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

Case No. ADJ9778324
Regular
Nov 08, 2017

JAIRO RAMOS vs. JTS JOSE TREE SERVICE, INC., JOSE MIGUEL SOTO, DANIEL SOTO, UNINSURED EMPLOYERS BENEFITS TRUST FUND

This case involves a workers' compensation claim where the applicant sustained an admitted industrial injury. The primary issue is determining the identity of the employer(s), with allegations of joint ownership/operation between JTS Jose Tree Service, Inc., Jose Miguel Soto, and Daniel Soto. Jose Soto's petition for reconsideration was dismissed as untimely and procedurally deficient. Daniel Soto's petition was granted because the original findings lacked evidentiary support and the record required further development regarding employment status and potential licensing issues. The case is remanded to the trial level for further proceedings.

Workers Compensation Appeals BoardJTS Jose Tree ServiceJose Miguel SotoDaniel SotoUninsured Employers Benefits Trust FundFindings of FactOrder of DeferralPetition for ReconsiderationJoint EmployersSubstantial Shareholder
References
Case No. ADJ8508466
Regular
Nov 05, 2013

ROBERTO RAMIREZ (Deceased); MARIA GUADALUPE DIAZ de RAMIREZ, Guardian ad Litem for MARIA LINA RAMIREZ DIAZ, vs. VISTA PAINT CORPORATION, Permissibly Self-Insured,

This Workers' Compensation Appeals Board decision grants reconsideration and returns the case to the trial level for further proceedings. While the WCJ correctly found the daughter was partially dependent, the Board noted an incomplete record regarding the wife's dependency status and potential eligibility under Labor Code section 3501(b). The Board also found the issue of attorney fees was not decided. Consequently, the matter is remanded for determination of the wife's dependency, the correct death benefit amount, and attorney fees, or for clarification on why these issues were not previously addressed.

Workers' Compensation Appeals BoardRoberto RamirezMaria Guadalupe Diaz de RamirezMaria Lina Ramirez DiazVista Paint CorporationLabor Code section 3501(a)Labor Code section 3501(b)conclusive presumptiondependencypartial dependent
References
Case No. ADJ3253563 (MON 0327671)
Regular
Sep 07, 2012

Jose Ramirez vs. CHUBB & SONS

The Workers' Compensation Appeals Board granted reconsideration to address ambiguities in a prior award. While affirming the sanction of attorney fees for the defendant's failure to timely comply with a medical treatment authorization, the Board deferred the issue of the applicant's personal transportation needs. This deferral was to allow for further clarification of the extent of the defendant's transportation obligations to the applicant, beyond those for his son's schooling and medical appointments. The award of transportation for the applicant's son's educational needs was otherwise affirmed.

Workers Compensation Appeals BoardChubb & SonsJose RamirezInterim Findings and AwardLabor Code Section 5813sanctionattorney's costsfeesMinute Orderweight loss program
References
Case No. ADJ10801516
Regular
Jul 24, 2017

JORGE RAMIREZ vs. MANN PACKING COMPANY, INC., ZURICH NORTH AMERICA INSURANCE COMPANY

In this workers' compensation case, Jorge Ramirez is the applicant, and Mann Packing Company, Inc. and its insurer are the defendants. Both the applicant and defendants challenged judges in the Salinas District Office, exhausting available judicial options there. Consequently, the Workers' Compensation Appeals Board ordered the venue transferred to the San Jose District Office. The case will now be heard by Judge David Lauerman in San Jose.

Workers' Compensation Appeals BoardVenue ChangeChallengesAppeals Board Rule 10453Salinas District OfficeSan Jose District OfficePresiding Workers' Compensation JudgeJudge David LauermanApplicantDefendant
References
Case No. ADJ10518881
Regular
Mar 17, 2025

JOSE RAMIREZ vs. QUALITY SCALES UNLIMITED, INSURANCE COMPANY OF THE WEST

Applicant Jose Ramirez sought reconsideration of a Findings and Awards (F&A) issued on December 17, 2024, which determined a 40% permanent disability (PD) rating, notably excluding any psychiatric component. Ramirez contended that this rating was inadequate, citing inconsistent PQME reports with higher PD ratings, unaddressed surgical scars, the omission of a psychiatric component despite claims of a catastrophic injury, and newly discovered evidence. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, ruling that the Workers' Compensation Judge's (WCJ) initial decision lacked sufficient explanation for the PD rating and the catastrophic injury determination. Additionally, the WCAB found that the WCJ improperly relied on an inadmissible consultative rating determination. As a result, the WCAB amended the F&A to defer the issues of permanent disability impairment rating and attorney's fees, while otherwise affirming the WCJ's decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardsPermanent DisabilityPQMEAMA GuidesCatastrophic InjuryPsychiatric ComponentLabor Code Section 5909Electronic Adjudication Management System (EAMS)
References
Case No. ADJ8642319
Regular
Apr 24, 2015

ISABEL RAMIREZ-RAMOS (spouse), ANGEL RAMIREZ (deceased) vs. OSTERIA COPPA, LLC, TRUCK INSURANCE EXCHANGE (FARMERS INSURANCE)

This case involves a deceased worker whose employer, Osteria Coppa, LLC, is challenging the Workers' Compensation Appeals Board's award of death benefits. The employer argued the WCJ erred by disallowing cross-examination and excluding a medical report. The Board denied reconsideration, affirming the original award because the employer failed to reject the claim within 90 days, thus triggering a presumption of compensability under Labor Code section 5402(b). Furthermore, the employer could not rebut this presumption with the excluded medical report, as the information it contained was discoverable within the 90-day period through reasonable diligence.

WCABIsabel Ramirez-RamosAngel RamirezOsteria CoppaLLCTruck Insurance ExchangeADJ8642319Opinion and Order Denying Petition for Reconsiderationindustrial injurydeath benefits
References
Case No. FRE 186612
Regular
Mar 26, 2008

, Jose Maravilla, vs. , JOSE AND FLORENCIA ALVERNAZ and CIGA, by CAMBRIDGE INTERGRATE SERVICES for FREMONT INSURANCE COMPANY, in liquidation; LIBERTY MUTUAL INSURANCE COMPANY; CALIFORNIA INDEMNITY INSURANCE COMPANY, adjusted by GAB ROBINS

This case involves Liberty Mutual/Golden Eagle Insurance Company's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision finding applicant sustained a cumulative trauma injury to both knees. The WCAB denied reconsideration, finding the Statute of Limitations defense was waived and that the *Benson* case regarding allocation of disability cause was not applicable as there was only one industrial injury. The WCAB adopted the WCJ's report in its entirety for its denial.

Workers' Compensation Appeals BoardJose MaravillaJose and Florencia AlvernaCIGAFremont Insurance CompanyLiberty Mutual Insurance CompanyCalifornia Indemnity Insurance CompanyGAB RobinsFRE 186612Opinion and Order Denying Petition for Reconsideration
References
Case No. ADJ9533697
Regular
Feb 19, 2015

JOSE RAMIREZ vs. NINO FARMS LABOR, INC., SECURITY NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board dismissed Jose Ramirez's Petition for Removal because the hearing it sought to remove proceeded as scheduled on January 22, 2015. The removal petition was rendered moot as the matter was submitted for decision after the hearing. Consequently, the Board found no basis to grant the removal.

Petition for RemovalMootSubmitted for decisionWorkers' Compensation Appeals BoardADJ9533697Bakersfield District OfficeSecurity National Insurance CompanyAmerican All-Risk Loss AdministratorsNino Farms LaborDavid Kestner & Associates
References
Case No. ADJ738549 (VNO 0522332)
Regular
Dec 17, 2012

JOSE RAMIREZ vs. PEDRO ALARCON, dba ALARCON IMPORTS \u0026 EXPORTS, UNINSURED EMPLOYERS BENEFIT TRUST FUND

The Workers' Compensation Appeals Board (WCAB) dismissed Jose Ramirez's petition for reconsideration because it was not verified as required by Labor Code section 5902. Had the petition been verified, the WCAB would have denied it on the merits based on the administrative law judge's report, which found the applicant's credibility to be highly persuasive. Furthermore, the WCAB ordered the uninsured employer, Pedro Alarcon, to provide a verified statement of employee numbers as per Labor Code sections 3722(d) and (e) to determine applicable penalties. The WCAB also noted the employer had not secured workers' compensation insurance.

Petition for ReconsiderationVerified StatementLabor Code section 5902Uninsured EmployerWorkers' Compensation Appeals BoardReport and RecommendationWCJCredibilityLabor Code section 3722(d)Labor Code section 3722(e)
References
Case No. ADJ10229956
Regular
Aug 13, 2018

VIRGIL GRAY vs. ARENA FOOTBALL LEAGUE, SAN JOSE SABERCATS, ZURICH AMERICAN INSURANCE, UNINSURED EMPLOYER BENEFITS TRUST FUND

This case denies the defendants' petition for reconsideration of a finding of joint employment for an industrial knee injury. The applicant, Virgil Gray, was found to be a joint employee of both the Arena Football League and the San Jose SaberCats, despite receiving paychecks from the League. Evidence such as the San Jose SaberCats' direct control over the applicant's work, provision of equipment, and housing, supported the finding that both entities exercised the right to direct and control his activities. The Appeals Board affirmed the administrative law judge's decision, finding the totality of the record supported joint employment.

joint employmentspecial employergeneral employerArena Football LeagueSan Jose SaberCatsZurich American InsuranceUninsured Employer Benefits Trust Fundprofessional athleteindustrial injuryleft knee
References
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