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

Case No. ADJ4476010 (SDO 0342658) ADJ4527276 (SDO 0343898)
Regular
Oct 27, 2008

TANIA ESQUIVEL vs. CORRECTIONS CORPORATION OF AMERICA SAN DIEGO DETENTION, NEW HAMPSHIRE INSURANCE COMPANY

This case involved an applicant injured in a motor vehicle accident while traveling to a medical appointment for prior industrial injuries. The Workers' Compensation Appeals Board (WCAB) granted reconsideration and reversed the trial judge's finding that the motor vehicle accident was a compensable consequence. The WCAB ruled the injury was not compensable due to the excessive distance from the applicant's home and the medical provider, thus exceeding the employer's reasonable geographic risk.

Workers' Compensation Appeals Boardcompensable consequenceindustrial injurymotor vehicle accidentcorrectional officerprimary treating physicianBehavior Pain ServicesLabor Codegoing and coming rulespecial mission
References
Case No. ADJ111089 (MON 0239711)
Regular
Feb 01, 2011

BONNIE PERRONE vs. PHARMACIA & UPJOHNS, ZURICH NORTH AMERICA INSURANCE COMPANY

This case involves a defendant's petition for reconsideration of a prior Appeals Board decision that had granted reconsideration on its own motion and remanded the case for further development of the record regarding a prior motor vehicle accident. The Board now finds reconsideration was improvidently granted, rescinds its previous order, and reinstates the original Workers' Compensation Judge's findings. The Board affirms the judge's finding of 84% permanent disability after apportionment, supported by an Agreed Medical Evaluator's opinion that one-third of the orthopedic disability was due to the motor vehicle accident.

Workers' Compensation Appeals BoardPharmacia & UpjohnsZurich North America Insurance CompanyIndustrial InjuryBack InjuryPsyche InjuryPermanent DisabilityApportionmentMotor Vehicle AccidentCompensable Consequence Injury
References
Case No. ADJ7418888 ADJ6523182
Regular
May 07, 2014

Frances Evans vs. San Joaquin Regional Transit District, York Risk Services Group, Inc.

This case involves Frances Evans' claim for workers' compensation benefits due to cumulative trauma to her back and spine and a subsequent motor vehicle accident. The Appeals Board denied reconsideration, affirming its prior decision that Evans failed to prove her cumulative trauma injury arose from her employment. Because no industrial injury was established, the motor vehicle accident sustained while en route to a medical evaluation was also deemed non-compensable. The Board found the Agreed Medical Examiner's conflicting opinions on causation insufficient to meet the applicant's burden of proof.

Workers' Compensation Appeals BoardPetition for ReconsiderationCumulative Trauma InjuryIndustrial InjuryCompensable Consequence InjuryAgreed Medical Examiner (AME)Substantial Medical EvidenceIndustrial CausationBurden of ProofPermanent Disability
References
Case No. ADJ17834281
Regular
Nov 10, 2025

JOSE MARTINEZ vs. CUSTOM PIPE COUPLING, FEDERAL INSURANCE CO.

Applicant Jose Martinez sought reconsideration of a finding that his injury did not arise out of and occur in the course of employment, as it fell under the "going and coming" rule. The WCJ's initial finding was based on a May 26, 2023 motor vehicle accident occurring while Martinez was driving a company truck home for personal use, specifically to transport scrap metal given to him by his employer. The Appeals Board, adopting the WCJ's report, denied reconsideration, concluding that none of the exceptions to the "going and coming" rule applied, as there was no benefit to the employer for Martinez to take the company truck home once the delivery task was removed.

Workers Compensation Appeals BoardPetition for ReconsiderationLabor Code section 5909Electronic Adjudication Management SystemGoing and Coming RuleSpecial Mission ExceptionSpecial Errand ExceptionAOE/COEMotor Vehicle AccidentCompany Vehicle
References
Case No. ADJ9896370
Regular
Oct 19, 2017

GUILLERMO RESTREPO vs. SAN GORGONIO MEMORIAL HOSPITAL, ALPHA FUND

The applicant sought compensation for an industrial injury sustained in a car accident while commuting to work, arguing it fell under exceptions to the going and coming rule. The Workers' Compensation Appeals Board (WCAB) affirmed the administrative law judge's denial of the claim. The WCAB found the applicant's testimony regarding the necessity of using his personal vehicle for work-related tasks lacked credibility. Crucially, the evidence did not establish that the employer expressly or impliedly required the applicant to use his vehicle or that such use was a custom and practice relied upon by the employer.

Going and Coming RuleIndustrial InjuryWorkers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrdersWCJDirector of Environmental ServicesMotor Vehicle AccidentEmployment ContractJob Duties
References
Case No. ADJ31300041 (VNO 0552733) ADJ2893120 (VNO 0552734)
Regular
Jun 19, 2009

Cesar Ramirez vs. Time Warner Cable, ESIS, INC.

This case concerns a denial of reconsideration for a workers' compensation claim. The Appeals Board reaffirmed its prior decision that the applicant did not sustain an industrial injury arising from a motor vehicle accident. The applicant's alleged ventricular fibrillation was deemed a spontaneous event unrelated to his employment, and his belated recollection of the accident was not credited as substantial evidence of industrial causation. The Board maintained its authority to reweigh evidence and reject the findings of the administrative law judge.

Workers' Compensation Appeals BoardCesar RamirezTime Warner CableESIS Inc.petition for reconsiderationindustrial causationmotor vehicle accidentlone ventricular fibrillationburden of proofdelayed memory
References
Case No. ADJ11207300
Regular
Jan 14, 2020

THOMAS BATISTA vs. LEE'S PAVING, INC., TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The Board affirmed the WCJ's finding that the applicant failed to prove his injury arose out of and in the course of employment from a motor vehicle accident. Furthermore, the applicant's claim was found to be time-barred as the employer lacked specific knowledge of a work-related injury claim, not merely knowledge of an accident. The applicant's arguments regarding exceptions to the going-and-coming rule and tolling of the statute of limitations were rejected.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactOrderMotor Vehicle AccidentGoing and Coming RuleHinojosa v. Workers' Comp. Appeals Bd.Labor Code Section 5405Claim FormCalifornia Ins. Guarantee Ass. v. Workers' Comp. Appeals. Bd.
References
Case No. ADJ8608456 MF\nADJ8608504\nADJ8523009\nADJ8551858\nADJ8609068
Regular
Oct 07, 2015

HORACIO CABRERA, Deceased MARIBEL BARAJAS, Widow, Guardian Ad\nLitem for LITZY CABRERA, LESLY\nCABRERA, MARIA CABRERA AND\nKASSANDRA CABRERA; BRIANNA\nCABRERA, for herself and Guardian Ad Litem for STEFANI ARIAS, ANTONIO SOLARES, MODESTO DOMINGUEZ, JOHNATHAN ALONSO vs. MV CONTRACTING, STAR INSURANCE COMPANY

In this workers' compensation case, the employer sought reconsideration of a ruling finding a fatal motor vehicle accident and related injuries industrial. The employer argued the administrative law judge erred in admitting evidence and presuming compensability due to a failure to issue timely denial notices. The employer also contended the "going and coming rule" barred the claims as the accident occurred during a standard commute. The Board denied reconsideration, affirming the judge's findings that the injuries were industrial and not barred by the going and coming rule, largely adopting the judge's reasoning.

WCABPetition for ReconsiderationDenying PetitionRulings and Order Admitting EvidenceFindings of FactMotor Vehicle AccidentIndustrial InjuriesFatal Industrial InjuryDependentsNotice of Denial
References
Case No. ADJ8574227
Regular
Sep 17, 2013

Victor Morales vs. Fresh Start Harvesting, Sedgwick Claims Management Services

The Workers' Compensation Appeals Board denied reconsideration of a decision finding Victor Morales' injuryAOE/COE. Morales was injured in a motor vehicle accident while traveling in a caravan led by his supervisor to a work site. The WCAB adopted the Administrative Law Judge's report, which concluded the "going and coming" rule did not apply as Morales was following direct employer orders. The evidence supported that the injury occurred within the course and scope of employment.

WCABADJ8574227Petition for ReconsiderationDenialWCJ ReportGoing and Coming RuleAOE/COEIndustrially RelatedCaravanMotor Vehicle Accident
References
Case No. ADJ31300041 (VNO 0552733) ADJ2893120 (VNO 0552734)
Regular
Apr 09, 2009

CESAR RAMIREZ vs. TIME WARNER CABLE, ESIS, INC.

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior award, finding applicant Cesar Ramirez did not sustain an industrial injury. The Board found his ventricular fibrillation, which caused a motor vehicle accident, was a spontaneous, non-industrial medical event. The applicant's claim that a sudden stop in traffic caused "shock" leading to the fibrillation was not credited by the Board. Therefore, the applicant failed to prove his injury arose out of and occurred in the course of employment.

Ventricular fibrillationLone ventricular fibrillationSpontaneous eventNon-industrial medical conditionMotor vehicle accidentIndustrial causationReconsiderationPanel Qualified Medical Evaluator (QME)FrankbackIdiopathic seizure
References
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