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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. 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. ADJ758263 (VNO 0361187)
Regular
Feb 27, 2012

JOHN SCHAUFUS vs. SHIRLEY BROTHERS, INC., LIBERTY MUTUAL INSURANCE CO., FERRANTE CONSTRUCTION, GOLDEN EAGLE INSURANCE CORPORATION, STATE COMPENSATION INSURANCE FUND

The State Compensation Insurance Fund (SCIF) petitioned for reconsideration of an arbitrator's decision enforcing a prior award of contribution. SCIF argued that Liberty Mutual, acting in dual capacities as an insurer and successor, should have filed a separate contribution petition within one year of the applicant's Compromise and Release (C&R) approval. The arbitrator found the prior decision to be res judicata, determining SCIF's 41.79% liability for benefits paid outside the C&R, thus rendering a new contribution petition unnecessary. The Workers' Compensation Appeals Board adopted the arbitrator's report and denied SCIF's petition for reconsideration.

Workers Compensation Appeals BoardShirley Brothers Inc.Liberty Mutual Insurance Co.Ferrante ConstructionGolden Eagle Insurance CorporationState Compensation Insurance FundSCIFPetition for ReconsiderationArbitrator's ReportFindings and Award
References
Case No. ADJ3816448 (LAO 0789900) ADJ335314 (LAO 0818843) ADJ1177078 (LAO 0789901)
Regular
Sep 25, 2015

RAYMUNDO PITONES vs. MEL CAST LITHO, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves CIGA, the California Insurance Guarantee Association, seeking to be absolved of liability for workers' compensation benefits for an injured worker, Raymundo Pitones. CIGA argues that a settlement with another insurer for a subsequent, overlapping injury constitutes "other insurance" that should relieve CIGA of its obligations. The Workers' Compensation Appeals Board denied CIGA's petition, finding that the subsequent settlement did not fully cover all of Pitones' injuries, particularly those that did not overlap. Therefore, CIGA remains liable for the benefits not covered by the prior settlement to ensure the applicant can recover his full benefits.

CIGACalifornia Insurance Guarantee AssociationMel Cast LithoInc.California Compensation Insurance CompanyliquidationSEDGWICK CLAIMS MANAGEMENT SERVICESPetition for ReconsiderationJoint Findings of Fact and Orderworkers' compensation administrative law judge
References
Case No. ADJ8517777
Regular
Oct 07, 2019

DOUGLAS ARONSON vs. WORLD LEAGUE OF AMERICAN FOOTBALL, LIBERTY MUTUAL INSURANCE, STATE COMPENSATION INSURANCE FUND, PHILADELPHIA EGLES, FAIRMONT PREMIER INSURANCE COMPANY

In *Aronson v. World League of American Football*, the Workers' Compensation Appeals Board denied a petition for reconsideration, upholding an arbitrator's finding. The core issue was whether the State Compensation Insurance Fund's (SCIF) policy covered all employees of the League injured within California's jurisdiction, or only those affiliated with the Sacramento Surge. The Board affirmed that standard workers' compensation policies cover all employees unless explicitly limited, and any ambiguity is resolved in favor of the insured. Therefore, SCIF's policy was interpreted to provide coverage for all League employees injured in California during the relevant period.

Workers' Compensation Appeals BoardPetition for ReconsiderationInsurance Policy InterpretationSCIF PolicyCalifornia JurisdictionAmbiguity Resolved Against InsurerGreatest CoverageArbitrator's DecisionFindings and AwardState Compensation Insurance Fund
References
Case No. SFO 0460461
Regular
Oct 11, 2007

HEIDI RUEDA vs. WESTAMERICA BANCORP., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, FREMONT INSURANCE, LIBERTY MUTUAL FIRE INSURANCE COMANY

This case involves CIGA's claim for reimbursement from Liberty Mutual for benefits paid to applicant Heidi Rueda due to industrial injuries sustained in 1992 and 1998. Liberty Mutual, liable for the 1998 injury, disputes CIGA's entitlement to 100% reimbursement, arguing the 1992 injury also contributed to the disability. The Workers' Compensation Appeals Board denied Liberty Mutual's request for reconsideration, upholding the arbitrator's findings.

Workers' Compensation Appeals BoardCIGAFremont InsuranceLiberty MutualReconsiderationFindings and AwardTemporary DisabilityPermanent DisabilityMedical BenefitsMedical-Legal Expenses
References
Case No. ADJ7432904
Regular
Sep 24, 2012

NEDA MOTAVAKEL vs. FANTASTIC SAM'S, TOWER SELECT INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, STAR INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, ENDURANCE WORKERS' COMPENSATION, SOUTHERN INSURANCE CO., FIRSTCOMP OMAHA

This case involves an appeal by Star and Tower Insurance Companies regarding a workers' compensation award. The primary issue is the applicant's average weekly earnings, specifically the inclusion of tip income, which was not adequately substantiated by documentary evidence. The Appeals Board found the initial decision lacked substantial evidence regarding earnings and rescinded the award. The matter is remanded for further proceedings to properly develop the evidentiary record on earnings and insurance coverage dates before a new decision is issued.

Workers' Compensation Appeals BoardNeda MotavakelFantastic Sam'sTower Select Insurance CompanyStar Insurance CompanyIllinois Midwest Insurance AgencyLLEndurance Workers' CompensationSouthern Insurance CompanyFirstComp Omaha
References
Case No. ADJ1575513 (ANA 0339482) ADJ4199991 (ANA 0342546)
Regular
Jun 16, 2017

ELIZABETH ORTEGA vs. REMEDY TEMPORARY SERVICES, RELIANCE NATIONAL INSURANCE, In Liquidation, Adjusted By INTERCARE INSURANCE COMPANY, J.C. PENNEY, LIBERTY MUTUAL INSURANCE COMPANY

This case involves Applicant Elizabeth Ortega's workers' compensation claim against Remedy Temporary Services, Reliance National Insurance, J.C. Penney, and Liberty Mutual Insurance Company. The Workers' Compensation Appeals Board reviewed the petition for reconsideration filed by one of the parties. After careful consideration of the record and the report of the workers' compensation judge, the Board denied the petition.

Workers Compensation Appeals BoardPetition for ReconsiderationWorkers' Compensation Administrative Law Judgedenial of reconsiderationRemedy Temporary ServicesReliance National InsuranceIntercare Insurance CompanyJ.C. PenneyLiberty Mutual Insurance CompanyElizabeth Ortega
References
Case No. ADJ3388315 (SBR 0294441) ADJ683842 (SBR 0340933)
Regular
Jul 22, 2014

Marvin Camacho vs. Western Metal Lathe, Sompo Japan Insurance Company, Broadspire, Remedy Temp, Reliance National, California Insurance Guarantee Association, Williams Furnace Company, St. Paul Fire & Marine, Kimco Staffing, Liberty Mutual Insurance

The Workers' Compensation Appeals Board denied Williams Furnace Company's petition for reconsideration and granted Sompo Japan Insurance Company's petition. The Board affirmed the original award for Marvin Camacho's neck and back injuries sustained while employed by Remedy Temp and Western Metal Lathe, as well as prior injuries to his cervical and lumbar spine from Williams Furnace Company. Issues of temporary total disability, additional attorney's fees, and other matters were deferred for further development at the trial level. Liberty Mutual Insurance, carrier for Kimco Staffing, was dismissed from the case.

WORKERS' COMPENSATION APPEALS BOARDWESTERN METAL LATHESOMPO JAPAN INSURANCE COMPANYBROADSPIREREMEDY TEMPRELIANCE NATIONALCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONWILLIAMS FURNACE COMPANYST. PAUL FIRE & MARINEKIMCO STAFFING
References
Case No. ADJ7539480
Regular
Sep 20, 2011

GARY KREFT vs. CELESTRON, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, COMPWEST INSURANCE COMPANY, HARTFORD INSURANCE COMPANY, AMERICAN CLAIMS MANAGEMENT, STATE COMPENSATION INSURANCE FUND, Everest National Insurance Co.

This case concerns a cumulative injury claim where the Workers' Compensation Appeals Board (WCAB) granted Everest National Insurance Co.'s Petition for Removal. The WCAB amended a prior order joining Everest and other carriers, clarifying that Labor Code section 5500.5(a) limits liability for cumulative injuries to employers/insurers covering the year immediately preceding the date of injury or last exposure. As the date of injury/exposure was not yet determined and appeared to be the last day of employment, only the carriers covering that final year (CompWest and Hartford) were ordered joined. Everest was removed as a party defendant pending further determination.

Petition for RemovalLabor Code section 5500.5(a)cumulative injurylast injurious exposurejoinder of partiesWorkers' Compensation Appeals Boarddate of injuryrepetitive job dutiesCalifornia Insurance Guarantee AssociationCIGA
References
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