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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ137248 (MON 0283474)
Regular
May 21, 2009

GARY BYRNES vs. KAR INVESTMENTS, INC., dba RIGOLI FIRE EXTINGUISHER, SIMPLEX GRINNELL, dba RIGOLI FIRE EXTINGUISHER, KURT REXIUS

This case involves an applicant's Labor Code section 132a discrimination claim against KAR Investments, Inc. (dba Rigoli Fire Extinguisher) and its successor, Simplex Grinnell. The WCAB rescinded a prior finding that barred the applicant from pursuing Simplex due to a statute of limitations issue. The Board ordered Kurt Rexius, the sole shareholder of KAR, joined as a necessary party defendant for full adjudication. The matter is returned to the trial level to determine if discrimination occurred and who is liable.

Workers' Compensation Appeals BoardKAR InvestmentsInc.Rigoli Fire ExtinguisherSimplex GrinnellKurt RexiusLabor Code section 132asuccessor-in-intereststatute of limitationreconsideration
References
Case No. ADJ7233959 ADJ7233792
Regular
Mar 28, 2011

SALVADOR LANDIN vs. STAFFMARK INVESTMENT, CHARTIS SAN DIEGO

This case involves an attorney's petition for reconsideration after an administrative law judge (WCJ) ordered them to pay defendant costs and a $\$500$ sanction. The applicant's attorney argued they did not have adequate notice and an opportunity to be heard regarding the sanctions. The Appeals Board granted reconsideration, rescinded the WCJ's orders, and returned the matter for further proceedings because the orders were issued without proper notice and opportunity to present a defense, violating due process. The Board emphasized that sanctions require proper procedure, including a notice of intent and a hearing.

WORKERS' COMPENSATION APPEALS BOARDSALVADOR LANDINSTAFFMARK INVESTMENTCHARTIS SAN DIEGOPETITION FOR RECONSIDERATIONWCJSANCTIONCOSTSLABOR CODE §5813DUE PROCESS
References
Case No. ADJ7319072
Regular
Nov 13, 2013

MARIO FABELA vs. STAFFMARK INVESTMENT, LLC, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

The Workers' Compensation Appeals Board denied Mario Fabela's petition for reconsideration of a decision that found he did not sustain an injury arising out of and in the course of employment. The Board adopted the judge's report, which found Fabela's testimony lacked credibility, particularly in light of surveillance video showing him performing various physical activities with little difficulty two months after the alleged fall. Medical evidence also questioned the extent of his reported symptoms, noting negative diagnostic tests. Therefore, the Board concluded the evidence did not justify the applicant's claim for an industrial injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedWCJGarza v. Workmen's Comp. Appeals Bd.Staffmark InvestmentLLCCannon CochranFabelaDate of Injury
References
Case No. ADJ7800258 ADJ7800270
Regular
Jun 03, 2013

DEBRA NICKELL vs. PKB INVESTMENTS, INC., dba HOME INSTEAD, CARE WEST INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and amended a prior finding. The amended decision clarifies that the applicant met her burden of proof for reaching maximum medical improvement on July 19, 2011, and for a 15% whole person impairment rating based on an Agreed Medical Evaluator's opinion. However, the applicant did not meet her burden of proof for injury to other claimed body parts. The case is returned to the trial level for further proceedings.

WORKERS' COMPENSATION APPEALS BOARDPKB INVESTMENTSINC.HOME INSTEADCARE WEST INSURANCE COMPANYPEGASUS RISK MANAGEMENTDEBRA NICKELLPetition for ReconsiderationFindings of FactOrder
References
Case No. ADJ10386703
Regular
Feb 22, 2016

JAMES ONTIVEROS vs. BRAGG INVESTMENT COMPANY, INC., SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted the applicant's petition for reconsideration of a prior decision. This grant was based on the WCAB's initial review indicating a need for further study of the factual and legal issues. The WCAB intends to thoroughly examine the record to ensure a just and reasoned decision. All future correspondence regarding the petition must be directed to the Office of the Commissioners, not the district office, and electronic filing through EAMS is prohibited for these matters.

Petition for ReconsiderationWorkers' Compensation Appeals BoardBragg Investment CompanySeabright Insurance CompanyADJ10386703San Francisco District OfficeOpinion and OrderStatutory time constraintsFactual issuesLegal issues
References
Case No. ADJ10474797
Regular
Nov 13, 2017

Hernan Fuentes vs. STAFFMARK INVESTMENT, LLC, ACE AMERICAN INSURANCE COMPANY, CANNON COCHRAN

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior Findings and Order, and returned the case for further medical record development. The Board found the Qualified Medical Evaluator's (QME) report lacked substantial evidence due to the physician's apparent misunderstanding of workers' compensation principles and conflicting dates of maximum medical improvement. The applicant's primary treating physician's reports were also insufficient as they did not address a significant MRI finding of a re-tear. Therefore, a new medical evaluation from an Agreed Medical Examiner or a WCJ-selected physician is required to determine the applicant's entitlement to temporary disability indemnity.

Workers' Compensation Appeals BoardHernan FuentesStaffmark Investment LLCACE AMERICAN INSURANCE COMPANYCannon CochranADJ10474797San BernardinoPetition for ReconsiderationTemporary Disability IndemnityPrimary Treating Physician
References
Case No. ADJ909128 (OXN 0124367)
Regular
Dec 07, 2009

Robert Schleifstein vs. EQUITY GROUP INVESTMENTS dba CHART HOUSE ENTERPRISES, INC., CNA GROUP

Reconsideration granted; Decision of October 5, 2009 affirmed except for amended Finding of Fact No. 1.

WORKERS' COMPENSATION APPEALS BOARDRECONSIDERATIONGRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONAMENDED FINDING OF FACTINDUSTRIAL INJURYLEFT LOWER EXTREMITYBACK INJURYRESTAURANT MANAGEREQUITY GROUP INVESTMENTS
References
Case No. ADJ2632439 (LAO 875926)
Regular
Jan 05, 2009

Miguel Diaz vs. Marcos L. Donald Investments, Inc., State Compensation Insurance Fund

The WCJ's October 17, 2008 decision is rescinded due to insufficient findings. The case is returned for further proceedings under Labor Code section 4062.2, preferably using an Agreed Medical Examiner (AME), to clarify injury details and the role of the defendant's medical provider network (MPN).

Workers' Compensation Appeals BoardState Compensation Insurance FundMIGUEL DIAZMARCOS L. DONALD INVESTMENTS INCOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings and AwardAdministrative Law JudgeMedical TreatmentHome Health Care
References
Case No. ADJ137248
Regular
Aug 25, 2010

GARY BYRNES vs. KAR INVESTMENT, INC., dba RIGOLI, FIRE EXTINGUISHER; SIMPLEX, GRINNELL, dba RIGOLI FIRE, EXTINGUISHER; KURT REXIUS

The applicant, Gary Byrnes, sought reconsideration of a decision denying his claim for workers' compensation discrimination under Labor Code section 132a. The administrative law judge found that while Byrnes sustained an industrial back injury, he failed to prove discrimination related to a denied $1,000 reimbursement. The Board denied reconsideration, agreeing that Byrnes failed to establish a prima facie case of discrimination by showing he was singled out for disadvantageous treatment due to his industrial injury. The Board found no evidence that the denial of the reimbursement was causally linked to the industrial injury or that other employees were treated differently.

Labor Code section 132aindustrial injurydiscriminationprima facie casedisparate treatment$1000 insurance reimbursementburden of proofbusiness realitiesreinstatement
References
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