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

Case No. ADJ7186657
Regular
Sep 30, 2011

Sergio Marquez vs. Alan's Lawnmower and Garden Center; INC, STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of a decision that found Sergio Marquez did not sustain an industrial injury. The applicant argued the employer's post-termination defense under Labor Code section 3600(a)(10) was inapplicable and that the presumption of injury under Labor Code section 5402 should apply. However, the Board adopted the WCJ's findings that neither the presumption nor an exception to the defense was established. The WCJ's report, which was incorporated by the Board, detailed why these arguments failed based on the evidence presented.

Workers Compensation Appeals BoardSergio MarquezAlan's Lawnmower and Garden CenterStar Insurance CompanyIllinois Midwest Insurance AgencyADJ7186657Order Denying Reconsiderationindustrial injuryLabor Code section 5402presumption of industrial injury
References
0
Case No. ADJ4433104 (ANA 0381115) ADJ4664599 (ANA 0381113)
Regular
Feb 02, 2016

JOSE CHONG (deceased) vs. SPORTS GRILL, EVEREST NATIONAL INSURANCE COMPANY, AMERICAN COMMERCIAL CLAIMS ADMINISTRATORS, INC., ZENITH INSURANCE COMPANY

This case involves a lien claimant seeking reconsideration of a decision denying applicant's cumulative and specific injury claims, finding a lack of medical evidence and credibility issues with the deceased applicant. The Workers' Compensation Appeals Board granted reconsideration to amend the original order concerning Labor Code section 5402. The Board affirmed the denial of the presumption of compensability, finding the lien claimant failed to meet its burden of proof regarding timely denial by the insurer Zenith. Issues related to Labor Code section 5402(c) were deferred.

WCABLien claimantPetition for ReconsiderationJoint Findings and OrderCumulative InjurySpecific InjuryAOE/COELabor Code section 5402Presumption of CompensabilityApplicant's Credibility
References
0
Case No. ADJ4140574 (VNO 0417628) ADJ3588068 (VNO 0472981)
Regular
Jun 03, 2013

KEVIN THOMPSON vs. COUNTY OF LOS ANGELES, TRISTAR RISK MANAGEMENT

The Workers' Compensation Appeals Board awarded applicant Kevin Thompson an additional attorney's fee of $1,500 under Labor Code section 5801. This fee is for services rendered by his attorney in successfully defending against the defendant's petition for writ of review to the Court of Appeal. The Board disallowed the requested clerical fees as section 5801 applies only to attorney services. Additionally, the request for costs under Labor Code section 5811 was denied due to the lack of required itemization and supporting documentation.

Labor Code § 5801Attorney's feePetition for Writ of ReviewAppeals BoardSupplemental awardReasonable attorney's feeAppellate levelPenaltyClerical servicesLabor Code § 5811
References
12
Case No. ADJ10908110
Regular
Mar 06, 2019

SHAKE KHACHATRIAN vs. STATE OF CALIFORNIA ATTORNEY GENERAL'S OFFICE, CALIFORNIA DEPARTMENT OF JUSTICE, Legally Uninsured, Adjusted by STATE COMPENSATION INSURANCE FUND

This case concerns an applicant's claim for psychiatric injury. The defendant did not deny liability within 90 days, creating a presumption of compensability under Labor Code section 5402(b). However, the Board held that this presumption does not preclude the defendant from presenting evidence to support a lawful, good faith personnel action defense under Labor Code section 3208.3(h). This defense is considered exempt from the 90-day investigatory limitation, allowing the defendant to present all competent evidence regardless of when it was obtained. The case is therefore returned to the trial level for a new decision on the merits of the personnel action defense.

Labor Code section 5402presumption of compensabilityLabor Code section 3208.3(h)good faith personnel actionreasonable diligencecumulative industrial injurypsychiatric injuryDWC-1 claim formsubstantial causejudicial interpretation
References
9
Case No. VEN 104138
Regular
Jul 08, 2008

CHANDRA DOSHI vs. BLUE CROSS OF CALIFORNIA by BROADSPIRE CLAIMS SERVICES

This case involves a lien claimant seeking reconsideration of a decision that denied a psychological injury claim. The Workers' Compensation Appeals Board granted reconsideration due to uncertainty regarding the administrative law judge's application of Labor Code sections 5402(b) (presumption of compensability for timely denial) and 3208.3 (threshold for psychiatric injury). The Board remanded the case for further proceedings to clarify whether the section 5402 presumption applies and, if not, to re-evaluate the psychiatric injury claim under section 3208.3 with a clear explanation of the reasoning.

Labor Code section 5402(b)presumption of compensabilitypsychiatric injurythreshold of compensabilitypredominant causeactual events of employmentcompromise and releaselien claimantcumulative traumamedical treatment
References
1
Case No. MISSING
Regular Panel Decision

In Re Pursuant to Section 304 of the Bankruptcy Code of Banco Nacional De Obras Y Servicios Publicos, S.N.C.

The International Association of Machinists and Aerospace Workers (IAM) sought relief from a preliminary injunction to pursue an action against Aeronaves de Mexico, S.A. de C.V. (Aeronaves) for declaratory judgment concerning a collective bargaining agreement. Aeronaves, represented by its Mexican bankruptcy trustee Banobras, objected, arguing the claims should be handled in Mexican bankruptcy court. Judge Tina L. Brozman analyzed the request in the context of section 304 of the Bankruptcy Code, emphasizing the specialized nature of American labor law, particularly the Railway Labor Act (RLA). Balancing international comity with the protection of American creditors, the court found that the issues regarding the existence and terms of the collective bargaining agreement required the expertise of an American district court. Therefore, the motion for relief from the stay was granted to permit the IAM action to proceed in the Southern District of New York.

Bankruptcy LawInternational ComitySection 304 StayRailway Labor Act (RLA)Collective Bargaining AgreementForeign BankruptcyAncillary ProceedingsDeclaratory ReliefLabor DisputeCreditor Claims
References
32
Case No. ADJ6699348
Regular
Mar 17, 2016

KANON MONKIEWICZ vs. RM STORE FIXTURES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) issued a Notice of Intention to find that Labor Code section 4903.8(a) does not preclude awards to lien claimants Rx Funding Solutions, LLC and PharmaFinance, LLC. This is because the 2014 amendments to section 4903.8(a)(2) specify that it does not apply to assignments completed prior to January 1, 2013. Both of the lien claimants' assignments were made before this date, thus exempting them from the preclusion. The WCAB is amending its previous order and returning the case to the trial level for further proceedings on the merits of the liens.

Labor Code 4903.8Lien claimantsAssignment of receivablesCessation of businessPharmacy lienMedical lienSB 863AB 2732Prospective vs. retrospective applicationWCAB rules
References
10
Case No. ADJ6822166
Regular
May 27, 2011

Jackie Thompson vs. Los Angeles Unified School District

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior finding that a school district police officer was entitled to a cancer presumption for his prostate cancer. The Board found that while the applicant was a peace officer, his authority was defined by Penal Code section 830.32, not section 830.1 as initially determined. Because Labor Code section 3212.1's cancer presumption specifically lists peace officers defined under certain Penal Code sections and does not include those under 830.32, the applicant is not entitled to the presumption.

Labor Code 3212.1Penal Code 830.32Peace OfficerSchool District Police OfficerCancer PresumptionIndustrial InjuryReconsiderationWCABLaw Enforcement ActivitiesWilliam Dallas Jones Cancer Presumption Act
References
3
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding the finding that his injury claims were filed after notice of termination. The Board agreed that the applicant's claims were barred under Labor Code sections 3600(a)(10) and 3208.3(e) as they were filed after notice of termination and no exceptions applied. The Board also determined that the defendant's denial letter encompassed both the specific and cumulative trauma claims, thus negating the presumption of compensability under Labor Code section 5402(b).

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and OrderWCJRalphs Grocery Companyindustrial injurypsycheheadright shoulderneck
References
0
Case No. ADJ967988 (VNO 0449090)
Regular
Jul 01, 2009

MARIA G. MAYA vs. LOS ANGELES UNIFIED SCHOOL DISTRICT, SEDGWICK CMS

The applicant sought reconsideration of a Workers' Compensation Appeals Board (WCAB) decision denying her claim for cumulative trauma injury to various body parts, arguing the employer failed to deny her claim within 90 days, thus triggering a presumption of compensability under Labor Code section 5402. The WCAB denied reconsideration, affirming the trial judge's finding that section 5402's 90-day period does not commence until a claim form is properly filed. The Board noted that the applicant did not provide proof of when the relevant claim form was received by the employer, and an earlier claim form pertained to a different, specific injury. Therefore, the applicant failed to establish the basis for the presumption of compensability.

Workers' Compensation Appeals BoardFindings and AwardPetition for ReconsiderationAdministrative Law JudgeIndustrial InjuryPermanent DisabilityFurther Medical TreatmentLabor Code Section 5402Presumed CompensableCumulative Trauma
References
2
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