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

Case No. ADJ11663247
Regular
Feb 03, 2020

JAIME ARAMBUL vs. ALEJANDRA ORTIZ, STATE FARM INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration, reversing an Administrative Law Judge's decision. The WCAB found the applicant was not excluded from employee status under Labor Code section 3352(a)(8) because he was contracted for over 52 hours of work and wages exceeding $100. Therefore, the applicant's claim for industrial injury as a painter is reinstated, with all other issues deferred.

Labor Code section 3352(a)(8)statutory exclusionemployee definitionpetition for reconsiderationrescinded decisioncontracted hourswagesindustrial injurypainterhead injury
References
Case No. ADJ8336161
Regular
Dec 31, 2012

Patrick Despres vs. Pacific Titan, Inc., Seabright Insurance Company

The Workers' Compensation Appeals Board granted reconsideration and amended a previous award. The applicant, a painter injured in 2011, was found to have unreasonably refused modified work offered by the defendant. Consequently, the applicant is not entitled to temporary total disability indemnity from May 12, 2012, to September 19, 2012, and no attorney's fees can be awarded from this period.

Workers' Compensation Appeals BoardPatrick DespresPacific Titan Inc.Seabright Insurance Companyindustrial injuryleft kneepaintertemporary total disabilityaverage weekly earningsindemnity rate
References
Case No. ADJ1299590
Regular
Jun 07, 2016

ANTHONY MANUEL GONZALEZ vs. MCMURRAY PAINTING, STATE COMPENSATION INSURANCE FUND

This case involves a defendant's petition for reconsideration of a finding of 100% permanent disability for the applicant, a painter. The defendant argued the administrative law judge erred, claiming their vocational expert's opinion was more substantial. The Appeals Board granted reconsideration on its own motion, not due to the defendant's arguments, but solely to correct a clerical error in the original findings. After correcting the clerical error, the Board affirmed all other aspects of the original decision.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationFindings and Awardpermanent disabilityvocational expertclerical errorReport and RecommendationAnswerOpinion and OrderMcMurray Painting
References
Case No. ADJ3576959
Regular
Jun 04, 2009

MIGUEL VILELA vs. JERRY THOMPSON AND SONS PAINTING, INC., ZURICH NORTH AMERICA INSURANCE COMPANY

This case involves an applicant who sustained a right knee injury while employed as a painter. The defendant sought reconsideration of the initial award, arguing the average weekly earnings (AWE) and temporary disability indemnity (TDI) rate were incorrectly calculated. The defendant also contended the applicant should reimburse EDD and that the defendant should receive credit for overpayment of TDI. The Appeals Board granted reconsideration, rescinded the original award, and returned the matter to the trial level for further proceedings and a new decision.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardAverage Weekly EarningsTemporary Disability IndemnityLabor Code section 4453(c)(4)Employment Development DepartmentEDD ReimbursementOverpaymentBifurcation
References
Case No. ADJ2748573
Regular
May 11, 2009

THOMAS HERNON vs. COUNTY OF SANTA CLARA

The Appeals Board granted reconsideration, reversing the prior finding on the applicant's occupational group number from 560 to 380 (painter), based on evidence of the applicant's actual job duties. The Board also modified the decision regarding apportionment, accepting the Agreed Medical Evaluator's opinion that 10% of the disability should be apportioned to pre-existing degenerative disease. However, the Board affirmed the application of the 1997 Permanent Disability Rating Schedule, as temporary disability payments were terminated before January 1, 2005, triggering notice requirements. Ultimately, the applicant's permanent disability was reduced to 63% after apportionment.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardApplicantDefendantPublic Service WorkerOccupational Group NumberIndustrial InjuryLow BackNeck
References
Case No. ADJ3576959 (OAK 0336251)
Regular
Oct 22, 2008

Miguel Vilela vs. Jerry Thompson and Sons Painting, Inc., Zurich North America Insurance Company

The Workers' Compensation Appeals Board granted reconsideration to address the defendant's contention that the applicant's Average Weekly Earnings (AWE) and resultant Temporary Disability Indemnity (TDI) rate were improperly determined. The Board found that the applicant's intermittent employment history meant his AWE should be calculated based on his earning capacity under Labor Code section 4453(c)(4), rather than a simple weekly rate. Consequently, the previous Findings and Award were rescinded, and the case was returned for further proceedings to redetermine the applicant's AWE accordingly.

Workers' Compensation Appeals BoardMiguel VilelaJerry Thompson and Sons PaintingZurich North America Insurance CompanyADJ3576959OAK 0336251Opinion and Order Granting ReconsiderationDecision After ReconsiderationFindings and Awardindustrial injury
References
Case No. ADJ2972385 (ANA 0400658)
Regular
Jan 16, 2009

Theodore Florentz vs. Paint Your Castle, State Compensation Insurance Fund

The Appeals Board dismissed the petition for reconsideration, granted removal, and reversed the order granting permission to select a qualified medical examiner. The Board held that the WCJ erred in ordering the parties to select their own QME, as the process for selecting a QME under Labor Code section 4062.2 must be followed.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalQualified Medical Examiner (QME)Labor Code Section 4062.2Medical UnitAgreed Medical EvaluatorComprehensive Medical EvaluationIndustrial InjuryPainter
References
Case No. ADJ7576606
Regular
Jan 20, 2018

LEOBARDO SANCHEZ vs. SCHAPER CONSTRUCTION, INC., ZURICH AMERICAN INSURANCE COMPANY

This case concerns a workers' compensation appeal where the defendant, Schaper Construction/Zurich Insurance, sought reconsideration of an order denying a replacement panel and awarding sanctions. The defendant argued that sanctions were improper because they were permissible in taking a position contrary to WCAB panel decisions. However, the Workers' Compensation Appeals Board (WCAB) denied reconsideration, adopting the WCJ's report which found the defendant's actions to be in bad faith. The WCJ noted that the defendant improperly sought a new panel despite the applicant waiving time limits, and then scheduled an appointment with the new panel even further out.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ Reportclerical errorspecific injuryback injuryconstruction workerpainterPanel QMEMMI
References
Case No. ADJ1577836
Regular
May 04, 2009

JESUS GAVINO-REMIGIO vs. STRATUS SERVICES GROUP, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant injured when stepping on a metal hook, sustaining an admitted industrial injury to his right foot. The applicant sought reconsideration after the Workers' Compensation Judge (WCJ) denied findings that the injury also affected his internal systems (diabetes), eyes, and psyche, along with associated disability. The Board denied reconsideration, finding the defendant's medical expert's opinion on non-industrial diabetes causation to be substantial evidence, while deeming the applicant's medical experts' opinions insufficient. A dissenting commissioner argued the applicant's medical evidence sufficiently supported industrial causation for diabetes aggravation, warranting reconsideration.

Workers' Compensation Appeals Boardindustrial injuryright footinternal systemseyespsychediabetes mellituspermanent disabilitytemporary disabilityGerald Markovitz M.D.
References
Case No. LAO 874417
Regular
Jan 17, 2008

FELIPE REBOLLAR vs. GENERAL COATING CORPORATION, VIRGINIA SURETY INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and returned the case for a new trial, finding the WCJ erred by denying a continuance. Defendant demonstrated good cause due to a sudden family emergency preventing key witnesses from testifying, which prejudiced their ability to present their case. The Board also directed the WCJ to issue findings on all disputed facts, including the alleged hernia injury.

Workers' Compensation Appeals BoardGeneral Coating CorporationVirginia Surety Insurance Companyindustrial injurybackpaintertemporary disabilitypermanent disabilityreconsiderationcontinuance
References
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