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

Case No. ADJ2353136 (STK 0213635)
Regular
Dec 19, 2016

AHMED SHOAIB vs. CAMBELL SOUP COMPANY

This case concerns a dispute over the payment of a workers' compensation settlement. The applicant, Ahmed Shoaib, settled a discrimination claim against Campbell Soup Company for $55,000. Campbell Soup unilaterally withheld over $19,000 from the applicant's share of the settlement for alleged payroll taxes. The Workers' Compensation Appeals Board denied Campbell Soup's petition for reconsideration, finding that the company unreasonably delayed payment by taking a unilateral credit. The Board affirmed the WCJ's decision and the awarded 25% penalty for the delayed payment.

Workers' Compensation Appeals BoardPetition for ReconsiderationStipulation and AwardLabor Code Section 132aAmended Petition for PenaltyDelayed PaymentLabor Code Section 5814Labor Code Section 5814.5Contract EnforcementUnilateral Credit
References
Case No. ADJ10330377
Regular
Jul 10, 2017

Taylor Baugh vs. Action Holdings, Inc., XL Specialty Insurance

This case concerns a defendant's petition for reconsideration regarding a 10% penalty for underpayment of temporary disability benefits. The Workers' Compensation Appeals Board granted reconsideration and amended the original decision. The penalty was adjusted to apply only to the specific amount of temporary disability that was delayed, not the entire awarded sum, in accordance with Labor Code section 5814.

Labor Code section 5814Petition for ReconsiderationTemporary DisabilityUnderpaymentPenaltyWCJWorkers' Compensation Appeals BoardFindings and AwardDecision After Reconsiderationunreasonable delay
References
Case No. ADJ2786953 (ANA 0317684), ADJ3789377 (ANA 0393014), ADJ3880205 (ANA 0317683), ADJ808964 (ANA 0317682)
Regular
Oct 04, 2011

OSCAR ORTEGA vs. DATA ANALYSIS; CHARTIS INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration regarding a penalty award. The Board rescinded the prior award, finding the Administrative Law Judge erred in applying penalty provisions and attorney fees without sufficient findings on unreasonable delay and a proper consideration of relevant factors. The case is returned to the trial level for further proceedings to determine the reasonableness of the delay and the appropriate penalty amount, with a requirement for the WCJ to explain their reasoning. Any claims for attorney fees should be properly submitted with supporting documentation.

WCABIndustrial InjuryPenaltyLabor Code Section 5814Labor Code Section 5814.5Petition for ReconsiderationAmended Findings and AwardCompromise & ReleaseSelf-Imposed PenaltyUnreasonable Delay
References
Case No. ADJ613281
Regular
May 03, 2016

AMANDINA ANDRADE vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board granted reconsideration, amending the judge's decision to find applicant entitled to penalties for unreasonable delay in permanent disability payments under Labor Code sections 5814 and 4650(d). The Board found the defendant failed to provide evidence of a genuine doubt for the delay after receiving multiple medical reports indicating permanent disability. The matter was returned to the trial level for further proceedings to determine the amount of penalties due, while affirming the judge's decision regarding a credit for overpayment of temporary disability.

WCABPetition for ReconsiderationFindings and AwardProbation Group SupervisorIndustrial InjuryNeckBackLeft KneeGastrointestinal SystemPsyche
References
Case No. ADJ10537068
Regular
Oct 09, 2020

BYRON GIBBONS vs. CALIFORNIA DEPARTMENT OF FORESTRY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed the finding that the applicant sustained an industrial injury to his respiratory system resulting in Guillain-Barre syndrome. While medical evidence supported the industrial causation of the applicant's condition, the Board deferred the issue of the lien claimant's reimbursement amount. The case is returned to the trial level for further proceedings regarding the lien amount, specifically to litigate whether it should be determined under the Official Medical Fee Schedule with penalties or potentially in excess of it. The original award of $1,085,678.88, a 15% penalty, and interest was rescinded pending this determination.

Guillain-Barre syndromeindustrial injuryAOE/COEreasonable medical probabilitysubstantial medical evidenceoccupational exposureinfectious agentsHVAC systemsewage treatmentofficial medical fee schedule
References
Case No. ADJ2831208 (GOL 0090431) ADJ894034 (GOL 0090432)
Regular
Aug 10, 2009

JOSE LOPEZ vs. QUALITY PLASTERING, GOLDEN EAGLE INSURANCE COMPANY

The applicant, Jose Lopez, was awarded a 25% penalty for the defendant's failure to pay the full settlement amount. The defendant sought reconsideration, arguing they paid the amount agreed upon in the addenda to the Compromise and Release Agreement. However, the Board found the Orders Approving Compromise and Release, which specified a higher payment to the applicant, became final when the defendant failed to seek timely reconsideration. Therefore, the defendant's petition for reconsideration was denied, affirming the penalty.

Workers' Compensation Appeals BoardQuality PlasteringGolden Eagle Insurance CompanyJose LopezReconsiderationFindings and AwardLabor Code section 5814PenaltyAttorney's FeeLabor Code section 5814.5
References
Case No. LAO 452456
Regular
Dec 27, 2007

Clennon Moore vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board granted reconsideration and rescinded a previous Findings and Award because the Administrative Law Judge (WCJ) failed to determine which version of Labor Code section 5814 applied to the applicant's claim for penalty payments. The WCJ also made conditional findings and left the exact penalty amount for future negotiation, which the Board found improper. The case is returned to the trial level for the WCJ to make definitive findings of fact and law on all presented issues.

Labor Code section 5814unreasonable delaycompensation penaltiesFindings and AwardreconsiderationrescindedWorkers' Compensation Appeals BoardWCJdate of injurytemporary disability
References
Case No. ADJ4579659
Significant
Sep 09, 2008

Dee Anne Ramirez, Applicant vs. Drive Financial Services, One Beacon Insurance Co.

The Appeals Board, in an en banc decision, holds that penalties under Labor Code section 5814(a) are discretionary, successive penalties are permissible under specific circumstances, and attorney's fees under section 5814.5 apply to private employers for unreasonable delays occurring after January 1, 2003, regardless of the injury date.

WCABLabor Code section 5814Labor Code section 5814.5penaltyattorney feesen bancreconsiderationdiscretionary penaltysuccessive penaltyunreasonable delay
References
Case No. ADJ6973825
Regular
May 21, 2012

MONICA BENARD vs. JENNY CRAIG, SEDGWICK CMS

This case concerns a penalty imposed on Jenny Craig for unreasonably delaying authorization for applicant Monica Benard's chiropractic treatment. The WCJ found a 25% penalty for the delay, which Jenny Craig appealed, arguing the delay was due to the applicant's choice of a chiropractor outside their Medical Provider Network (MPN). The Appeals Board affirmed the unreasonable delay finding but reduced the penalty to 20% of the delayed treatment's value, citing a failure in case management rather than intentional disregard. Jurisdiction was reserved for the parties to adjust the penalty amount.

Workers Compensation Appeals BoardMonica BenardJenny CraigSedgwick CMSADJ6973825ReconsiderationFindings and AwardLabor Code section 5814Medical Provider Network (MPN)chiropractic treatment
References
Case No. ADJ4702650 (MON 0094741), ADJ1144686 (MON 0124794)
Regular
2012-2011

ANA SAMI vs. HUGHES AIRCRAFT COMPANY, SPECIALTY RISK SERVICES, INC.

The Appeals Board partially granted reconsideration, reversing most penalties for unreasonable delay and sanctions against the applicant's attorney, finding insufficient evidence for these claims. However, they affirmed the WCJ's finding of unreasonable delay regarding Weight Watchers coupons, deferring the penalty amount for further determination. The Board also affirmed that the applicant's attorney is entitled to fees for enforcing the medical treatment award related to the coupons. The matter was returned for further proceedings on the penalty amount and attorney's fees.

Workers Compensation Appeals BoardReconsiderationJoint Findings and AwardPenaltiesSanctionsLabor Code Section 5813Labor Code Section 5814Labor Code Section 5814.5Unreasonable DelayMedical Treatment
References
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