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Case Law Database

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

Case No. SAC 293290
Regular
Feb 21, 2008

WILLIAM MENDOZA vs. LEE CUNEO dba THE BODY SHOP, UNINSURED EMPLOYERS FUND

The Workers' Compensation Appeals Board granted reconsideration to address the Uninsured Employers Benefits Trust Fund's (UEBTF) contentions. While affirming the award of retroactive vocational rehabilitation maintenance allowance (VRMA) at the delay rate, the Board amended the original order to allow the UEBTF credit for wages earned by the applicant as a property manager and for his net recovery in a third-party civil action against the uninsured employer. This credit will reduce the UEBTF's liability for the VRMA.

UEBTFVRMAdelay ratecredit for wagescivil action recoveryLabor Code section 139.5Labor Code section 4909property manager earningsthird party actionnet recovery
References
Case No. ADJ302560
Regular
Jan 10, 2012

DAVID COE vs. PROFESSIONAL ASSOCIATION OF DIVING INSTRUCTORS, MISSION INSURANCE COMPANY, IN LIQUIDATION, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The Appeals Board granted reconsideration on its own motion to correct a clerical error in a prior decision regarding a Labor Code section 5710 attorney's fee. The original award of $1,903.75 was twice the applicant's attorney's requested fee of $1,093.75, which the WCJ and the Board's prior decision acknowledged. The Board corrected its decision to reflect the accurate attorney fee of $1,093.75, while reaffirming that CIGA has no liability for this fee due to a credit against the applicant's third-party recovery, which is reduced by the corrected fee amount.

Workers' Compensation Appeals BoardProfessional Association of Diving InstructorsMission Insurance CompanyCalifornia Insurance Guarantee Association (CIGA)Labor Code section 5710attorney's feeclerical errorpetition for reconsiderationthird-party recoverynet third party recovery
References
Case No. ADJ7479989
Regular
Dec 18, 2015

CARMEN ANDRADE vs. VISITING NURSE & HOSPICE CARE SANTA BARBARA, ILLINOIS MIDWEST INSURANCE COMPANY

The applicant sought reconsideration of a decision that allowed the defendant a credit against her workers' compensation award for her full third-party settlement recovery. The applicant argued the credit should be limited to her net recovery of $2,449.62. The Appeals Board granted reconsideration, finding the applicant failed to prove resolution of the defendant's credit rights. The Board amended the decision to defer the exact credit amount, remanding for further proceedings to determine its value. The September 29, 2015 decision was otherwise affirmed.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and OrderThird Party CreditNet RecoveryLabor Code Section 3861Industrial InjuryCompromise and ReleaseLien ClaimEmployer Negligence
References
Case No. ADJ8350670
Regular
Jun 24, 2014

SALOMON LOPEZ vs. D & T FOODS, ILLINOIS MIDWEST INSURANCE CO.

This case involves a dispute over the approval of a Compromise and Release (C&R) in a workers' compensation claim. The applicant sustained injuries to his back, legs, and abdomen. The WCJ issued an order requiring further medical evaluation despite the parties filing an amended C&R. The defendant petitioned for removal, arguing the WCJ's order was inappropriate. The Appeals Board granted the petition, rescinded the WCJ's order, and approved the amended C&R, awarding the applicant a net recovery of $15,335.71.

Petition for RemovalCompromise and ReleaseWCJ OrderQME evaluationAME evaluationabdominal aspectsdriver unloaderindustrial injurypermanent disability advancesattorney's fee
References
Case No. ADJ8118860
Regular
Jul 25, 2012

REBECCA BURSON BROWN vs. NEC ELECTRONICS, MITSUI SUMITOMO MARINE MANAGEMENT

This case involves a defendant's petition for removal seeking to overturn a prior administrative order denying their request for a third-party credit without prejudice. The defendant argued a due process violation, while the applicant suggested a settlement was anticipated. The Appeals Board denied removal because the prior denial was without prejudice, allowing the defendant to refile with proper documentation regarding net recovery and employer negligence. The Board found no significant prejudice or irreparable harm to the defendant from the WCJ's procedural ruling.

Petition for RemovalThird Party CreditLabor Code section 3861Employer NegligenceDue ProcessWCJ OrderWithout PrejudiceNet RecoveryApplicant ObjectionWCAB Rule 10843
References
Case No. VNO 465419
Regular
Jul 11, 2008

ALFREDO GONZALES vs. TRW SPACE & ELECTRONICS, AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA

This case involves a workers' compensation claim where the applicant was awarded further medical treatment and reimbursement for self-procured treatment, but no permanent disability. The defendant appealed, arguing errors regarding permanent disability, the clarity of a third-party credit, and the WCJ's explanation for the no permanent disability finding. The Appeals Board affirmed the WCJ's decision, clarifying the third-party credit to apply against all benefits up to the applicant's net recovery, and imposed a $100 sanction against defense counsel for attaching extraneous documents to the reconsideration petition.

Workers' Compensation Appeals BoardReconsiderationSanctionsLab. Code § 5813Cal. Code Regs.tit. 8§ 10842Petition for ReconsiderationSecond Findings and AwardIndustrial Respiratory Injury
References
Case No. ADJ9464655
Regular
Dec 21, 2020

JOSE GARCIA vs. COUNTY OF ORANGE, PSI, YORK RISK SERVICES GROUP, INC.

This case involves a worker's compensation claim where the employer sought a third-party credit against the applicant's settlement. The Appeals Board amended the findings to attribute 5% of the fault to the applicant and 95% to the employer's employees. Despite the applicant's settlement of $26,000, the employer was denied credit because their 95% fault ($24,700) exceeded the applicant's net recovery ($17,500). The Board affirmed the WCJ's decision that the employer's contribution based on their fault exceeded the credit amount, thus preventing a credit for future benefits.

third-party creditcomparative negligenceemployer negligenceMartinez v. Associated EngineeringLabor Code section 3861settlementindustrial injuryWCJ credibilityproximate causeAssociated Construction & Engineering Co.
References
Case No. ADJ11880536
Regular
Aug 01, 2025

SERGIO AVILA vs. ADVANCED CONSTRUCTION, BITCO/OLD REPUBLIC GENERAL INSURANCE CORP.

The initial Findings and Order (F&O) from May 8, 2025, granted a credit to defendant Advanced Construction (ACS) from a third-party settlement. Applicant Sergio Avila sought reconsideration, arguing the WCJ erred in calculating ACS's comparative negligence and the total value of his case. The Appeals Board found the F&O lacked definite findings and identified evidentiary gaps concerning the net recovery, the WCJ's reliance on experts, and proof of benefits paid by ACS. Consequently, the Appeals Board rescinded the F&O and remanded the case for further proceedings consistent with its opinion.

Labor Code section 3861Third-party settlement creditComparative negligenceEmployer negligenceApplicant negligenceTotal damagesNet recoveryAllocation of faultPetition for ReconsiderationFindings and Order
References
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. ADJ14649906
Regular
Sep 08, 2025

JUAN CARLOS HERNANDEZ vs. YMCA OF THE FOOTHILLS, INSURANCE COMPANY OF THE WEST

The Workers' Compensation Appeals Board granted applicant Juan Carlos Hernandez's Petitions for Reconsideration and Removal. The Board aims to conduct a further review of the merits of the petitions and the entire record, citing concerns about the lack of evidence supporting the initial Findings and Orders by WCJ Bushin, which awarded a third-party credit of $147,625.51 to the defendants. The decision ensures due process and a comprehensive adjudication of factual and legal issues before a final ruling. The Board also noted the timeliness of its action in accordance with Labor Code section 5909(a) and admonished applicant's counsel for procedural violations.

Petition for ReconsiderationPetition for RemovalThird-Party CreditNet RecoveryDue ProcessSubstantial EvidenceLabor Code 5909EAMSWCJAppeals Board
References
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