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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ7601670 ADJ9457797 ADJ9576710
Regular
Jun 28, 2016

MARGARITA GUTIERREZ vs. DYNAMIC DETAILS, INC, ACE FIRE UNDERWRITERS INS. CO., ESIS, THE HARTFORD INS. CO., EVEREST NATIONAL INS. CO., SEDGWICH CMS

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's petition for reconsideration. The WCJ had previously issued an order vacating the original findings and setting a status conference. This order vacating the decision was issued within the 15-day period allowed for a WCJ to amend, modify, or rescind an award after a petition for reconsideration is filed. Therefore, the applicant's petition for reconsideration became moot and was properly dismissed.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderWorkers' Compensation Administrative Law JudgeOrder VacatingWCAB Rule 10859Moot PetitionOrder Denying Petition for RemovalChairwoman CaplaneCommissioner Sweeney
References
Case No. ADJ1200873 (OAK 0337904) ADJ479879 (OAK 0337905)
Regular
Apr 06, 2009

CARMEN CHACON vs. NATIONAL UPHOLSTERING CO., NATIONAL LIABILITY & FIRE INS. CO.

The Workers' Compensation Appeals Board (WCAB) rescinded an approved Compromise and Release (C&R) agreement due to potential mutual mistake of fact regarding duplicate payments of Temporary Disability Indemnity (TDI) and Unemployment Insurance (UI). Both the defendant and the Employment Development Department (EDD) sought reconsideration, arguing the original order did not adequately protect their interests regarding these duplicate payments. The WCAB found that EDD's due process rights were violated by a lack of proper notice and service regarding the C&R. The matter was returned to the trial level for a new decision to determine if a mutual mistake occurred and to consider EDD's lien.

Workers' Compensation Appeals BoardCarmen ChaconNational Upholstering Co.National Liability & Fire Ins. Co.Employment Development Department (EDD)Compromise and Release (C&R)Order Approving Compromise and Release (OACR)Mutual Mistake of FactDuplicate PaymentsTemporary Disability Indemnity (TDI)
References
Case No. VEN 0115536
Regular
Aug 04, 2008

ROBERT FROELICH vs. CONTRACTORS LABOR POOL, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCATION, RELIANCE NATIONAL INSURANCE CO., GM NORTHROP CORP., NATIONAL FIRE INSURANCE COMPANY OF HARTFORD

This case concerns a dispute over workers' compensation liability following an industrial injury sustained by an employee who was a general employee of Contractors Labor Pool (insured by insolvent Reliance) and a special employee of GM Northrup Corp. The Workers' Compensation Appeals Board granted reconsideration to reverse a prior finding, determining that National Fire Insurance Company's policy for GM Northrup Corp. constituted "other insurance." Consequently, National Fire Insurance Company is now liable for the applicant's benefits, and the California Insurance Guarantee Association is not liable as the claim is not a "covered claim."

CIGAReliance National InsuranceNational Fire Insurance Companycovered claimsother insurancegeneral employerspecial employerjoint and several liabilitypolicy constructionInsurance Code section 1063.1
References
Case No. ADJ16491268; ADJ15884384; ADJ16161110; ADJ16161057; ADJ16161093; ADJ15760386; ADJ18891808; ADJ19153721; ADJ16116250
Significant

Steve Hoddinott, et al. vs. Bravo Security Services, Inc.; National Liability Fire Ins. Co., administered by Biberk Business Insurance, et al.

The Appeals Board issued a notice to set a status conference to assist the parties in further discussing their stipulations with a designated hearing officer.

En BancRemovalStipulationSupplemental BriefingStatus ConferenceHearing OfficerDeputy CommissionerAppeals BoardAdjudication NumbersBravo Security Services
References
Case No. ADJ1526910 (LAO 0881311) ADJ1183697 (LAO 0881312)
Regular
Apr 14, 2017

MARGARITA GIUSTRA vs. PRIMARY PROVIDER MANAGEMENT, NATIONAL LIABILITY AND FIRE INSURANCE COMPANY, DELOS INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Delos Insurance Company's petition for reconsideration. The Board adopted the arbitrator's report, which found that a prior Compromise and Release agreement between the applicant and Delos Insurance Company only settled a specific injury, not the continuous trauma claim. This decision allowed National Liability and Fire Insurance Company's petition for contribution against Delos Insurance Company for a portion of benefits paid for the continuous trauma injury. The arbitrator also determined that prior conflicting judicial decisions did not bar Delos Insurance Company from being joined in the contribution proceedings.

Workers Compensation Appeals BoardMargarita GiustraPrimary Provider ManagementNational Liability and Fire Insurance CompanyDelos Insurance CompanyADJ1526910ADJ1183697Petition for ReconsiderationArbitrator's ReportCompromise and Release
References
Case No. ADJ3461326
Regular
Aug 30, 2013

MARK CLEMENTI, TOM CLEMENTI vs. BURCH CONSTRUCTION CO., INC., CALIFORNIA INS. GUARANTEE ASSOCIATION, BROADSPIRE, SUPERIOR NATIONAL INS. CO.

The Workers' Compensation Appeals Board (WCAB) granted a petition for removal to further develop the record in this case. The WCAB rescinded the trial setting order and returned the matter to the WCJ for further proceedings. This action was taken to address questions regarding the applicant's competency to sign a compromise and release agreement in 2011. The WCAB indicated potential avenues for further discovery, including supplemental medical opinions and depositions, but left the scope to the WCJ's discretion.

Petition for RemovalGuardian ad LitemTrusteeCalifornia Ins. Guarantee AssociationSuperior National Ins. Co.LiquidationSupplemental OpinionCompromise and Release AgreementCompetencyCross-examine
References
Case No. ADJ908115 (LBO 0381637)
Regular
Jan 28, 2010

AARON VILLEGAS vs. CAMPOS TACOS, NATIONAL LIABILITY & FIRE INSURANCE CO.

This case involves a lien claim by an interpreter for services rendered to an applicant who ultimately was found not to be an employee. The Workers' Compensation Appeals Board (WCAB) granted reconsideration and reversed a prior order disallowing the lien. The WCAB determined that interpreter fees incurred for services at WCAB conferences and hearings are allowable costs under Labor Code section 5811(b), regardless of employee status. However, fees for interpretation at medical or medical-legal appointments were affirmed as not allowable.

Workers' Compensation Appeals BoardLien claimantReconsiderationWCJMedical-legal expensesLabor Code section 5811Interpretation servicesCampos TacosNational Liability & Fire Insurance Co.Applicant
References
Case No. ADJ10021120 ADJ8949346
Regular
Apr 14, 2017

ANTHONY BERNARD EDWARDS (Dec'd), CANDACE EDWARDS (Widow), ASHLEY EDWARDS (Daughter), ANTHONY EDWARDS, JR. (Son) vs. CITY OF LOS ANGELES; LOS ANGELES WORLD AIRPORTS, Permissibly Self-Insured

This case involves a workers' compensation death benefit claim for Anthony Bernard Edwards, who died in the course of his employment. The dependents seek death benefits and burial expenses, which were initially awarded by the WCJ. The employer, City of Los Angeles, sought reconsideration, arguing it should receive credit for a third-party settlement the dependents obtained from Kaiser Permanente. The Board agreed to reconsider the issue of credit, specifically whether Civil Code section 3333.1 bars such credit. The Board ultimately deferred the credit issue, affirming the death benefit award and returning the matter for further proceedings to determine the applicability of Civil Code section 3333.1 and potential employer negligence.

Workers' Compensation Appeals BoardADJ10021120ADJ8949346death benefitsLabor Code section 4702burial expensesCivil Code section 3333.1Medical Injury Compensation Reform ActMICRAthird-party settlement
References
Case No. ADJ642902 (OXN 0128105)
Regular
Mar 22, 2011

FAWN BUBAN vs. ANDRIA'S SEAFOOD SPECIALTIES, CIGA, SEDGWICK CMS for ALISTAR, EVEREST NATIONAL INSURANCE CO., AMERICAN CLAIMS MGT, COMBINED SPECIALTY INS. CO., VIRGINIA SURETY, XCHANGING, INC.

The Workers' Compensation Appeals Board (WCAB) denied Fawn Buban's Petition for Reconsideration in a consolidated case involving multiple insurance carriers. The Order indicates the Board found no grounds to disturb its prior decision. This denial means the applicant's request for a review and potential reversal of the Board's findings was unsuccessful. The case was served on several law firms, suggesting significant legal representation for all parties involved.

ADJ642902ADJ2864783ADJ257673ADJ1072160ADJ871252FAWN BUBANANDRIA'S SEAFOOD SPECIALTIESCIGAALISTAREVEREST NATIONAL INSURANCE CO.
References
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