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

Case No. ADJ10083989
Regular
Sep 12, 2016

LUIS PARTIDA vs. ABOVE ALL ROOFING, STATE COMPENSATION INSURANCE FUND

This case concerns a defendant's petition for reconsideration and removal of a WCJ's order deeming a prior stipulation a "continuing award" of temporary disability benefits. The defendant argued this prejudiced their right to present evidence of the applicant's employment and that the stipulation only set the rate and start date, not ongoing benefits. The Board denied both petitions, finding the defendant's subsequent payment of benefits beyond the stipulation date established it as a continuing award. Furthermore, the Board noted that under Labor Code section 4651.1, a rebuttable presumption of continuing disability exists until a petition to terminate liability is properly filed and overcome.

Petition for ReconsiderationPetition for Removalcontinuing awardtemporary disability indemnityStipulations and Awarddue processexpedited trialrebuttable presumptionterminate liabilityLabor Code
References
2
Case No. MISSING
Regular Panel Decision

Pension Benefit Guaranty Corp. v. Pension Committee of Pan American World Airways, Inc.

The Pension Benefit Guaranty Corporation (PBGC) petitioned the court to terminate underfunded retirement benefit plans associated with Pan American World Airways, citing an unreasonable increase in potential long-run liability as per 29 U.S.C. § 1342(c). The Pension Committee of Pan American World Airways and several unions intervened, opposing both the termination and the proposed July 24, 1991 termination date. The court reviewed PBGC's termination decision under the Administrative Procedure Act's 'arbitrary and capricious' standard, ultimately finding it justified by substantial evidence of the plans' underfunding and the company's inability to meet its contribution obligations. The court dismissed arguments regarding internal PBGC guidelines, stating they do not have the force of law and were, in any event, adhered to due to 'extraordinary circumstances'. For the termination date, the court applied the Broadway Maintenance test, requiring 'constructive notice' sufficient to extinguish beneficiary reliance, and determined July 31, 1991, as the appropriate date, based on widespread public awareness of PBGC's petition by that time. The court therefore granted the petition for termination.

Pension plan terminationPBGCERISAUnderfunded plansTermination dateConstructive noticeAdministrative Procedure ActArbitrary and capricious standardDistrict CourtPan American World Airways
References
8
Case No. ADJ9553023
Regular
Nov 02, 2016

JACQUELINE MORRIS vs. COVENANT CARE, INC. d/b/a AFFIRMA, ZURICH NORTH AMERICAN INSURANCE COMPANY

In this workers' compensation case, the defendant sought reconsideration of the denial of their petition to terminate temporary disability indemnity benefits. The applicant sustained an admitted industrial injury in 2014. The defendant improperly stopped payments and filed their termination petition significantly after the applicant's temporary disability was initially awarded and after receiving a QME report suggesting the condition was permanent and stationary. The Board denied the defendant's petition, noting procedural missteps including failing to seek reconsideration of the initial award. The Board also clarified that the applicant is not entitled to 240 weeks of temporary disability benefits, but rather a statutory limit.

Petition to Terminate LiabilityTemporary Disability IndemnityPanel Qualified Medical EvaluatorPQMEFindings of FactPetition for ReconsiderationReport and RecommendationRebuttable PresumptionLab. Code§ 4651.1
References
0
Case No. ADJ6877517
Regular
Feb 10, 2017

LILIANA PEREZ vs. E. & J. GALLOW WINERY

The Workers' Compensation Appeals Board denied the defendant winery's petition for reconsideration. The defendant argued that the applicant's prior petition to reopen initiated all subsequent proceedings, including their own petition to terminate benefits. However, the Board found this contention meritless as the applicant's petition sought only new and further disability, not termination, and was withdrawn before trial. Labor Code section 4607, regarding unsuccessful proceedings to terminate awards, thus applied only to the defendant's actions.

Petition for ReconsiderationPetition to ReopenNew and Further DisabilityTerminate Medical AwardLabor Code 4607Unsuccessful TerminationInitiated ProceedingsWithdrawal of PetitionWCJ ReportAppeals Board Rule 10848
References
0
Case No. ADJ3519701
Regular
Nov 04, 2013

SHERYL SEIFERT vs. BLOCKBUSTER VIDEO, SEDGWICK RIVERSIDE

The applicant, injured in 2001, sought further temporary disability benefits more than five years after her injury date. While the Workers' Compensation Appeals Board (WCAB) generally retains jurisdiction for benefits beyond five years if no final award has been issued, this case involved a prior stipulated award of temporary disability that was subsequently terminated. Therefore, to seek additional benefits, the applicant was required to file a petition to reopen or for new and further disability within the five-year statutory period. Since no such petition was filed within the timeframe, the WCAB properly denied the applicant's petition for reconsideration, upholding the WCJ's finding of lack of jurisdiction to award further benefits.

Petition for ReconsiderationTemporary Disability BenefitsDate of InjuryJurisdictionAward TerminationPetition to ReopenNew and Further DisabilityInsidious Progressive DiseaseStated ReasonsAdministrative Law Judge
References
11
Case No. SJO 231212, SJO 231977
Regular
Jun 03, 2008

EVA DIAZ vs. HUNG QUOC NGUYEN dba SAFETRANS TRANSPORTATION aka SAFETRANS

The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's petition for reconsideration and granted the applicant's petition. The WCAB found the applicant's claim was not barred as a post-termination claim because the defendant had notice of the injury prior to the termination notice. The case is returned to the trial level for determination of benefits for the compensable industrial injury.

post-termination claimLabor Code section 3600(a)(10)employer notice of injuryindustrial injurymotor vehicle accidentuninsured employerWCJpetition for reconsiderationcompensabilitymedical treatment
References
1
Case No. ADJ8810795
Regular
Jul 21, 2014

MARIA AGUIRRE vs. LOMPOC VALLEY MEDICAL CENTER

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. This decision affirmed the award of attorney's fees to the applicant under Labor Code section 4651.3. The Board found that the defendant's continued pursuit of terminating temporary disability benefits, despite medical evidence indicating ongoing disability and a subsequent withdrawal attempt, triggered the attorney fee liability. This denial upholds the principle that applicant's attorney fees are awarded for successfully resisting a petition to terminate benefits, regardless of the defendant's intent.

WCABPetition for ReconsiderationLabor Code section 4651.3attorney's feesPetition to Terminatetemporary disabilitystrict liability statutemedical reportingdepositionPTP
References
1
Case No. ADJ3947517
Regular
Sep 30, 2009

RUDY GONZALES vs. CELITE CORPORATION, NATIONAL UNION FIRE INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) denied the applicant's petition for reconsideration, upholding the prior ruling that his claim for retroactive vocational rehabilitation maintenance allowance (VRMA) was terminated by the repeal of Labor Code section 139.5 on January 1, 2009. The WCAB granted the defendant's petition, vacating the Rehabilitation Unit's order awarding VRMA because the applicant's right to benefits had not vested in a final order before the effective date of the repeal. The Board clarified that a determination of Qualified Injured Worker status does not constitute a final award of VRMA, and jurisdiction over such claims cannot be conferred by waiver. Therefore, the applicant is not entitled to any further vocational rehabilitation benefits.

Labor Code section 139.5vocational rehabilitationVRMAQIWvested rightinchoate rightfinal orderrepealjurisdictionreconsideration
References
1
Case No. ADJ2742024 (SAC 0321214)
Regular
Aug 24, 2009

RAYMOND GASTINELL, JR. vs. EMPIRE PACIFIC WINDOWS CORPORATION, LIBERTY MUTUAL FIRE INSURANCE COMPANY

This case concerns an applicant's appeal of a Workers' Compensation Judge's (WCJ) decision terminating temporary disability benefits. The applicant argued the defendant's petition to terminate failed to comply with procedural rules and that the WCJ's decision was made by an unauthorized judge. The Appeals Board found the defendant's petition was missing from the file and that procedural deficiencies existed regarding notice and preparation for hearings. Consequently, the Board granted reconsideration, rescinded the prior order, and remanded the case for further proceedings to address the termination petition and the applicant's objections.

Permanent and stationary datePetition to Terminate Temporary DisabilityBoard Rule 10464interim orderQualified Medical EvaluatorDeclaration of Readiness to Proceedexpedited hearingviolation of Labor Code section 5900Electronic Adjudication Management System (EAMS)Petition for Reconsideration
References
2
Case No. ADJ10387978
Regular
Aug 13, 2019

MELE LATU vs. HEWLETT PACKARD ENTERPRISE SERVICES, SUBSEQUENT INJURIES BENEFITS TRUST FUND

This case involves a denied petition for reconsideration regarding Subsequent Injuries Benefits Trust Fund (SIBTF) benefits. The applicant settled her industrial injury claim for $937,166, then sought SIBTF benefits. The Board denied the petition because the applicant failed to prove a pre-existing "labor disabling" condition, which is a requirement for SIBTF eligibility even after statutory changes. Medical evidence indicated the applicant was asymptomatic and functional prior to her industrial injury, and any apportionment was to asymptomatic pathology, not a labor-disabling condition.

Subsequent Injuries Benefits Trust FundSIBTFLabor Code section 4751labor disablingpermanent partial disabilityapportionmentSenate Bill 899SB 899asymptomatic pathologyEscobedo v. Marshalls
References
2
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