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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. 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. ADJ700106 (SAL 0075388) ADJ4293270 (SAL 0067937) ADJ3847224 (SAL 0067938) ADJ1646200 (SAL 0011386)
Regular
Sep 01, 2015

WILLIE PEARSON vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS, Chamberlain's Children Center, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, SUPERIOR NATIONAL INSURANCE COMPANY

In this workers' compensation case, CIGA sought to be relieved of liability for applicant's medical treatment, arguing that the State of California Department of Corrections ("the State") constituted "other insurance." The Appeals Board affirmed the WCJ's decision that the State does not qualify as "other insurance" under Insurance Code section 1063.1(c)(9)(A). Unlike private self-insured employers, the State is not required to obtain workers' compensation insurance or a certificate of self-insurance, and thus does not fall within the statutory definition of an "insurer." The Board further clarified that the State Compensation Insurance Fund's role in claim adjustment services for the State does not make it "other insurance" when the State is not otherwise insured with SCIF.

CIGASupernational Insurance Companylegally uninsuredother insurancecovered claimsInsurance Code Section 1063.1State of California Department of Correctionsreimbursementstipulated awardjoint and several liability
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. 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. ADJ4684775 (VEN 0117727) ADJ4381820 (VEN 0117723)
Regular
Dec 19, 2011

JOANNE LUTZ, JOANN LUTZ vs. RUSSELL WARNER dba ROTO ROOTER SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for PAULA INSURANCE COMPANY, in liquidation, and for FREMONT INSURANCE COMPANY, in liquidation, LINDA McDONALD, STATE FARM INSURANCE COMPANY

The Workers' Compensation Appeals Board reversed a prior ruling, allowing CIGA to pursue reimbursement from State Farm for benefits paid due to applicant's industrial injuries. The Board found that unlike a request to alter a prior award, CIGA's petition sought to enforce its statutory right to reimbursement from "available" insurance under Insurance Code section 1063.1(c)(9). Since State Farm, as a jointly and severally liable insurer, appears to be such "available" insurance, the case is remanded for further proceedings on CIGA's reimbursement claim.

California Insurance Guarantee AssociationCIGAPaula Insurance CompanyFremont Insurance CompanyState Farm Insurance Companystipulated awardreconsiderationreimbursementcontributionother insurance
References
Case No. ADJ854108 (OAK 0281808)
Regular
Oct 07, 2008

PATRICIA BECK vs. INTEGRATED DEVICES TECHNOLOGY, SAFETY NATIONAL CASUALTY CORPORATION, MATRIX ABSENCE MANAGEMENT, RANDSTAND, CIGA ON BEHALF OF LEGION INSURANCE IN LIQUIDATION, BROADSPIRE

This case involves an applicant who sustained an industrial injury to her left thumb, hand, and wrist while employed by both a general employer (Randstand) and a special employer (Integrated Devices Technology, IDT). The Workers' Compensation Appeals Board (WCAB) granted reconsideration to correct minor errors in the original Findings and Award, specifically regarding citations to the Insurance Code and the identification of the general employer. The WCAB affirmed the original decision that IDT's insurer, Safety National Casualty Corporation, constitutes "other insurance," thereby relieving CIGA of liability for the claim.

Workers' Compensation Appeals BoardIntegrated Devices TechnologySafety National Casualty CorporationMatrix Absence ManagementRandstandCIGALegion InsuranceBroadspirespecial employergeneral employer
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. VNO 0457283
Regular
Aug 28, 2007

GREGORY BRIDGES vs. FILM PAYMENT SERVICES, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for LEGION INSURANCE COMPANY, in liquidation, by BROADSPIRE, KELLEY PRODUCTIONS, INC., NATIONAL SURETY CORPORATION now FIREMAN'S FUND

The Workers' Compensation Appeals Board (WCAB) rescinded a previous award and returned the case for further proceedings to determine if the special employer's insurer, National Surety Corporation, provides "other insurance" under Insurance Code section 1063.1(c)(9). The WCAB ruled that a prior appellate decision did not collaterally estop CIGA from asserting this issue and found that the National Surety Corporation policy may constitute such "other insurance." The case now requires a determination on the merits of whether National Surety Corporation's policy is available to applicant, impacting CIGA's liability.

CIGALegion Insurance CompanyNational Surety CorporationFireman's Fundgeneral employerspecial employerjointly and severally liableother insuranceInsurance Code section 1063.1(c)(9)collateral estoppel
References
Case No. ANA 0366568
Regular
Aug 21, 2007

STACY MACK vs. CAREER STRATEGIES TEMP., INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for SUPERIOR NATIONAL INSURANCE COMPANY, BROADSPIRE, SUN AMERICA, STATE COMPENSATION INSURANCE FUND, TELEFLORA, LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the prior award, remanding the case to determine if the State Compensation Insurance Fund (SCIF) policy for Sun America constitutes "other insurance" under Insurance Code section 1063.1(c)(9). This determination is crucial for assessing the liability of the California Insurance Guarantee Association (CIGA), which seeks to avoid coverage by arguing the SCIF policy is available. The WCAB requires further proceedings to fully develop the record regarding the intent and applicability of the SCIF policy for special employees.

CIGAcovered claimother insurancegeneral employerspecial employerSuperior National Insurance CompanyState Compensation Insurance FundInsurance Code section 1063.1(c)(9)Insurance Code section 11663joint and several liability
References
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