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Case Law Database

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

Case No. ADJ10443669
Regular
Oct 04, 2017

Donna Carter vs. Rose International Group, OneBeacon Insurance Group

The Appeals Board affirmed the Workers' Compensation Judge's finding that Donna Carter sustained an industrial injury to her right knee and left wrist on May 18, 2016. Despite inconsistencies in the applicant's testimony regarding a slip and fall incident, her account was corroborated by a witness who found her on the floor. Medical records from the day of the incident also supported the applicant's claim, establishing a clear mechanism of injury. The Board found that the common sense nature of a slip and fall does not require expert medical opinion to establish industrial causation for the incident itself.

ADJ10443669Rose International GroupOneBeacon Insurance GroupDonna CarterWorkers' Compensation Appeals BoardOpinion and Decision After Reconsiderationslip and fallindustrial injuryright kneeleft wrist
References
Case No. ADJ10173387; ADJ19907358; ADJ3052978; ADJ3882676; ADJ4063239; ADJ4429907; ADJ883851; ADJ8926536
Regular
Sep 22, 2025

AURORA MUNOZ vs. FIRST GROUP AMERICA, NEW HAMPSHIRE INSURANCE COMPANY

This case concerns an applicant's petition for reconsideration of a denial of increased benefits for serious and willful misconduct by her employer. The applicant, a bus driver, was injured when a passenger lift malfunctioned. The Board denied reconsideration, affirming the WCJ's finding that the employer did not engage in serious and willful misconduct, as they reasonably relied on a mechanic's report stating the vehicle was safe to operate after an electrical short. The Board also found no basis for a presumption of serious and willful misconduct due to the employer's alleged failure to respond to discovery requests, as such procedures are not typically applicable in workers' compensation proceedings.

Serious and Willful MisconductLabor Code Section 4553Vehicle Inspection ReportPassenger LiftMechanic's Opinion"OK to Drive"Knowledge of DangerIntentional ActReckless DisregardAdverse Inference
References
Case No. ADJ1508875
Regular
Sep 16, 2019

DERRELL FELDMAN vs. CRITCHFIELD MECHANICAL, ENSTAR U.S., INC., O.C. MCDONALD, TRAVELERS INDEMNITY COMPANY OF CT, PARAGON MECHANICAL, INC., STATE COMPENSATION INSURANCE FUND

This Workers' Compensation Appeals Board case involved applicant Derrell Feldman and multiple defendants. The Board granted reconsideration of a prior decision. The amended decision affirmed the original ruling but increased the applicant's attorney fees to $10,432.80. Additionally, the award for permanent disability indemnity was adjusted, and the attorney fees were ordered payable directly to the applicant's counsel.

Workers' Compensation Appeals BoardPetition for ReconsiderationDecision After ReconsiderationWCJ's reportSeabright Insurance CompanyPermanent disability indemnityLabor Code Section 4658(d)Attorney feesADJ1508875Critchfield Mechanical
References
Case No. ADJ1508875 (SAL 0120616) ADJ10261915 ADJ7549983
Regular
Oct 31, 2019

DERREL FELDMAN vs. CRITCHFIELD MECHANICAL, ENSTAR U.S., INC., d.b.a ENSTAR ADMINISTRATORS, SEABRIGHT INSURANCE COMPANY, O.C. MCDONALD, TRAVELERS INDEMNITY COMPANY of CT, PARAGON MECHANICAL, INC., STATE COMPENSATION INSURANCE FUND

This case involved a clerical error in a prior Workers' Compensation Appeals Board (WCAB) decision that inadvertently awarded a second Labor Code section 4658(d) increase. The defendant requested a correction, which the WCAB granted. The WCAB has the authority to correct clerical errors at any time. Therefore, the September 16, 2019 decision was affirmed but amended to remove the erroneous second increase, clarifying the permanent disability indemnity awarded.

Workers' Compensation Appeals BoardPetition for ReconsiderationClerical ErrorLabor Code section 4658(d)Permanent disability indemnityAttorney feesSeabright Insurance CompanyTravelers Indemnity CompanyState Compensation Insurance FundCritchfield Mechanical
References
Case No. ADJ2010922
Regular
Sep 07, 2010

MICHAEL ROSADO vs. KJM ELECTRONIC WORKS, INC., STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and rescinded the WCJ's finding of industrial injury AOE/COE due to lack of substantial evidence. Key issues include a deficient record, absence of a medical-legal report connecting the injury to employment, and significant inconsistencies in the applicant's testimony regarding the date of injury, treatment, and the mechanism of injury. The case is remanded for further proceedings and a new decision by the WCJ, emphasizing the applicant's burden to prove injury AOE/COE.

AOE/COEsubstantial evidencereconsiderationrescindedreturn to trial levelburden of proofmedical-legal reportcredibilitymechanism of injuryindustrial injury
References
Case No. ADJ10620323
Regular
May 14, 2019

EDWARD ZOZOSKY vs. INTERSTATE DISTRIBUTOR CO.; XL INSURANCE COMPANY, Administered by SEDGWICK CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board affirmed a finding that Edward Zozosky sustained a right shoulder injury arising out of and in the course of employment, despite conflicting evidence regarding a forceful braking event. The Board found that medical reports from Dr. Kupfer and Dr. Zardouz constituted substantial evidence supporting the injury AOE/COE. While the defendant presented testimony and evidence questioning the mechanics of the alleged forceful stop, the Board gave deference to the administrative law judge's credibility determination of the applicant. However, one Commissioner dissented, arguing that the applicant failed to present substantial evidence of an industrial injury, emphasizing the lack of corroborating medical history and applicant's credibility issues.

AOE/COEhard braking eventOnGuard systemABS brakesrotator cuff capsule sprainindustrial aggravationQMEmedical opinioncredibility determinationsubstantial evidence
References
Case No. ADJ383777
Regular
Apr 04, 2011

Roxanna Ortiz vs. ONE SOURCE, ESIS

The Workers' Compensation Appeals Board denied Roxanna Ortiz's petition for reconsideration of a prior findings and order. The initial ruling determined she sustained industrial injury only to her cervical spine as a janitor, not to other body parts or any resulting temporary/permanent disability or need for further medical treatment. Ortiz argued the judge erred by favoring defense medical reports and discrediting her testimony due to minor inconsistencies in her injury description. The Board adopted the WCJ's report, emphasizing deference to credibility determinations and that admissibility of medical reports should have been challenged at trial, not on reconsideration. A dissenting opinion argued the judge overemphasized minor variations in Ortiz's account and that medical evidence did not sufficiently support denial of other injuries or further treatment.

OrtizOne SourceESISWCABFindings and OrderPetition for ReconsiderationWorkers' Compensation Administrative Law Judgeindustrial injurycervical spineright arm
References
Case No. ADJ3328242 (SAC 0369772)
Regular
Mar 07, 2009

FRANK R. SANTOS vs. AMERICAN AIR MECHANICAL, INC., FIRST COMP OMAHA for ENDURANCE INSURANCE COMPANY

This case involves an applicant, Frank R. Santos, and defendants American Air Mechanical, Inc. and First Comp Omaha. The Workers' Compensation Appeals Board (WCAB) has issued an order denying reconsideration of a prior decision. The WCAB adopted the findings of the workers' compensation administrative law judge and gave great weight to their credibility determination. Therefore, the petition for reconsideration has been denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeCredibility FindingGarza v. Workers' Comp. Appeals Bd.Denial of ReconsiderationAmerican Air MechanicalFirst Comp OmahaEndurance Insurance CompanyADJ3328242
References
Case No. ADJ705744 (AHM 0148879)
Regular
Feb 05, 2013

PATRICK MURRAY vs. BALTAZAR PEREZ, DBA PERFORMANCE AIR AND MECHANICAL, UNINSURED EMPLOYERS BENEFITS TRUST FUND, CALIFORNIA COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Patrick Murray's petition for reconsideration, upholding the findings of the Workers' Compensation Judge (WCJ). The WCJ's report, which was adopted by the Board, determined that Murray was not an employee of California Auto Collision on the date of his injury. The Uninsured Employers Benefits Trust Fund's (UEBTF) petition for reconsideration was dismissed as skeletal and would have been denied on its merits as well. The Board found that the evidence supported the conclusion that Murray was an employee of Baltazar Perez, DBA Performance Air and Mechanical, and not California Auto Collision.

Workers' Compensation Appeals BoardPetition for ReconsiderationUninsured Employers Benefits Trust FundSkeletal PetitionWCAB Rule 10846Employee StatusIndependent ContractorControl TestSecondary IndiciaBorello Factors
References
Case No. ADJ3057068
Regular
Nov 01, 2010

Cecilio Torres vs. Holbrook Construction, Inc., Lincoln General Insurance Company, American Claims Management, State Compensation Insurance Fund

The Workers' Compensation Appeals Board granted reconsideration, rescinded a prior decision, and returned the case for further proceedings. The applicant claimed a back and other injuries, alleging he notified his supervisor of the incident and subsequent pain before termination. The Board found the applicant met his burden to prove he provided sufficient notice of injury to his supervisor prior to termination, fulfilling the notice requirement of Labor Code section 3600(a)(10). Defendants failed to rebut the applicant's evidence that he reported the injury and requested medical treatment from his supervisor.

Workers' Compensation Appeals BoardReconsiderationLabor Code Section 3600(a)(10)Notice of InjuryTerminationPreponderance of EvidenceSupervisor NoticeActual NoticeEmployer KnowledgeWCJ Decision
References
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