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

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. ADJ9090850
Regular
Jun 28, 2017

VINCE FERRAGAMO vs. ST. LOUIS RAMS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT INDEMNITY COMPANY, in liquidation, HOME INSURANCE COMPANY, in liquidation, BUFFALO BILLS, INC., GREEN BAY PACKERS, NORTHWESTERN NATIONAL INSURANCE COMPANY merged with HIGHLANDS INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) reversed a prior decision, finding that Vince Ferragamo's current claim for cumulative brain injury is not barred by a 1988 compromise and release agreement. The Board determined that the brain injury was unknown and not intended to be covered by the prior settlement, which focused on orthopedic and other known injuries. Therefore, the doctrine of res judicata did not preclude this new claim, and the case was returned for further proceedings.

Workers' Compensation Appeals BoardVince FerragamoSt. Louis RamsFremont Indemnity CompanyHome Insurance CompanyBuffalo BillsGreen Bay PackersNorthwestern National Insurance CompanyHighlands Insurance Companycumulative trauma
References
Case No. ADJ18217235; ADJ18217236
Regular
Apr 29, 2025

Crispin Bermudez vs. Elkhorn Packing Company, LLC; Zenith Insurance Company

The Workers' Compensation Appeals Board addressed a petition for reconsideration filed by Zenith Insurance Company challenging an arbitrator's finding that applicant Crispin Bermudez was covered by a workers' compensation policy despite signing a waiver. The Board granted the petition, rescinded the arbitrator's decision, and issued a new decision. It found that as a managing member of a limited liability company, Bermudez had executed a valid written waiver of his workers' compensation rights under Labor Code sections 3351(f) and 3352(a)(17). Consequently, the applicant was deemed excluded from the definition of an employee and thus not entitled to workers' compensation coverage.

Workers' CompensationManaging MemberWaiver of CoverageLabor Code Section 3352(a)(17)Conclusive PresumptionIndustrial InjuryPetition for ReconsiderationArbitrator's DecisionRescinded DecisionLimited Liability Company
References
Case No. ADJ7110663
Regular
May 09, 2016

WILLIAM BO MATTHEWS vs. SAN DIEGO CHARGERS, ZENITH INSURANCE COMPANY, NEW YORK GIANTS, INSURANCE COMPANY OF NORTH AMERICA/ACE USA, DENVER GOLD, THE NORTH RIVER INSURANCE COMPANY

This case involves a petition for reconsideration of an arbitrator's decision regarding workers' compensation liability for a professional football player's cumulative trauma injuries. The Workers' Compensation Appeals Board (WCAB) granted reconsideration and modified the arbitrator's award, finding the applicant sustained two separate cumulative trauma injuries due to distinct periods of employment exposure. Consequently, the WCAB ruled that the petitioner, Insurance Company of North America/ACE USA (ESIS), is not liable for contribution to another insurer, The North River Insurance Company (NRIC), which had mistakenly paid a portion of a settlement. The Board affirmed the finding of two injuries, citing a significant break in employment as creating separate compensable periods, but rescinded the award to NRIC, holding NRIC should recover nothing from ESIS.

WCABPetition for ReconsiderationArbitration DecisionContributionCumulative InjuryProfessional Football PlayerInsurance Company of North America/ACE USAZenith Insurance CompanyThe North River Insurance CompanyLabor Code Section 5500.5
References
Case No. ADJ591293 (GRO 0031424) ADJ3541062 (GRO 0031102)
Regular
Oct 16, 2014

GENE FREITAS vs. THE KROGER COMPANY DBA RALPHS GROCERY COMPANY, SEDGWICK CMS

This case concerns an applicant's appeal challenging his permanent disability rating. The applicant argued his vocational expert demonstrated 100% disability, seeking to rebut the standard 2005 Permanent Disability Rating Schedule (PDRS). The Workers' Compensation Appeals Board (WCAB) affirmed the initial findings, holding the applicant failed to prove his industrial injury was the sole cause of his inability to participate in rehabilitation. The WCAB emphasized that factors like lack of education or general aptitude, rather than solely the industrial injury, must be demonstrably absent for a successful rebuttal under *LeBoeuf* principles.

Workers' Compensation Appeals BoardGene FreitasThe Kroger CompanyRalphs Grocery CompanySEDGWICK CMSOpinion and Decision After ReconsiderationFindings and AwardPermanent Disability Rating ScheduleVocational ExpertOgilvie
References
Case No. ADJ7661799
Regular
Nov 20, 2012

ELIU OBESO GARCIA vs. THE KROGER COMPANY dba FOOD 4 LESS OF CALIFORNIA, INC., SEDGWICK CLAIMS MANAGEMENT SE

This case before the Workers' Compensation Appeals Board involves Eliu Obeso and defendant The Kroger Company. The Board issued an Opinion and Order Granting Reconsideration. Pending a decision after reconsideration, all future filings and communications are to be submitted in writing directly to the Office of the Commissioners in San Francisco, not to any district office or via e-filing.

WORKERS' COMPENSATION APPEALS BOARDReconsiderationELIU OBESOTHE KROGER COMPANYFOOD 4 LESSPermissibly Self-InsuredSEDGWICK CLAIMS MANAGEMENT SERVICESADJ7661799Riverside District OfficeOPINION AND ORDER GRANTING RECONSIDERATION
References
Case No. ADJ2515407 (OXN 0138411)
Regular
Sep 16, 2013

ROBERT VOELTZ vs. THE KROGER COMPANY dba RALPH'S GROCERY COMPANY permissibly self-insured and administered by SEDGWICK

The Workers' Compensation Appeals Board granted Defendant's Petition for Reconsideration, increasing Applicant's permanent disability from 82% to 89%. The Board found the WCJ erred in the calculation using the Multiple Disabilities Table and in the apportionment of psychiatric disability. Specifically, 10% of the psychiatric disability was apportioned to non-industrial factors per Dr. Charuvastra's opinion. The Board also affirmed the use of the 1997 Permanent Disability Rating Schedule and the admission of Dr. Liker's reports.

VOELTZROBERTKROGER COMPANYRALPH'S GROCERY COMPANYSEDGWICKADJ2515407OXN 0138411WORKERS' COMPENSATION APPEALS BOARDRECONSIDERATIONFINDINGS AND AWARD
References
Case No. ADJ4445992 (MON 0029719)\nADJ887768 (MON 0029718)
Regular
Mar 30, 2017

BERNARD BILLIK vs. HUGHES AIRCRAFT COMPANY, LIBERTY MUTUAL INSURANCE COMPANY, WAUSAU INSURANCE COMPANY

The Court of Appeal ordered the Workers' Compensation Appeals Board (WCAB) to award applicant's attorney's fees for responding to a denied petition for writ of review. The applicant's counsel and the defendant's insurer subsequently stipulated to attorney's fees and costs totaling $6,492.50. The WCAB found this amount reasonable and issued an award for these fees and costs against Wausau Insurance Company, payable in addition to any compensation owed to the applicant.

Workers' Compensation Appeals BoardAttorney's FeesLabor Code § 5801Petition for Writ of ReviewRemandStipulationAppellate Attorney's FeesWausau Insurance CompanyHughes Aircraft CompanyLiberty Mutual Insurance Company
References
Case No. ADJ3366924 (MON 0344712) ADJ1413399 (VNO 0343360)
Regular
Nov 18, 2014

RICHARD MARQUEZ vs. CO-OPPORTUNITY CONSUMERS, INC., VIRGINIA SURETY COMPANY, ILLINOIS MIDWEST INSURANCE AGENCY, THE KROGER COMPANY

The Workers' Compensation Appeals Board (WCAB) granted Co-Opportunity Consumers, Inc.'s petition for reconsideration of a prior decision. This decision was made after an initial review of the record, recognizing the need for further study of the factual and legal issues. The WCAB intends to fully understand the case to issue a just and reasoned decision after reconsideration. All future communications regarding this case must be filed in writing with the WCAB Commissioners' office, not with any district office or via e-filing.

Workers' Compensation Appeals BoardPetition for ReconsiderationStatutory time constraintsFactual and legal issuesJust and reasoned decisionOffice of the CommissionersElectronic Adjudication Management SystemSelf-insuredCo-Opportunity ConsumersVirginia Surety Company
References
Case No. ADJ1801165 (VNO 0533524)
Regular
Apr 30, 2010

WILFREDO MARROQUIN vs. THE KROGER COMPANY dba RALPHS GROCERY COMPANY/FOOD 4 LESS, PERMISSED BY SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves an employee, Wilfredo Marroquin, who sustained industrial injuries to his neck, shoulders, and elbows. The primary dispute concerns the employer's claim for credit for temporary disability payments, which significantly exceeded the permanent disability award. The Administrative Law Judge initially denied the credit, citing equity concerns due to the large sum relative to the award and the employer's proper benefit payments. The Appeals Board granted reconsideration, recognizing the discretion to allow credit but emphasizing that denial is appropriate if it undermines the purpose of permanent disability benefits. The case is returned to the trial level for the WCJ to assess the equities of both parties regarding partial credit.

Wilfredo MarroquinThe Kroger CompanyRalphs Grocery CompanySedgwick Claims Management ServicesADJ1801165VNO 0533524Petition for ReconsiderationFindings and Awardindustrial injuryjanitor
References
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