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Case Law Database

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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. MON 0255472
Regular
Mar 17, 2008

MARIA RODRIGUEZ vs. LOS ANGELES COUNTY METROPOLITAN TRANSPORTATION AUTHORITY, TRAVELERS INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a previous award, rescinding the arbitrator's decision that equally divided liability between the County and Travelers Insurance. The Board found the arbitrator improperly determined the date of injury and confused initial liability proceedings with apportionment. The case is remanded to the trial level for specific findings on the date(s) of injury and last injurious exposure, followed by a reconsidered liability apportionment based on proportionate coverage during the relevant one-year period.

Cumulative injuryDate of injuryInjurious exposureApportionment of liabilityContributionTravelers Insurance CompanyLos Angeles County Metropolitan Transportation AuthoritySection 5500.5Section 5412Permissibly self-insured
References
Case No. ADJ3588884 (FRE 0222309) ADJ4330880 (FRE 0223217)
Regular
Feb 22, 2011

ENEDELIA LUNA vs. FRESNO UNIFIED SCHOOL DISTRICT, UNITED ARTISTS THEATRE CIRCUIT; AMERICAN MOTORISTS INSURANCE COMPANY, Administered By BROADSPIRE

This case concerns American Motorists Insurance Company's petition for reconsideration of a Joint Findings and Award. The original award addressed two admitted industrial injuries sustained by the applicant, one against Fresno Unified School District (FUSD) and another against United Artists Theatre Circuit, insured by American Motorists. The petition specifically challenges the WCJ's failure to incorporate a stipulated liability apportionment between the defendants into the award. The Appeals Board denied the petition, ruling that the WCJ correctly deferred the issue of contribution between co-defendants, as they remain jointly and severally liable to the applicant.

Petition for ReconsiderationJoint Findings and AwardSpecial Education Teacher's AideCumulative InjuryBilateral Upper ExtremitiesPermanent DisabilityFurther Medical TreatmentPermissibly Self-InsuredStipulated Percentage of LiabilityContribution Between Co-Defendants
References
Case No. ADJ2497883 (SFO 0450940) ADJ3261393 (SFO 0504693)
Regular
Apr 30, 2010

JANETTE HARDIN vs. COUNTY OF ALAMEDA, SEDGWICK CLAIMS MANAGEMENT SERVICES, CHARTIS INSURANCE, TRISTAR RISK MANAGEMENT

This case involves Chartis Insurance seeking reconsideration of an arbitrator's decision setting the date of cumulative trauma injury for Janette Hardin's breast cancer as May 28, 1997, not the previously stipulated date of May 16, 2001. Chartis argued the stipulated date was res judicata and could not be altered, especially in a contribution proceeding. The Workers' Compensation Appeals Board denied the petition, affirming that contribution proceedings allow for a relitigation of liability and the determination of the true date of injury based on facts, not prior stipulations between the applicant and one defendant. The Board reasoned that findings of liability in the primary case are not binding in supplemental contribution proceedings.

Cumulative traumaDate of injuryContribution proceedingsRes judicataStipulated awardLabor Code section 5500.5Apportionment of liabilityCase-in-chiefSupplemental proceedingsGreenwald v. Carey Distribution Company
References
Case No. ADJ865164 (AHM 0127447)
Regular
Mar 22, 2011

DARRIEN GORDON vs. OAKLAND RAIDERS, PACIFIC EMPLOYERS INSURANCE COMPANY, XCHANGING, INC., ATLANTA FALCONS, ST PAUL TRAVELERS

This case concerns a professional football player's cumulative trauma injury claim. The Workers' Compensation Appeals Board granted reconsideration to correct an arbitrator's apportionment of liability. The Board found that under Labor Code section 5500.5, liability should be based on employment within the one year preceding the date of injury. Consequently, Travelers Indemnity, as insurer for the Atlanta Falcons, was ordered to reimburse the Oakland Raiders for 4% of benefits paid, reflecting the Falcons' minimal employment during the last year of injury. This reversed the original award which had apportioned liability at 39%.

Cumulative TraumaProfessional Football PlayerDate of InjuryLast Year of EmploymentApportionment of LiabilityContinuous TraumaOccupational DiseaseInsurer LiabilityContribution ClaimWorkers' Compensation Appeals Board
References
Case No. ADJ4357759 (SDO 0267149) ADJ4317475 (SDO 0359844) ADJ4224537 (SRO 0130138) ADJ4649631 (SRO 0140956)
Regular
Jun 21, 2010

SUSAN KUJAWA vs. SAN DIEGO UNIFIED SCHOOL DISTRICT, NOVATO UNIFIED SCHOOL DISTRICT

This case involves apportionment of liability between two school districts for an applicant's industrial injuries. The Workers' Compensation Appeals Board granted reconsideration to clarify liability for temporary disability. The Board reversed the judge's finding, holding San Diego Unified School District responsible for 94% of temporary disability benefits after January 29, 2002, aligning with prior apportionment for medical treatment. The Board also deferred the issue of credit for Novato Unified's overpayment of permanent disability.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderTemporary DisabilityMedical TreatmentApportionmentAgreed Medical EvaluatorPermanent DisabilitySpecific InjuryCumulative Injury
References
Case No. ADJ8210063
Significant

Grace Nunes, Applicant vs. State of California, DEPT. OF MOTOR VEHICLES, Legally Uninsured; STATE COMPENSATION INSURANCE FUND, Adjusting Agency, Defendants

The Appeals Board denied the applicant's Petition for Reconsideration, affirming its prior en banc decision that vocational evidence cannot substitute for valid medical apportionment from a physician, as mandated by Labor Code section 4663.

Labor Code Section 4663Vocational ApportionmentMedical ApportionmentPermanent DisabilityQualified Medical EvaluatorSubstantial EvidencePetition for ReconsiderationEn Banc DecisionWorkers' Compensation Appeals BoardApportionment Analysis
References
Case No. ADJ1747488
Regular
Dec 19, 2011

ADRIENNE BOYLAN vs. NEW COVENANT CARE GROUP, STATE COMPENSATION INSURANCE FUND

This case concerns the defendant's petition for reconsideration of a prior Board decision. The Board previously affirmed the dates of temporary disability for the applicant but amended the original award to grant the full value of temporary disability indemnity, rather than an apportioned percentage. The defendant argued against this full award, but the Board found that while liability for indemnity can be apportioned between defendants, an employee's entitlement to temporary disability indemnity cannot be apportioned. The Board denied the petition for reconsideration, reaffirming that the defendant is solely liable for the full value of temporary disability indemnity.

Temporary Disability IndemnityCumulative Trauma InjuryApportionment of LiabilityExclusive LiabilityLabor Code Section 3208.2FibreboardGranadoWCAB OpinionPetition for ReconsiderationSpecific Injury
References
Case No. ADJ8210063; ADJ8621818
En Banc
Aug 29, 2023

GRACE NUNES vs. STATE OF CALIFORNIA, DEPT. OF MOTOR VEHICLES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, affirming its prior en banc decision that permanent disability apportionment must be based on a physician's medical evaluation as mandated by Labor Code section 4663, and that vocational evidence cannot substitute an impermissible 'vocational apportionment' in place of a valid medical apportionment.

VOCATIONAL APPORTIONMENTMEDICAL APPORTIONMENTPERMANENT DISABILITYQUALIFIED MEDICAL EVALUATORLABOR CODE SECTION 4663SUBSTANTIAL EVIDENCEAPPEALS BOARD EN BANCFINDINGS OF FACT AND AWARDFINAL ORDERRECONSIDERATION DENIED
References
Case No. ADJ2711930 (OAK 0251340) ADJ1889959 (OAK 0318838)
Regular
Jul 21, 2015

MARK BAXTER vs. WASTE MANAGEMENT, INC., RELIANCE INSURANCE COMPANY, GALLAGHER BASSETT, PASCO SANITATION COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, FREMONT

This case involves complex workers' compensation claims with multiple defendants and insurers, including CIGA, regarding injuries in 1998 and 1999. The appeals board granted reconsideration, rescinded the WCJ's decision, and returned the matter to the trial level. Key issues include the proper application of Insurance Code section 1063.1, the apportionment of liability between successive injuries, and the clarity of the liable entity for the 1999 injury. Further proceedings are needed to address these disputed issues.

Workers' Compensation Appeals BoardReconsiderationFremont Indemnity Insurance CompanyLiquidationCalifornia Insurance Guarantee Association (CIGA)Self-insurance deductibleTransient exacerbationJoint and several liabilityApportionment of liabilitySuccessive injury
References
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