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Case Law Database

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

Case No. ADJ2192154 (LBO 0345063)
Regular
Nov 12, 2010

IRMA ZAMORA vs. STATE OF CALIFORNIA, DEPT. OF AGRICULTURE, Adjusted By SCIF CONTRACT SERVICES

The Board granted reconsideration to address ambiguities in the original award. Defendant sought credit for prior permanent disability payments and argued a penalty for delayed compensation should only apply from the date the disability increased, not the entire delayed amount. The Board agreed defendant is entitled to credit for prior payments. However, due to unclear findings on attorney fees and a confusing reference to a "self-assessed penalty," the Board rescinded the original decision and returned the case for further proceedings and a clarified new decision.

WCABpetition to reopenpermanent disabilitypenaltyattorney feescredit for paymentsagreed medical evaluatorLabor Code section 4650Labor Code section 5814unreasonable delay
References
Case No. ADJ9614737 ADJ9613068
Regular
Oct 30, 2018

NORA MAY RAMIREZ-CORTES vs. MARQUEZ BROTHERS ENTERPRISE, INC., TRAVELERS INSURANCE COMPANY

This case involves a defendant's petition for reconsideration of an administrative law judge's (WCJ) order assessing penalties for late payment of a workers' compensation award. The defendant argued that confusion over the applicant's name justified the delay, but the Board found the four-month delay after the initial inquiry unreasonable. The Board adopted the WCJ's report, denying reconsideration and upholding the penalty, interest, and attorney's fees. The Board found no evidence the defendant took reasonable steps to resolve the payment issue after May 9, 2017.

Workers' Compensation Appeals BoardFindings and OrdersCompromise and ReleaseLabor Code section 5814Penalty assessmentInterestAttorney's feesPetition for ReconsiderationWCJ Report and RecommendationGood faith
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. 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. VNO 113665 VNO 113666 VNO 113667 VNO 113668
Regular
Aug 06, 2007

MARIA A. GARCIA vs. CITY OF LOS ANGELES LIBRARY SERVICES

The Workers' Compensation Appeals Board granted reconsideration and reversed a WCJ's award of penalties and attorney fees against the City of Los Angeles for delayed payment of home healthcare charges. The Board found that while payments were delayed, Labor Code section 5814(e) bars penalties when the only dispute concerns the payment of a provider's bill, not a denial of treatment. Furthermore, the Board found no basis to assess penalties under Labor Code section 5814.6 for a pattern of business practice violation.

Labor Code 5814Labor Code 5814.5Labor Code 5814.6unreasonable delayhome health carebilling disputemedical treatmentnursing servicespenaltyattorney fees
References
Case No. ADJ9932467
Regular
Oct 16, 2017

THERESA MCFARLAND vs. REDLANDS UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied an applicant's petition for reconsideration, affirming the WCJ's decision that "Return-To-Work" supplemental payments under Labor Code section 139.48 are not "compensation" as defined by Labor Code section 3207. Therefore, the applicant was not entitled to a second penalty under Labor Code section 5814 for the employer's delay in providing a Supplemental Job Displacement Benefit voucher, as that delay did not cause a delay in a compensable benefit. The Board found that the applicant's penalty claim for the voucher delay was already resolved and that imposing a second penalty for a non-compensable benefit delay would be unfair and against the principle of balancing justice.

Labor Code section 139.48Return-To-Work supplemental paymentscompensation definitionLabor Code section 3207Labor Code section 5814 penaltyLabor Code section 4658.7 voucherSupplemental Job Displacement Benefitcompromise and release agreementGage v. Workers' Comp. Appeals Bd.unreasonable delay
References
Case No. ADJ1775698 (LAO 0800658)
Regular
Aug 21, 2012

ANTONIO CERVANTES-LOPEZ vs. UNIVERSAL FURNITURE, AMERICAN HOME ASSURANCE COMPANY

Applicant sought reconsideration of a WCJ's decision denying substantial attorney fees and sanctions related to a $14,800 compromise and release for a low back injury. The WCJ awarded $2,222 in attorney fees but rejected the applicant's claim for over $29,000 in penalties, interest, and sanctions for alleged bad faith. The Board denied reconsideration, agreeing with the WCJ that the requested fees were unreasonable. Both parties' counsel were admonished for unprofessional conduct that wasted the Board's time.

Labor Code section 5814.5attorney feesreconsiderationFindings and Ordersbad faithsanctionsCompromise and Releasepenaltiesself-assessed penaltyunreasonable delay
References
Case No. VNO 388892, VNO 388897
Regular
Dec 21, 2007

DARRELL BOWEN vs. GALPIN MOTORS, INC., LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a prior decision regarding Darrell Bowen's claim against Galpin Motors and Liberty Mutual. While affirming the original decision, the Board amended one finding of fact to assess a 25% penalty for unreasonable delay in providing medical treatment, not exceeding $10,000. The parties were directed to adjust this penalty with jurisdiction reserved.

Workers' Compensation Appeals BoardReconsiderationWCJ reportMedical treatment delayPenalty assessmentUnreasonably delayedJurisdiction reservedOpinion and OrderDecision After ReconsiderationFindings of Fact
References
Case No. ADJ7792304
Regular
Aug 08, 2012

RUBEN AYALA HERNANDEZ vs. ANAWALT LUMBER COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The defendant sought reconsideration of a WCJ's finding of industrial injury and a 15% penalty for delayed temporary disability benefits. The Appeals Board granted reconsideration and affirmed the finding of industrial injury, giving great weight to the WCJ's credibility assessment of the applicant's testimony. However, the Board reversed the penalty, finding the defendant had a reasonable basis to question the applicant's claims given testimony that the applicant never reported an injury.

Workers' Compensation Appeals BoardCumulative Industrial InjuryTemporary Total DisabilityLabor Code §5814(a)Petition for ReconsiderationFindings and OrderReport and RecommendationCredibility AssessmentSubstantial EvidenceGood Faith Personnel Action
References
Case No. GRO 0027359
Regular
Feb 29, 2008

TERESA KENNEDY vs. SANSUM SANTA BARBARA MEDICAL FOUNDATION CLINIC, ROYAL SUN ALLIANCE

The Workers' Compensation Appeals Board granted reconsideration and reversed a penalty assessed against the defendant for unreasonably delaying bariatric surgery follow-up care. The Board found no basis for the penalty as the defendant reasonably relied on medical opinions indicating the applicant's weight loss had resolved obesity-related issues impacting the industrial injury. The matter of attorney's fees under LC 5814.5 was returned to the trial level for further proceedings due to ambiguity in the original award.

Bariatric surgeryWorkers' Compensation Appeals BoardLabor Code section 5814Penalty assessmentReconsiderationQualified Medical EvaluatorAttorney's feesUnreasonable delayFollow-up careMedical treatment necessity
References
Showing 1-10 of 1,049 results

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