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Case Law Database

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

Case No. ADJ7427901
Regular
Oct 29, 2013

PABLO GONZALES vs. KVS TRANSPORTATION, INC., SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a finding that Pablo Gonzales sustained a specific industrial injury of Valley Fever on December 29, 2009. The Board found that while medical evidence did not support a specific injury date, the record might support a cumulative injury, occupational disease, or latent injury arising from employment. The case is returned to the WCJ to determine if pleadings should be amended to conform to this proof and to issue a new decision. Issues regarding self-procured medical treatment and medical-legal expenses were improperly addressed and should be limited to issues identified at trial.

Workers Compensation Appeals BoardKVS TransportationSeabright Insurance CompanyPablo GonzalesADJ7427901Findings and AwardReconsiderationIndustrial InjuryDecember 29 2009Chest
References
6
Case No. 534593
Regular Panel Decision
Jan 12, 2023

In the Matter of the Claim of Pablo Figueroa Ceja

Claimant Pablo Figueroa Ceja sought workers' compensation benefits after an injury while working for Manetta Enterprises, Inc. The State Insurance Fund (SIF) controverted coverage, asserting policy cancellation for nonpayment. The Workers' Compensation Board determined SIF had not effectively canceled its policy due to a lack of strict compliance with Workers' Compensation Law § 54 (5) regarding notice. The Appellate Division affirmed the Board's decision, reiterating the necessity of serving separate cancellation notices to each insured entity, even with shared addresses. The court also declined to address SIF's new argument about the claimant's employer status, as it was not raised administratively.

Policy CancellationWorkers' Compensation LawInsurance Coverage DisputeAppellate ReviewStatutory ComplianceEmployer-Employee RelationshipNotice of CancellationThird Judicial DepartmentState Insurance FundWorkers' Compensation Board
References
6
Case No. ADJ4347295 (SJO 0206086)
Regular
Mar 14, 2014

Judith Gonzales vs. TRI-CITY RECOVERY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) denied Judith Gonzales's petitions for reconsideration of the administrative law judge's (ALJ) Findings and Order. The WCAB adopted the ALJ's report, finding that Gonzales failed to support her fraud allegations with specific record references or legal citations as required by WCAB rules. Additionally, her request for automatic reassignment of the ALJ was untimely, and appended documents were either improperly included or not shown to be undiscoverable at trial. Therefore, both petitions were denied.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderPetition for ReconsiderationQualified Medical EvaluatorState Compensation Insurance FundStipulations with Request for AwardMedicare Set-AsideApplication for Adjudication of ClaimCumulative Trauma
References
0
Case No. ADJ9613485
Regular
Jan 03, 2015

DORIS GONZALES vs. HARBOR FREIGHT TOOLS, SAFETY NATIONAL INSURANCE CO.

The Workers' Compensation Appeals Board denied Doris Gonzales's Petition for Removal to rescind an order continuing her case to trial. Gonzales argued she hadn't completed discovery regarding her admitted psyche injury's permanent and stationary status and a newly diagnosed condition, fibromyalgia. The majority found her petition did not demonstrate substantial prejudice or irreparable harm, rendering removal an inappropriate remedy. Commissioner Sweeney dissented, believing further discovery was necessary and the trial date premature, especially concerning the un-evaluated psyche injury.

Petition for RemovalPsyche InjuryFibromyalgiaPermanent and Stationary StatusDiscoveryWorkers' Compensation Appeals BoardAdministrative Law JudgeMandatory Settlement ConferenceDue DiligencePremature Trial
References
0
Case No. MISSING
Regular Panel Decision

National Council of La Raza v. Gonzales

A coalition of non-profit organizations and a labor union, referred to as Plaintiffs, brought an action against various U.S. government officials and agencies, referred to as Defendants. Plaintiffs sought a declaratory judgment and injunction against the policy and practice of entering and disseminating civil immigration information through the National Crime Information Center (NCIC) database, alleging violations of the Administrative Procedures Act and unconstitutional arrests by state and local officials. Defendants filed a motion to dismiss for lack of jurisdiction and failure to state a claim upon which relief may be granted. The Court granted the motion to dismiss, concluding that the Plaintiffs lacked standing to pursue their claims as they failed to establish an actual injury-in-fact to their members, finding claims of heightened risk of arrest, fear of unlawful arrest, and loss of privacy to be too speculative.

Immigration LawStanding DoctrineAdministrative Procedure ActNational Crime Information CenterDeclaratory JudgmentInjunctive ReliefFederal JurisdictionMotion to DismissCivil Immigration EnforcementFourth Amendment
References
30
Case No. 2016 NY Slip Op 03122 [138 AD3d 615]
Regular Panel Decision
Apr 26, 2016

Pareja v. Davis

The Appellate Division, First Department, reversed an order of the Supreme Court, New York County, which had denied the defendant's motion for summary judgment. The defendant, Anthony Davis, successfully argued for an exemption under Labor Law §§ 240(1) and 241(6) as an owner of a one or two-family dwelling who did not direct or control the work. Evidence showed Davis was living in England during renovations, and his agent lacked authority to direct construction methods. The plaintiff, Pablo Pareja, failed to present sufficient evidence to counter the defendant's prima facie entitlement to the homeowner's exemption, offering only unfounded speculation about commercial use of the property. Consequently, the defendant's motion for summary judgment was granted, and the complaint dismissed.

Labor Law ExemptionHomeowner's ExemptionSummary JudgmentAgency AuthorityDirection and ControlConstruction AccidentsAppellate ReviewPersonal InjuryPrima Facie EvidenceRespondent
References
5
Case No. ADJ7514657
Regular
Jun 09, 2016

Kenneth White vs. City of San Pablo

The Workers' Compensation Appeals Board (WCAB) denied the City of San Pablo's petition for reconsideration, adopting the reasoning of the workers' compensation judge (WCJ). The WCAB found that the applicant's psychiatric injury claim was not barred by the statute of limitations, as the employer failed to provide a claim form, thus tolling the limitations period. Furthermore, the WCAB upheld the WCJ's finding that the applicant, acting through his "attorney-in-fact" (his aunt with power of attorney), was unrepresented for the purposes of selecting a Qualified Medical Evaluator (QME). Therefore, the applicant retained the right to select a QME from the panel, and the employer could not strike a physician from that panel.

WCABPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeWCJQMEQualified Medical EvaluatorStatute of LimitationsDurable Power of AttorneyAttorney-in-FactDWC-1
References
3
Case No. ADJ2033145 (LAO 0877321) ADJ1126357 (LAO 0877370)
Regular
Jun 06, 2012

PABLO RAMIREZ vs. BAU FURNITURE MANUFACTURING, BERKSHIRE HATHAWAY

This Workers' Compensation Appeals Board case involved applicant Pablo Ramirez and defendants Bau Furniture Manufacturing and Berkshire Hathaway. The Board granted reconsideration of a prior decision. The amended decision affirmed the original ruling but dismissed a remaining lien balance for Paramount Physicians Medical Group with prejudice. This modification specifically addressed a lien claim previously asserted.

WORKERS' COMPENSATION APPEALS BOARDPABLO RAMIREZBAU FURNITURE MANUFACTURINGBERKSHIRE HATHAWAYADJ2033145ADJ1126357OPINION AND ORDER GRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONworkers' compensation administrative law judgeWCJ
References
0
Case No. ADJ8896804
Regular
Apr 25, 2023

KAMI GONZALES vs. WALMART, SEDGWICK EL DORADO HILLS

The Workers' Compensation Appeals Board granted reconsideration and amended the previous Findings and Award to establish April 25, 2015, as the commencement date for the applicant's permanent total disability benefits. The Board also clarified that Cost of Living Adjustments (COLAs) for permanent disability would begin on January 1, 2016, following the established rule in *Brower v. David Jones Construction*. The applicant, Kami Gonzales, sustained an injury AOE/COE on February 25, 2013, and was found to be 100% disabled. The Board also confirmed the applicant's temporary disability rate and reserved jurisdiction for informal calculation of retroactive temporary disability and attorney's fees.

AOE/COEPermanent Total DisabilityPermanent Stationary DateCOLARetroactive Temporary DisabilityEarning CapacityUnapportioned AwardFuture Medical CarePetition for ReconsiderationFindings and Award
References
1
Case No. ADJ8386118
Regular
Jan 04, 2013

RALPH GONZALES vs. PURELY CLEAN POOLS, PREFERRED EMPLOYERS INSURANCE

This Workers' Compensation Appeals Board case involves an applicant, Ralph Gonzales, and defendants Purely Clean Pools and Preferred Employers Insurance. A petition for removal was filed by a party in this matter. However, the petitioner subsequently withdrew the petition for removal. Consequently, the Board has issued an order dismissing the petition, and no further action will be taken.

Petition for RemovalWithdrawn PetitionDismissed PetitionWorkers' Compensation Appeals BoardPurely Clean PoolsPreferred Employers InsuranceADJ8386118Oakland District OfficeAlfonso J. MoresiRonnie G. Caplane
References
0
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