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

Case No. ADJ7232076
En Banc
Sep 26, 2011

Tsegay Messele vs. Pitco Foods, Inc.; California Insurance Company

The Appeals Board holds that the 10-day period for agreeing on an AME under Labor Code § 4062.2(b) is extended by five days when the initial proposal is served by mail, and clarifies the method for calculating this time period, finding both parties' panel requests premature.

Workers' Compensation Appeals BoardTsegay MesselePitco FoodsInc.California Insurance CompanyADJ7232076Opinion and Decision After ReconsiderationOrder Granting RemovalDecision After RemovalEn Banc
References
Case No. ADJ9625407
Regular
Sep 12, 2018

KEITH FIELD vs. CITY OF PINOLE

This case involves a firefighter who sustained bilateral carpal tunnel syndrome after retirement. The Appeals Board reversed the trial judge, holding that Labor Code section 4458.5 applies, entitling the applicant to permanent disability benefits calculated at the maximum indemnity rate. This applies regardless of the applicant's actual earnings or the fact that carpal tunnel syndrome is not a specifically enumerated presumptive injury. The case is remanded for determination of the precise date of injury to calculate the benefit rate.

Workers' Compensation Appeals BoardKeith FieldCity of PinolePermissibly Self-InsuredMunicipal Pooling AuthorityADJ9625407Opinion and Decision After Reconsiderationindustrial injuryfirefighterbilateral upper extremities
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. LAO 843759
Regular
Jul 16, 2007

JOSE GALARRETA vs. H.R. STAFFING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a prior administrative law judge's (WCJ) award due to confusion regarding the defendant's compensation payments, the applicant's penalty claims, and the WCJ's reasoning. The WCAB returned the case to the trial level for clarification on specific payment delays, penalty calculations, and the basis for attorney's fees awarded under Labor Code § 5814.5. The WCAB emphasized the need for specific findings on what compensation was delayed, when it was due and paid, and why any penalty was imposed to ensure fair and substantial justice between the parties.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardLabor Code § 5800Labor Code § 4650Labor Code § 5814Labor Code § 5814.5Attorney's FeesUnreasonable DelayPenalty
References
Case No. VNO 113665 VNO 113666 VNO 113667 VNO 113668
Regular
Aug 06, 2007

MARIA A. GARCIA vs. CITY OF LOS ANGELES LIBRARY SERVICES

The Workers' Compensation Appeals Board granted reconsideration and reversed a WCJ's award of penalties and attorney fees against the City of Los Angeles for delayed payment of home healthcare charges. The Board found that while payments were delayed, Labor Code section 5814(e) bars penalties when the only dispute concerns the payment of a provider's bill, not a denial of treatment. Furthermore, the Board found no basis to assess penalties under Labor Code section 5814.6 for a pattern of business practice violation.

Labor Code 5814Labor Code 5814.5Labor Code 5814.6unreasonable delayhome health carebilling disputemedical treatmentnursing servicespenaltyattorney fees
References
Case No. ADJ2155279 (RIV 0040729)
Regular
Nov 28, 2012

JACK RAMSEY vs. CALIFORNIA PAVEMENT MAINTENANCE, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, Sedgwick CMS, LEGION INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) amended a previous award to defer the issue of attorney fees for enforcing an award of Labor Code section 5710 fees. The WCAB affirmed the remainder of the award, including a $100 penalty for unreasonable delay in authorizing medical treatment, finding the 100-day delay in authorizing treatment with the applicant's chosen physician was unreasonable. The Board also affirmed the award of attorney fees under Labor Code section 5814.5 for enforcing the medical treatment award. The case was returned to the trial level for further proceedings regarding the amount of section 5814.5 fees, with a dissenting opinion arguing for further proceedings on the unreasonable delay issue due to insufficient evidence.

Workers' Compensation Appeals BoardCIGALegion Insurance CompanySedgwick CMSJack RamseyLabor Code section 5814Labor Code section 5814.5Labor Code section 5710Medical Provider NetworkMPN
References
Case No. ADJ3849140 (RDG 0119253)
Regular
Apr 04, 2011

THEMAS TRESLER vs. MOUNTAIN SATELLITE, STATE COMPENSATION INSURANCE FUND

This case involves a dispute over workers' compensation jurisdiction regarding a left shoulder injury. The defendant, SCIF, sought reconsideration of a WCJ's award of treatment for the shoulder, arguing lack of jurisdiction. The Appeals Board granted reconsideration, rescinded the prior award, and returned the matter for further proceedings. This decision acknowledges that the left shoulder claim may not have been definitively resolved by prior stipulations and requires the WCJ to determine if Labor Code section 5815 applies, potentially leading to a full hearing on the shoulder injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryLow Back InjuryLeft Shoulder InjuryStipulation with Request for AwardDeclaration of Readiness to ProceedContinuing JurisdictionLabor Code Section 5909
References
Case No. OXN 0140967
Regular
Jan 07, 2008

HILDA HERNANDEZ vs. AMERICAN TOOTH INDUSTRIES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration, rescinded the prior award, and amended the decision. The WCAB affirmed the Labor Code section 5814 penalty for the employer's unreasonable delay in paying a portion of the deposition attorney's fees. However, the WCAB rescinded the Labor Code section 5814.5 attorney's fees award because there was no prior enforcement of an award to justify them, and remanded the issue of sanctions for further proceedings.

Workers' Compensation Appeals BoardLabor Code section 5710deposition attorney's feesLabor Code section 5814unreasonable delayLabor Code section 5814.5attorney's feesenforcement of awardreconsiderationWCJ
References
Case No. ADJ1309169 (AHM 0045971)
Regular
Jul 30, 2009

MARY PRUITT vs. CNA INSURANCE CO., AMERICAN CASUALTY

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award of attorneys' fees under Labor Code § 5814.5. The Board found the prior decision lacked a proper evidentiary record and the necessary predicate finding of increased compensation under Labor Code § 5814 required for § 5814.5 attorneys' fees. The case was returned to the trial level for further proceedings to ensure compliance with evidentiary record requirements and to re-evaluate the § 5814.5 attorneys' fees issue.

WCABReconsiderationLabor Code § 5814.5Attorneys' FeesIncreased CompensationLabor Code § 5814Findings and AwardWCJEvidence RecordMinutes of Hearing
References
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