prior decision.

Workers' Compensation Appeals BoardReconsideration deniedWCJ reportAdministrative law judgeADJ6722603ADJ6722349REC SolarPraetorian Insurance CompanyAARLATony Peak
References
Case No. SFO 0492831
Regular
Jan 23, 2008

ELIAS MONTOYA vs. ASTON BARNES, INC., STATE COMPENSATION INSURANCE FUND

The Board granted reconsideration to clarify the application of Labor Code section 4656 regarding temporary disability indemnity limits. The Board held that "new and further" disability does not extend the 104-week limit under section 4656(c)(1), nor do spinal disc excisions and bone grafts qualify as "amputations" under section 4656(c)(2)(C). Consequently, the applicant is entitled to temporary disability indemnity only up to two years from the date of the first payment.

Workers' Compensation Appeals BoardElias MontoyaAston Barnes Inc.State Compensation Insurance FundSFO 0492831Opinion and Decision After ReconsiderationTemporary Disability IndemnityIndustrial InjuryThoracic SpineChest Injury
References
Case No. ADJ9074637
Regular
Dec 03, 2018

ANA RAMOS vs. TRI-STATE EMPLOYMENT SERVICES/ DIAMOND STAFFING; LUMBERMEN'S UNDERWRITING ALLIANCE, in liquidation, administered by CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The Appeals Board denied the Petition for Removal because the petitioner failed to demonstrate substantial prejudice or irreparable harm that reconsideration would not adequately address. Additionally, the lien claimant violated WCAB rules by including impermissible attachments to their petition. One attachment documented prohibited ex parte communications with the judge. The lien claimant was admonished to follow Appeals Board rules to avoid potential sanctions.

Petition for RemovalSubstantial PrejudiceIrreparable HarmReconsiderationEx Parte CommunicationLien ClaimantWCAB Rule 10842WCAB Rule 10324(c)SanctionsLabor Code Section 5813
References
Case No. SDO 0354449
Regular
Sep 20, 2007

ADAM PERRY vs. HAMMOND \& MASING CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed a prior award denying additional temporary disability payments beyond the statutory 104-week limit. The applicant sought to extend payments based on his knee surgeries, arguing they constituted "amputations" under Labor Code section 4656(c)(2)(C). The Board held that the term "amputation" in this context refers to the severance of external body parts, not the surgical removal of internal knee fragments or cartilage.

Workers' Compensation Appeals BoardIndustrial InjuryPsyche InjuryTemporary Total DisabilityLabor Code Section 4656(c)(1)Labor Code Section 4656(c)(2)(C)AmputationsOsteochondral FragmentChondroplastyACL Reconstruction
References
Case No. SAC 0284418
Regular
Apr 04, 2008

AARON CARTER vs. POLYMER TECHNOLOGIES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for SUPERIOR NATIONAL INSURANCE COMPANY

The Appeals Board granted reconsideration, finding that the California Insurance Guarantee Association (CIGA) is contractually obligated to pay U.C. Davis Medical Center's bill based on a prior compromise and release agreement. The Board rescinded the prior decision, ruling that CIGA's agreement to "hold harmless" the applicant from the UCD bill constituted a promise to pay it. The case was returned to the trial level for further proceedings to consider any defenses CIGA may have against the UCD bill.

Workers' Compensation Appeals BoardCIGAPolymer TechnologiesSuperior National Insurance CompanyU.C. Davis Medical CenterU.C. Davis Professional Medical Grouplien claimantscompromise and releasehold harmlesscollateral estoppel
References
Case No. ADJ7709630
Regular
Feb 21, 2012

CARLOS RUIZ vs. VULCAN MATERIAL COMPANY, OLD REPUBLIC INSURANCE

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration regarding temporary disability benefits, finding no exception applied to the 104-week limit. However, the Board granted the applicant's Petition for Removal, rescinded the Order Compelling a medical examination, and returned the matter for further proceedings. This action was taken due to allegations of defendant's violation of Labor Code section 4062.3(c) and potential prejudice to the applicant.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFindings and OrderOrder Compelling Medical ExaminationLabor Code section 4656(c)(2)Labor Code section 4656(c)(3)temporary disability benefitsstatutory limitamputation exception
References
Case No. ADJ11421915
Regular
Aug 20, 2019

RACHEL NIGRO vs. ALLERGAN W.C. HOLDING, INC., ACE AMERICAN INSURANCE COMPANY

In this case, the Workers' Compensation Appeals Board (WCAB) granted reconsideration and amended a previous decision. The amendment specifically subjected the award of temporary disability payments to the 104-week limit within a two-year period as stipulated by Labor Code section 4656(c)(2). The WCAB found that the administrative law judge's original decision failed to account for this statutory limitation. Otherwise, the WCAB affirmed the administrative law judge's decision.

Workers' Compensation Appeals BoardRACHEL NIGROALLERGAN W.C. HOLDINGINC.ACE AMERICAN INSURANCE COMPANYADJ11421915Van Nuys District OfficePetition for ReconsiderationWCJ reporttemporary disability
References
Case No. ADJ6779280, ADJ6783287
Regular
Feb 09, 2011

DANA COX vs. FIRST TRANSIT, NEW HAMPSHIRE INSURANCE COMPANY

This case involves an applicant with two distinct industrial injuries to different body parts, leading to concurrent temporary disability. The defendant argued the 104-week limit under Labor Code section 4656(c)(2) should run concurrently for both injuries. The Appeals Board rescinded the prior award, finding the WCJ did not properly apply the statute. The Board remanded the case for a new decision, clarifying that for overlapping periods of temporary disability from multiple injuries, the 104-week limitation runs concurrently.

Labor Code section 4656(c)(2)petition for reconsiderationFindings and Awardparatransit driver104 compensable weeksaggregate disability paymentssuccessive injuriesconcurrent temporary disabilityoverlapping body partsLabor Code section 4656(c)(1)
References
Case No. GRO 0034594 GRO 0034827
Regular
May 22, 2008

WILLIAM BARKS vs. C & C TILE, PREFERRED EMPLOYERS INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of the WCJ's April 30, 2008 decision because the applicant informed the Board that the case is being settled. The prior decision has been rescinded, and the matter is returned to the trial level for further proceedings by the WCJ. If the settlement is not approved, the original decision may be reinstated.

Workers' Compensation Appeals BoardReconsiderationRescindTrial LevelWCJSettlementPetition for ReconsiderationDecision After ReconsiderationApplicantDefendant
References
Case No. ADJ473373 (ANA 0406381)
Regular
Feb 10, 2012

FERNANDO GUTIERREZ vs. SOCAL FRAMING aka BMHC; ACE AMERICAN INSURANCE, administered by ESIS, INC.

This case concerns applicant's claim for extended temporary disability (TD) benefits beyond 104 weeks due to a left eye injury. The Appeals Board affirmed the WCJ's denial of the "amputation" exception, ruling that the surgical removal of an eye does not fit the statutory definition. However, the Board remanded the case for further development of the record on the "high-velocity eye injury" exception, as the velocity and force of the object that struck the applicant's eye were unclear. The applicant's Petition for Removal was dismissed as reconsideration was the appropriate remedy.

Workers' Compensation Appeals BoardFernando GutierrezSoCal FramingBMHCACE American InsuranceESISInc.ADJ473373ANA 0406381Opinion and Decision
References
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