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

Case No. ADJ6540543
Regular
Jun 07, 2013

Christopher Toms vs. Marvin Lee Weatherbee dba BEELINE TRANSPORTATION, illegally uninsured, KIEWIT PACIFIC COMPANY, permissibly self-insured

This case involves Christopher Toms, an applicant injured while employed as a truck driver by Beeline Transportation, an illegally uninsured entity. The Workers' Compensation Appeals Board granted reconsideration of a finding that Kiewit Pacific Company, permissibly self-insured, was a dual employer. The Board rescinded the prior award, finding that Kiewit was a contracting party who engaged Beeline as an independent contractor. No statutory basis existed to deem Toms an employee of Kiewit, therefore Kiewit is not liable for workers' compensation benefits.

Workers Compensation Appeals BoardChristopher TomsMarvin Lee WeatherbeeBeeline TransportationKiewit Pacific Companyillegally uninsuredpermissibly self-insureddual employersultimate hirerjoint and severally liable
References
2
Case No. 2017 NY Slip Op 07023 [154 AD3d 1037]
Regular Panel Decision
Oct 05, 2017

Matter of Passero v. Uninsured Employers' Fund

The claimant, Edmund Passero, a bricklayer, filed a workers' compensation claim in 2011 for an occupational disease resulting from repetitive stress. A Workers' Compensation Law Judge (WCLJ) initially established the claim against DeSpirit Mosaic & Marble Co. and later apportioned liability among three employers, including J. William Pustelak Inc., found to be uninsured. The Uninsured Employers' Fund (UEF) sought administrative review, but the Workers' Compensation Board denied the appeal as untimely. The Appellate Division, Third Department, reversed the Board's finding on the timeliness of UEF's application, holding that UEF would not have incurred an obligation until the WCLJ's December 2014 decision which apportioned liability. The case was remitted to the Workers' Compensation Board to consider the merits of UEF's appeal.

Workers' CompensationOccupational DiseaseUntimely AppealAdministrative ReviewLiability ApportionmentUninsured EmployerDate of DisablementThird DepartmentAppellate DivisionClaimant Benefits
References
5
Case No. LAO 0784069
Regular
Feb 11, 2008

RICARDO LOPEZ vs. HYON SEOP KIM, Individually and dba H.B. CONSTRUCTION, AARON SONG, an Individual, Illegally Uninsured, THE DIRECTOR OF INDUSTRIAL RELATIONS, As Administrator of THE UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Uninsured Employers Benefits Trust Fund (UEBTF) was not liable for a penalty on an attorney's fee award due to unreasonable delay. However, Labor Code section 3716.2 obligates the UEBTF to seek such penalties in civil enforcement actions against uninsured employers. Therefore, the Appeals Board amended the award to clarify that while UEBTF is not directly liable for the penalty, it remains part of the underlying award that UEBTF must pursue from the uninsured employers.

Uninsured Employers Benefits Trust FundUEBTFAttorney's fee awardLabor Code section 5814Labor Code section 3716.2Civil suitReconsiderationFindings and AwardWCJPenalty
References
1
Case No. MISSING
Regular Panel Decision

Claim of Shutter v. Philips Display Components Co.

The claimant, injured in a work-related single-car accident, received workers' compensation benefits and also pursued an uninsured motorist claim, recovering $124,697.95. The Workers' Compensation Board ruled that the employer's insurance carrier was entitled to offset this recovery against future compensation benefits, overturning a prior WCLJ decision. The claimant appealed, arguing that Workers' Compensation Law § 29's offset provisions apply only to third-party tortfeasor actions, not uninsured motorist proceeds. The court rejected this argument, finding the statute's general terminology encompasses uninsured motorist benefits and that legislative intent for exclusion only exists for no-fault benefits, not uninsured motorist benefits under Insurance Law § 3420 (f). Consequently, the Board's decision was affirmed.

Uninsured motoristWorkers' Compensation LawOffsetInsurance carrierThird-party tortfeasorLien provisionsStatutory interpretationLegislative intentNo-fault insuranceCompensation benefits
References
3
Case No. MISSING
Regular Panel Decision

In re the Arbitration between Williams

Amoco Oil appealed two judgments from the Supreme Court, Nassau County, concerning arbitration for uninsured motorist and no-fault benefits. The first judgment, dated January 6, 1977, granted New Hampshire Insurance Company's application to stay arbitration, deeming Amoco Oil's coverage primary and New Hampshire's secondary for uninsured motorist benefits. The second judgment, dated March 30, 1977, permanently stayed arbitration for no-fault benefits under New Hampshire's policy. The Appellate Division affirmed both judgments, concluding that the claimant was "occupying" the Amoco Oil vehicle, making Amoco Oil primarily liable for uninsured motorist benefits. However, the claimant was precluded from receiving these benefits due to already receiving workers' compensation benefits in excess of the maximum, and was also ineligible for no-fault benefits under the New Hampshire policy.

Insurance DisputeArbitration ProceedingsUninsured Motorist CoverageNo-Fault InsuranceWorkers' CompensationPrimary vs Secondary LiabilityAppellate DivisionNassau County Supreme CourtVehicle OccupancyBenefit Eligibility
References
3
Case No. ADJ843966 (SDO 0338705)
Regular
Dec 13, 2013

Reed Thomas Kirby vs. Arthur Gonzales, STATE FARM INSURANCE COMPANY, KEITH PATRICK DONNELLY, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to amend a prior award. The WCAB affirmed the finding that the applicant sustained an injury while employed as a tree trimmer by an uninsured employer, Keith Patrick Donnelly. However, the WCAB amended the award to reflect that liability rests solely with the uninsured employer, not the Uninsured Employers Benefits Trust Fund (UEBTF), as UEBTF's liability is derivative. The WCAB rejected arguments that the City of San Diego was also responsible and confirmed the applicant is entitled to benefits from Donnelly.

Uninsured Employers Benefits Trust FundUEBTFKeith Patrick DonnellyTarzan Tree SpecialistsArthur GonzalesState Farm Insurance Companytree trimmerderivative defendantLabor Code section 3352(h)City of San Diego
References
2
Case No. MISSING
Regular Panel Decision

In re the Arbitration between Lane & Endicott Johnson Corp.

The Motion for permission to appeal to the Court of Appeals was denied. The stay is continued until the appellant has an opportunity to apply to the Court of Appeals for permission to appeal, if so advised.

Appellate ProcedurePermission to AppealCourt of AppealsStay of ProceedingsJudicial Panel
References
1
Case No. ADJ387954 (OXN 0145858) ADJ2973719 (OXN 0145147)
Regular
Oct 27, 2017

FRANCISCO PRIETO vs. O.C. CONTRACTING, INC., AMERICAN INTERNATIONAL GROUP, INC., UNINSURED EMPLOYERS BENEFITS TRUST FUND

This case concerns a Petition for Reimbursement filed by Granite State Insurance Company against the Uninsured Employers Benefits Trust Fund (UEBTF). Granite State mistakenly paid workers' compensation benefits to an employee injured while working for an uninsured employer. The Workers' Compensation Appeals Board (WCAB) rescinded a prior order granting reimbursement, holding that UEBTF is not statutorily liable to reimburse insurance carriers for erroneous payments. The WCAB emphasized that UEBTF's purpose is to provide benefits to injured workers of uninsured employers, not to indemnify insurers. A dissenting opinion argued for amending the order to allow reimbursement to Granite State through applicant from funds UEBTF owes the applicant.

Uninsured Employers Benefits Trust FundGranite State Insurance CompanyPetition for ReimbursementLabor Code sections 37153716mistaken paymentillegally uninsured employerLabor Code section 4909creditdirect reimbursement
References
0
Case No. MISSING
Regular Panel Decision

In re the Arbitration between Country-Wide Insurance & Manning

Daisy P. Manning, an employee of the Department of Transportation, was injured by an uninsured vehicle while driving a city-owned vehicle. She sought arbitration from her personal insurer, Country-Wide, which then moved to permanently stay arbitration. Country-Wide argued that the City of New York, a permissibly self-insured municipality, should provide primary uninsured motorist coverage. Judge Bloom dissents in part, agreeing with the necessity of reversal but advocating for a remand with specific directions to join the City of New York as a party. This would allow for a full determination of rights, particularly concerning the City's potential primary liability under uninsured motorist provisions and the exclusivity of the Workers' Compensation Law.

Uninsured Motorist CoverageWorkers' Compensation LawSelf-Insured MunicipalityStay of ArbitrationPrimary vs. Secondary LiabilityJoinder of PartiesVehicle and Traffic LawInsurance LawExclusive RemedyAppellate Dissent
References
1
Case No. LAO 0722567
Significant

Daniel Milbauer, Applicant vs. Erez Boostan, an individual and dba American Runner Attorney Service, uninsured; Uninsured Employers Fund

The Appeals Board dismisses the Uninsured Employers Fund's petition for reconsideration because UEF is not legally 'aggrieved' by the prior decision, the challenged procedures are not a 'final' order, and the petition is successive.

Uninsured Employers FundPetition for ReconsiderationEn BancActing Director of Industrial RelationsAdministrative Law JudgeSupplemental Findings and AwardIndustrial InjuryLegal Identity of EmployerAggrieved PartyFinal Order
References
9
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