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

Case No. ADJ6995425
Regular
Apr 27, 2012

SERGIO SANCHEZ vs. LIDA KOHANSAMEH, PACIFIC SPECIALTY INSURANCE

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior ruling finding the applicant an employee of Lida Kohansameh. While agreeing the applicant was not an employee of Pacific Great West Construction, the Board remanded the case for further proceedings. The trial judge must now determine if the applicant is excluded from workers' compensation coverage under Labor Code sections 3351(d) and 3352(h), specifically regarding residential or casual employment and hours worked. This decision avoids a final determination on employment status and focuses on potential statutory exclusions.

Workers' Compensation Appeals BoardLida KohansamehPacific Specialty InsuranceTristar Risk ManagementSergio SanchezFindings and OrderEmployee statusPacific Great West ConstructionReport and RecommendationPetition for Reconsideration
References
Case No. ADJ4359205
Regular
Aug 07, 2013

HECTOR GONZALEZ vs. DIMAS ERNESTO RAMOS, BZZZ CONSTRUCTION, STATE COMPENSATION INSURANCE FUND, PACIFIC SPECIALTY INSURANCE COMPANY, TRISTAR RISK MANAGEMENT

This case concerns a petition for reconsideration in a workers' compensation matter where the applicant, Hector Gonzalez, claimed injury while working on a construction project. The defendant, Dimas Ernesto Ramos, contested that he was the employer, arguing Gonzalez was an independent contractor or a residential employee. The Administrative Law Judge found Ramos to be the employer based on extensive contradictions in Ramos's testimony and the credible testimony of others, establishing an employer-employee relationship. The Workers' Compensation Appeals Board denied the petition for reconsideration, upholding the WCJ's findings and giving them great weight.

WCABPetition for ReconsiderationWCJ reportcredibility findingGarza v. Workmen's Comp. Appeals Bd.construction projectbuilder-ownerlicensed general contractorBZZZ ConstructionState Compensation Insurance Fund
References
Case No. ADJ9685765
Regular
Feb 09, 2015

MARTIN VAN DOORN vs. WEST VALLEY CONSTRUCTION COMPANY, INC., ZURICH AMERICAN INSURANCE COMPANY, OLD REPUBLIC INSURANCE COMPANY

This case concerns a petition for reconsideration by West Valley Construction Company and Zurich American Insurance Company regarding a prior decision that reversed an arbitrator's finding. The arbitrator had barred the applicant's claim for specific injuries to his neck and back due to the statute of limitations. The defendants argued the applicant's petition was procedurally defective and that the Board did not properly weigh evidence. The Board denied reconsideration, finding the applicant's amended petition cured any initial defects and that the defendants were not prejudiced by the form of the original filing. The Board affirmed its previous decision based on its prior reasoning.

Workers' Compensation Appeals BoardPetition for ReconsiderationStatute of LimitationsSpecific InjuryCumulative InjuryProcedural DefectVerificationCase NumberArbitrator's FindingsDecision After Reconsideration
References
Case No. LAO 0832818, VNO 0508728
Regular
Jan 22, 2008

TOMAS ALONZO (deceased) BEATRIZ ALONZO (widow) vs. NHAN VAN NGUYEN aka KEVIN CONSTRUCTION, illegally uninsured, DAVID BENAVIDES; PACIFIC SPECIALTY INSURANCE COMPANY

This case involves a deceased worker, Tomas Alonzo, whose widow claims he was an employee of homeowner David Benavides. The Appeals Board denied reconsideration, upholding the finding that Alonzo was Benavides' employee because Alonzo's direct employer, Kevin Construction, was an unlicensed contractor. California law presumes unlicensed contractors and their employees are employees of the hiring party to ensure compensation.

Workers' Compensation Appeals BoardTomas AlonzoBeatriz AlonzoNhan Van NguyenKevin Constructionillegally uninsuredDavid BenavidesPacific Specialty Insurance CompanyLAO 0832818VNO 0508728
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ473373 (ANA 0406381)
Regular
Feb 10, 2012

FERNANDO GUTIERREZ vs. SOCAL FRAMING aka BMHC; ACE AMERICAN INSURANCE, administered by ESIS, INC.

This case concerns applicant's claim for extended temporary disability (TD) benefits beyond 104 weeks due to a left eye injury. The Appeals Board affirmed the WCJ's denial of the "amputation" exception, ruling that the surgical removal of an eye does not fit the statutory definition. However, the Board remanded the case for further development of the record on the "high-velocity eye injury" exception, as the velocity and force of the object that struck the applicant's eye were unclear. The applicant's Petition for Removal was dismissed as reconsideration was the appropriate remedy.

Workers' Compensation Appeals BoardFernando GutierrezSoCal FramingBMHCACE American InsuranceESISInc.ADJ473373ANA 0406381Opinion and Decision
References
Case No. ADJ9419247
Regular
Aug 09, 2016

GUADALUPE ALVAREZ vs. CITY WALL CONSTRUCTION, THE HARTFORD INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of a prior order finding the applicant was not an employee of City Wall Construction. The applicant claimed a work injury to his back and foot, but the judge found his testimony regarding employment lacked credibility against the defendant's consistent testimony. The Board also rejected the applicant's request to reopen based on newly discovered evidence, as he failed to demonstrate due diligence in discovering and presenting this information at trial. Therefore, the applicant did not meet his burden of proof to establish an employer-employee relationship.

Workers' Compensation Appeals BoardGuadalupe AlvarezCity Wall ConstructionThe Hartford Insurance CompanyADJ9419247denial of reconsiderationindustrial injuryconstruction workeremployment statusnewly discovered evidence
References
Case No. ADJ9539091
Regular
Sep 23, 2016

MARY RAMSGARD vs. PACIFIC VINEYARD COMPANY, INSURANCE COMPANY OF THE WEST

The Workers' Compensation Appeals Board denied reconsideration, affirming the WCJ's finding that applicant's L3-4 back injury was not industrially caused, based on Dr. Sharma's opinion. Dr. Sharma's opinion was found to be substantial evidence, utilizing the correct legal standard of reasonable medical probability and supported by the applicant's pre-existing back issues. The Board also upheld the 20% apportionment of permanent disability to non-industrial causes, finding it supported by credible evidence, including prior medical reports and applicant's inconsistent testimony. Applicant's petition failed as her contentions regarding the medical opinion's legal theory and factual basis were not substantiated.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardAdministrative Law JudgeApplicantDefendantPacific Vineyard CompanyInsurance Company of the WestPermanent DisabilityApportionment
References
Case No. ADJ9920215
Regular
Dec 12, 2017

ALICIA OLMOS vs. JM CONSTRUCTION AND ENGINEERING, INSURANCE COMPANY OF THE WEST

This Workers' Compensation Appeals Board (WCAB) decision denies the applicant's petition for reconsideration. The WCAB adopted the WCJ's report, finding the applicant failed to prove causation for her claimed industrial injury by a preponderance of the evidence. Although the WCAB can amend pleadings to conform to proof, the applicant still bears the burden of proof. Additionally, the applicant's attorney was admonished for citing evidence not admitted into the record.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeAmendment of PleadingsBurden of ProofIndustrial InjuryCausationEvidence AdmittedAppeals Board Rule 10842(c)Advocacy Letter
References
Case No. ADJ3360730 (AHM 0146980)
Regular
Dec 13, 2013

PEDRO PATINO vs. GREAT PACIFIC EQUIPMENT, INC., COMPWEST INSURANCE CO.

This case involves a lien claimant whose lien was dismissed for failure to pay a lien activation fee. The claimant petitioned for reconsideration, arguing they never received proper notice of the dismissal order due to the defendant's six-month service delay. The Appeals Board granted reconsideration, rescinded the dismissal order, and returned the matter for further proceedings, noting the significant service delay and a federal court injunction against enforcing lien activation fees.

Workers' Compensation Appeals BoardLien ClaimLien Activation FeePetition for ReconsiderationOrder Dismissing Lien ClaimService ObligationDue ProcessPreliminary InjunctionAngelotti Chiropractic v. BakerRescinded Order
References
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