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

Case No. ADJ7775170
Regular
Jul 16, 2012

JUANA NEGRETE vs. SHURFLO, HAMPSHIRE INSURANCE COMPANY

This case involves an applicant's workers' compensation claim filed after layoff, triggering Labor Code Section 3600(a)(10). The Appeals Board granted reconsideration, finding the applicant met her burden of proof that she notified her employer of her injury prior to her layoff. The applicant's unrebutted testimony and supporting medical evidence demonstrated employer notice, thus overcoming the statutory bar to compensation. The case was remanded for further proceedings on the merits of the applicant's claim.

Workers' Compensation Appeals BoardJuana NegreteShurfloHampshire Insurance CompanyADJ7775170Opinion and Order Granting ReconsiderationDecision After Reconsiderationbilateral armsbilateral elbowssleep problems
References
Case No. LAO 854789
Regular
Oct 09, 2007

Juana Manriquez vs. KENVIN, INC., dba CORDOVAN & GREY LTD, STATE COMPENSATION INSURANCE FUND

The applicant sought extended temporary disability benefits, claiming a rotator cuff debridement during shoulder arthroscopy constituted an "amputation" under Labor Code section 4656(c)(2)(C). The Board denied reconsideration, affirming the WCJ's finding that "debridement" of an internal body part, like bone, does not meet the statutory definition of amputation. This definition requires the severance or removal of a limb or body appendage, conforming to the common understanding of the term.

Juana ManriquezKenvin IncState Compensation Insurance FundLAO 854789Petition for ReconsiderationAugust 6 2007 Findings and Ordershoulder arthroscopyamputationLabor Code section 4656(c)(2)(C)temporary disability
References
Case No. SJO 0258872
Regular
Aug 12, 2008

JUANA MICHEL vs. JACK-IN-THE-BOX, AMERICAN CASUALTY COMPANY OF READING PENNSYLVANIA

The Appeals Board reconsidered a decision regarding Juana Michel's workers' compensation claim and amended the original award. The Board found that medical reports predating January 1, 2005, sufficiently indicated permanent disability, thereby making the 1997 Permanent Disability Rating Schedule applicable. Consequently, the applicant's permanent disability rating was increased from 31% to 53% based on the parties' stipulation and the application of the older rating schedule.

Workers' Compensation Appeals BoardPermanent DisabilityReconsiderationIndustrial InjuryLow Back InjuryPermanent Disability RatingSchedule for Rating Permanent DisabilitiesAmerican Medical Association GuidesAgreed Medical ExaminerTreating Physician
References
Case No. ADJ8890512
Regular
Aug 23, 2018

JUANA FLORES vs. MCDONALD'S, UNITED STATES FIDELITY AND GUARANTY COMPANY, BROADSPIRE

The Workers' Compensation Appeals Board (WCAB) dismissed Juana Flores's petition for reconsideration because it was unverified, violating Labor Code section 5902. The WCJ's report provided notice of this defect, yet Ms. Flores failed to cure it by filing a verification or providing a compelling explanation within a reasonable time. Had the petition not been dismissed for procedural defect, the WCAB would have denied it on the merits, adopting the WCJ's findings and giving great weight to their credibility determination.

Petition for ReconsiderationVerifiedLabor Code section 5902Cal. Code Regs.tit. 8§ 10450(e)Lucena v. Diablo Auto BodyUnverified PetitionDismissalWCJ Report
References
Case No. ADJ10666000
Regular
Jun 04, 2018

JUANA ALEMAN vs. CITISTAFF SOLUTIONS, OLD REPUBLIC INSURANCE, GALLAGHER BASSETT SERVICES, INC.

The applicant, Juana Aleman, seeks reconsideration of a decision that denied her workers' compensation claim for cumulative injury. The appeals board granted reconsideration because the panel Qualified Medical Examiner's (QME) report lacked substantial evidence. Specifically, the QME's description of the applicant's job duties was inconsistent with testimony from both the applicant and her supervisor. Consequently, the board rescinded the prior decision and returned the matter to the WCJ for further proceedings, recommending the parties provide an accurate job description to the QME.

Petition for ReconsiderationPanel Qualified Medical Examiner (QME)Substantial EvidenceJob Description InaccuracyCumulative InjuryWorkers' Compensation Appeals Board (WCAB)Medical OpinionLabor CodeRestored to CalendarFindings Order Opinion
References
Case No. ADJ7158302
Regular
Jun 27, 2013

JUANA ZAVALA PEREZ vs. VIRGINIA SMITH, dba ZIP SORT SUPPORT, ACE AMERICAN INSURANCE, administered by ESIS

The Workers' Compensation Appeals Board dismissed Juana Zavala Perez's petition for reconsideration because it was not filed from a "final" order that determined substantive rights. The Board also denied the petition for removal, finding that the applicant failed to demonstrate substantial prejudice or irreparable harm. The case involved an appeal against Virginia Smith, dba Zip Sort Support, and Ace American Insurance.

Petition for ReconsiderationRemovalFinal OrderSubstantive RightInterlocutory OrderProcedural DecisionEvidentiary DecisionSubstantive QuestionPre-trial OrderEvidence
References
Case No. ADJ9876582
Regular
Sep 05, 2018

MICHAEL NEGRETE vs. THERMAL STRUCTURES, TRAVELERS INSURANCE

The Workers' Compensation Appeals Board denied the defendant's petition for removal, which sought to overturn a trial setting order for a lien trial. The defendant argued the trial setting prejudiced them by not allowing discovery on the Labor Code section 4615 stay issue. The Board found the EAMS notation provided sufficient notice of the potential defense, making discovery feasible. Therefore, removal was denied as there was no substantial prejudice or irreparable harm, and reconsideration would be an adequate remedy.

Petition for RemovalLien TrialLabor Code Section 4615Stay of LiensReshealth Medical GroupTruCare PharmacyAbuse of DiscretionPrejudicial ErrorDiscoveryWCJ Report and Recommendation
References
Case No. ADJ3533713
Regular
Nov 07, 2011

JUANA LOPEZ vs. THE MERCHANT OF TENNIS, HARTFORD INSURANCE

The Workers' Compensation Appeals Board (WCAB) removed this matter for the purpose of imposing sanctions. The WCAB found that the petition for reconsideration filed by SIR Practice Solutions, LLC on behalf of several lien claimants was skeletal, unintelligible, and violated multiple WCAB rules regarding evidentiary and legal support. The lien claimants and SIR Practice Solutions, LLC failed to object to the Notice of Intention to Impose Sanctions within the allotted time. Therefore, the WCAB imposed sanctions of $250.00 against each individual lien claimant and found SIR Practice Solutions, LLC jointly and severally liable for these sanctions.

Workers' Compensation Appeals BoardRemovalSanctionsLien ClaimantsSIR Practice SolutionsPetition for ReconsiderationSkeletal PetitionAppeals Board Rule 10846Labor Code Section 5813Notice of Intention to Impose Sanctions
References
Case No. ADJ2217160
Regular
Jul 16, 2012

ALICIA NEGRETE vs. MARRIOTT INTERNATIONAL, MARRIOTT CLAIMS SERVICES

The Workers' Compensation Appeals Board granted defendants' petition for reconsideration because a crucial document, their First Amended Petition for Penalties, was missing from the EAMS record. This missing petition was referenced in their petition for reconsideration and is essential for a complete understanding of the case. The Board will dismiss the defendants' petition for reconsideration unless they provide a copy of the referenced document within 15 days. All future filings must be sent directly to the Appeals Board Commissioners' office, not district offices or EAMS.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationFirst Amended Petition for PenaltiesCosts and SanctionsEAMSNotice of Intention to DismissAdmitted EvidenceStatutory Time ConstraintsFactual and Legal IssuesDecision After Reconsideration
References
Case No. RIV 0069711
Regular
Apr 04, 2008

JUANA CASTANEDA vs. BRAWLEY BEEF, AMERICAN HOME ASSURANCE

The Workers' Compensation Appeals Board dismissed the lien claimant's petition for reconsideration because it was filed untimely. The lien claimant failed to object within the allowed ten days to the Notice of Intention to Dismiss Lien and then filed the petition for reconsideration 20 days after the statutory deadline. The Board found that the lien claimant did not adequately overcome the defendant's proof of service for a prior hearing notice.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationDismissalUntimely filingBoard Rule 10770Compromise and ReleaseLabor Code section 5903JurisdictionProof of Service
References
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