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

Case No. ADJ8455911
Regular
Nov 20, 2013

SANDRA VACA vs. CAPISTRANO UNIFIED SCHOOL DIST.,, SCHOOL DIST.,, CORVEL CORP.

This case concerns a dispute over the correct temporary disability indemnity rate for an applicant who worked as both a substitute teacher and a self-employed realtor. The applicant's net income as a realtor, after expenses, was used for the calculation, not her gross receipts. The Board rescinded the original award and found the applicant entitled to $395.93 per week in temporary disability, affirming the use of net income and earnings up to her last day of work. The issue of attorney's fees was deferred.

Workers' Compensation Appeals BoardTemporary Disability RateAverage Weekly EarningsSelf-Employed IncomeGross ReceiptsNet IncomeEarning CapacitySubstitute TeacherIndustrial InjuryGross Income
References
Case No. ADJ6649763
Regular
Oct 30, 2009

LESLIE ADAM MACK vs. ATLAS VAN LINES, ZURICH AMERICAN INSURANCE, GALLAGHER BASSETT

Reconsideration granted; temporary disability indemnity rate to be calculated based on net income, not gross income.

Average weekly earningsTemporary disability indemnityGross incomeNet incomeIndependent contractorSpecial expensesRemunerationLabor Code section 4454Hupp v. Workers' Compensation Appeals BoardSelf-employment earnings
References
Case No. ADJ3014811 (SFO 0511804)
Regular
Jul 09, 2010

ROBERT SULLIVAN vs. TASTE CATERING, FIRST COMP OMAHA

The Workers' Compensation Appeals Board granted reconsideration of a prior award, rescinding the temporary disability rate calculated based on the applicant's estimated tip income. The Board found the applicant's uncorroborated testimony regarding tips lacked credibility, particularly due to contradictory tax return information. The matter was returned to the trial level for further proceedings, urging the parties to agree on earnings or present substantial evidence. This decision emphasizes that earnings calculations must be supported by substantial evidence, not just applicant testimony.

Average Weekly EarningsTips IncomeEDD Wage StatementIndustrial InjuryTemporary Total DisabilityPermanent and StationarySubstantial EvidenceCredible TestimonyTax ReturnUnderreported Tip Income
References
Case No. ADJ2969875
Regular
Nov 16, 2012

ROBERTA FRANCINE YOUNG vs. COUNTY OF MONTEREY, LIBERTY MUTUAL INSURANCE GROUP

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding the WCJ's denial of her petition for commutation. The WCJ found that commuting benefits to allow the applicant to purchase a home would result in a net monthly loss of income, based on projected expenses exceeding her reduced income. Applicant argued the WCJ failed to consider future income increases and the stabilization benefits of homeownership. The Board agreed with the WCJ's findings and suggested a new petition could be filed in the future, addressing cognitive disability and financial assistance resources.

Petition for CommutationFindings and OrderWCJ ReportMonthly ExpensesRent PaymentsStorage UnitPG&EHomeowners InsuranceProperty TaxesWorkers' Compensation Payments
References
Case No. ADJ7750099
Regular
Apr 01, 2014

JERRI USREY vs. SIERRA OAKS SENIOR CENTER

The Workers' Compensation Appeals Board granted reconsideration to affirm the finding that Sierra Oaks Senior Center violated Labor Code section 132a by terminating applicant Jerri Usrey's employment due to her filing a workers' compensation claim. The Board adopted the WCJ's reasoning on witness credibility and evidence resolution. However, the determination of reinstatement and lost wages was deferred due to insufficient evidence regarding the availability of suitable work and applicant's ability to perform it. The award of $10,000 for the section 132a violation was affirmed, with further proceedings to address reinstatement and lost wages.

Labor Code section 132aPetition for ReconsiderationFindings and Awardreinstatementlost wagespoor performanceindustrial injuryadverse treatmentcredibility assessmenttrier of fact
References
Case No. ADJ799845
Regular
Sep 06, 2012

BOBBY RIVERA vs. STURGEON & SONS, INC., ZURICH NORTH AMERICA

This Workers' Compensation Appeals Board case denied a defendant's petition for reconsideration. The WCJ had awarded temporary total disability and further medical treatment for a knee injury. The defendant argued disability payments should cease after the applicant's termination for cause (positive drug test). However, the Board found no evidence the applicant could have returned to modified work within his restrictions, even if he had passed the drug test, thus upholding the temporary disability award.

Workers' Compensation Appeals BoardFindings and AwardReconsideration DeniedTemporary DisabilityFurther Medical TreatmentTermination for CauseDrug ScreenQualified Medical EvaluatorWork RestrictionsModified Work
References
Case No. ADJ8139465
Regular
Apr 18, 2013

Robert Scharfe vs. VI-TEL, LUMBERMANS UNDERWRITING ALLIANCE

This case concerns applicant Robert Scharfe's petition for reconsideration of a workers' compensation award. Scharfe argued the administrative law judge erred in calculating his average weekly earnings, claiming the judge disregarded significant self-employment income. The Board denied reconsideration, affirming the judge's decision that Scharfe failed to provide substantial evidence of his self-employment earnings, as his tax returns showed a net loss. Additionally, the Board found no error in the admission of income declarations from Scharfe's child support cases, which contradicted his claimed earnings.

Robert ScharfeVi-TelLumbermans Underwriting AllianceADJ8139465Opinion and Order Denying Reconsiderationtemporary disability indemnityaverage weekly earningsself-employment incomechild support casesLos Angeles County Superior Court
References
Case No. AHM 0110026
Regular
Jun 12, 2008

SAMUEL C. OROPALLO vs. U.S. FOODSERVICES, INC., LUMBERMAN'S MUTUAL CASUALTY COMPANY

This case involves a dispute over an industrial injury and alleged Labor Code section 132a discrimination by U.S. Foodservices. The Workers' Compensation Appeals Board denied the employer's petition for reconsideration but granted the employee's petition. The Board affirmed the original award but deferred the issues of reinstatement, lost wages/benefits, and costs related to the discrimination finding, remanding these to the trial level.

Workers' Compensation Appeals BoardLabor Code section 132aPetition for ReconsiderationFindings Award and OrderIndustrial InjuryPermanent Disability IndemnityTransitional ProgramDiscriminationReinstatementLost Wages
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. STK 175646 STK 175647
Regular
Jul 08, 2008

Shaw vs. Clovis Unified School District

The Appeals Board affirmed a prior decision finding the employer violated Labor Code section 132a by terminating the applicant due to her industrial injury. The applicant demonstrated a prima facie case of discrimination, and the employer failed to prove a business necessity for her termination, as she was able to perform her job with self-modification and the employer's justification was not supported by evidence available at the time of the termination. Consequently, the employer was ordered to pay increased compensation, lost wages, and benefits, subject to collateral source reductions.

Labor Code section 132adiscriminationreinstatementlost wagesbenefitscollateral sourcesprima facie casequalified injured worker (QIW)customary occupationbusiness necessity
References
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