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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ1988743 (OAK 0328856)
Regular
Aug 10, 2012

JAMES KENDALL (Deceased) vs. OPENWAVE SYSTEMS, INC., AMERICAN PROTECTION INSURANCE CO., BROADSPIRE, A CRAWFORD CO., TRAVELERS INDEMNITY CO. OF CONNECTICUT, LUMBERMEN'S MUTUAL CASUALTY CO.

This case concerns the determination of liability for a deceased worker's cumulative trauma injury, specifically carpal tunnel syndrome. The Workers' Compensation Appeals Board granted reconsideration to amend the period of injurious exposure. The Board found that the applicant's date of injury, based on the onset of temporary disability, was September 30, 2004. Therefore, the statutory period of liability under Labor Code § 5500.5 was established as September 30, 2003, through September 29, 2004, the employee's last day of work. This amendment impacts the contribution between insurers APIC and Travelers.

Cumulative traumaLabor Code section 5500.5Labor Code section 5412Period of liabilityCarpal tunnel syndromeTemporary disabilityPermanent disabilityDate of injuryInjurious exposureReconsideration
References
Case No. ADJ7463100
Regular
Jun 13, 2013

MICHAEL SCOTT vs. LOS ANGELES AVENGERS; SAN JOSE SABERCATS; STATE COMPENSATION INSURANCE FUND; ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board granted reconsideration and amended a prior award. The Board found that while the applicant sustained industrial injuries as a professional football player, only the Los Angeles Avengers, insured by SCIF, were liable for benefits. This determination was based on Labor Code section 5500.5, which limits liability for cumulative injuries to employers within the one-year period preceding the last date of exposure. Therefore, the San Jose Sabercats were relieved of liability as the applicant's employment with them fell outside this statutory period.

Workers' Compensation Appeals BoardSan Jose SabercatsLos Angeles AvengersState Compensation Insurance FundZurich North AmericaMichael ScottPetition for ReconsiderationFindings and Award and OrderWCJJoint and several liability
References
Case No. ADJ2497883 (SFO 0450940) ADJ3261393 (SFO 0504693)
Regular
Apr 30, 2010

JANETTE HARDIN vs. COUNTY OF ALAMEDA, SEDGWICK CLAIMS MANAGEMENT SERVICES, CHARTIS INSURANCE, TRISTAR RISK MANAGEMENT

This case involves Chartis Insurance seeking reconsideration of an arbitrator's decision setting the date of cumulative trauma injury for Janette Hardin's breast cancer as May 28, 1997, not the previously stipulated date of May 16, 2001. Chartis argued the stipulated date was res judicata and could not be altered, especially in a contribution proceeding. The Workers' Compensation Appeals Board denied the petition, affirming that contribution proceedings allow for a relitigation of liability and the determination of the true date of injury based on facts, not prior stipulations between the applicant and one defendant. The Board reasoned that findings of liability in the primary case are not binding in supplemental contribution proceedings.

Cumulative traumaDate of injuryContribution proceedingsRes judicataStipulated awardLabor Code section 5500.5Apportionment of liabilityCase-in-chiefSupplemental proceedingsGreenwald v. Carey Distribution Company
References
Case No. ADJ9761409, ADJ10946911
Regular
Sep 11, 2018

ANGELA COLE vs. MARCONI CONFERENCE CENTER, STATE COMPENSATION INSURANCE FUND, AMERICAN INSURANCE CO.

The Workers' Compensation Appeals Board granted reconsideration, reversing a prior finding that SCIF was solely liable for applicant's cumulative injury. The Board determined the correct Labor Code section 5412 date of injury was December 10, 2014, based on the concurrence of disability and knowledge of its industrial nature. Consequently, the Labor Code section 5500.5(a) liability period is the year preceding that date, making American Insurance Company, the carrier during that period, solely liable for compensation. The Board rescinded the prior award and issued a new decision and award against American Insurance Company.

Labor Code section 5500.5Labor Code section 5412cumulative injurydate of injurydisabilityknowledgeliability periodconcurrent disability and knowledgetemporary disabilitypermanent disability
References
Case No. ADJ1179569 (AHM 0099178)
Regular
Jun 10, 2011

JERRY CHASTAIN vs. COUNTY OF ORANGE, ORANGE COUNTY FIRE AUTHORITY, STATE COMPENSATION INSURANCE FUND, AMERICAN HOME ASSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, USF&G

In this workers' compensation case, the Appeals Board granted reconsideration to address USF&G's challenge to liability for an applicant's prostate cancer, who died after a prolonged period following exposure. The Board rescinded the prior decision, finding the WCJ erred by not fully addressing liability under Labor Code section 5500.5, specifically regarding the latency period and last date of injurious exposure. The matter was returned to the trial level for further proceedings and a new decision on liability, while affirming the presumption under Labor Code section 3212.1.

Workers' Compensation Appeals BoardFire Apparatus EngineerProstate CancerContinuous Trauma InjuryLabor Code Section 5412Labor Code Section 5500.5Labor Code Section 3212.1 PresumptionLatency PeriodInjurious ExposureCumulative Injury
References
Case No. ADJ2678977 (VNO 0516619) ADJ2789939 (VNO 0516618)
Regular
Jul 26, 2017

THOMAS BELLISSIMO vs. CAST & CREW ENTERTAINMENT SERVICES, INC., ZURICH NORTH AMERICA, ENTERTAINMENT PARTNERS, AIG

This case involves two insurers, Zurich and AIG, disputing liability for a worker's cumulative trauma injury. The Arbitrator initially set the liability period as July 4, 2004, to July 3, 2005, and apportioned fault based on days worked. Both insurers sought reconsideration, with AIG challenging the date of injury and allocation method, and Zurich arguing for apportionment based on exposure arduousness. The Board affirmed the Arbitrator's pro rata allocation based on days worked, but amended the liability period to June 28, 2004, to June 28, 2005, based on the last date of injurious exposure.

Labor Code section 5500.5cumulative trauma injuryliability periodapportionmentpro ratadate of injuryLabor Code section 5412disabilityinjurious exposuresuccessive employers
References
Case No. ADJ10132416
Regular
Sep 04, 2019

ARMANDO SALAZAR vs. DOTY BROS. EQUIPMENT COMPANY, AIG CLAIMS for NATIONAL UNION FIRE INSURANCE COMPANY, STARR INDEMNITY & LIABILITY COMPANY

This case concerns the determination of the cumulative trauma injury date and the corresponding liability period for a workers' compensation claim. The Appeals Board clarified that the date of injury under Labor Code section 5412 is July 30, 2005, through September 30, 2015, based on when the applicant should have reasonably recognized his disability as work-related, evidenced by his attorney filing a claim. Crucially, the Board distinguished this from the liability period under Labor Code section 5500.5, which was established as July 30, 2014, through July 30, 2015, the applicant's last day of work. This revised liability period confirmed that Starr Indemnity & Liability Company was within coverage for the claim.

Labor Code Section 5412Labor Code Section 5500.5cumulative trauma perioddate of injuryinjurious exposureknowledge of disabilityApplication for Adjudication of Claimpetition to dismisscoverageamended findings
References
Case No. ADJ4629950
Regular
Dec 21, 2012

JOHNNY BETTENCOURT vs. DONALD WILLIAMS, SAFECO INSURANCE COMPANY, UNINSURED EMPLOYERS' BENEFIT TRUST FUND DEPARTMENT OF INDUSTRIAL RELATIONS

The Uninsured Employers' Benefit Trust Fund (UEBTF) sought reconsideration, arguing Safeco's policy covered the applicant's injury. The Arbitrator previously ruled Safeco had no liability as its policy with Donald Williams did not include "comprehensive personal liability" insurance as required by Insurance Code section 11590. The Appeals Board affirmed this decision, finding the Safeco policy explicitly limited coverage to premises liability and lacked the necessary language for comprehensive personal liability coverage. Therefore, Safeco was correctly found not liable for the applicant's injury.

Uninsured Employers' Benefit Trust Fundcomprehensive personal liability insuranceLabor Code section 3351(d)Labor Code section 3352(h)Insurance Code section 11590premises liability insuranceSafeco Insurance CompanyDonald WilliamsJohnny Bettencourtworker's compensation coverage
References
Case No. ADJ10168929 ADJ10047992
Regular
Jan 31, 2019

MARYEL KAUHANE-JONES vs. JOHN SPAETH, O.D., ZENITH INSURANCE COMPANY, REPUBLIC INDEMNITY INSURANCE COMPANY OF AMERICA, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

This case concerns Zenith Insurance Company's petition for reconsideration of a workers' compensation award. The administrative law judge found the applicant sustained a single cumulative injury and that Zenith, as the sole carrier during the relevant one-year liability period preceding the applicant's last day of employment, was solely liable. Zenith argued the liability period should have been earlier based on the applicant's alleged date of injury under Labor Code section 5412. The Board denied reconsideration, adopting the judge's reasoning that compensable disability requires wage loss or ratable permanent disability, which occurred after the applicant's employment ended and was definitively established by an agreed medical evaluator.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Findings of FactAward and OrderIndustrial InjuryOpticianOffice ManagerCumulative InjuryPermanent DisabilityLabor Code section 5500.5
References
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