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

Case No. ADJ6461309
Regular
Jul 19, 2012

JOSEPH MARTIN vs. City of Ukiah, Permissibly Self-Insured, administered by REDWOOD EMPIRE MUNICIPAL FUND

The Workers' Compensation Appeals Board denied reconsideration, upholding the WCJ's decision regarding air ambulance service fees. The board found that California Administrative Rule 9789.70, which dictates reasonable fees for ambulance services, is preempted by the federal Airline Deregulation Act. This preemption applies because the rule attempts to regulate the prices and services of air carriers, which is exclusively within federal purview. Therefore, the board concluded that the specific fee limitations in Rule 9789.70 do not apply to air ambulance services.

Workers Compensation Appeals BoardAD Rule 9789.70Air Ambulance ServicesAirline Deregulation ActADA Preemption49 U.S.C. ยง 41713(b)(1)Morales v. Trans World AirlinesState Regulation of Air CarriersWCABPetition for Reconsideration
References
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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. LAO 0689496
Regular
Jul 18, 2007

FLORENCIO ALVARADO vs. FISCH-HORWITZ 12TH STREET PROJECT, FISCH PROPERTIES, FISCH LIVING TRUST, STATE COMPENSATION INSURANCE FUND, TIG INSURANCE COMPANY, ALLSTATE INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) reconsidered a prior decision and affirmed the finding that the applicant was employed by Fisch Properties, insured by TIG Insurance Company, at the time of his injury. The WCAB reversed the prior ruling that barred SCIF from seeking contribution from TIG based on the doctrine of laches, finding no prejudice demonstrated by TIG. Consequently, SCIF is entitled to contribution from TIG.

Workers' Compensation Appeals BoardFisch-HorwitzFisch PropertiesState Compensation Insurance FundTIG Insurance CompanyAllstate Insurance CompanyReconsiderationDoctrine of LachesContributionCompromise and Release
References
Case No. GOL 0087934, GOL 0087935, GOL 0087936
En Banc
Feb 13, 2002

Alonso Navarro vs. A&A Farming, Western Growers Insurance Co.

The Board held that the applicant's claim of discrimination under Labor Code section 132a was preempted by the federal Employee Retirement Income Security Act (ERISA), as the claim was premised on the employer's termination of contributions to an ERISA-regulated health plan.

ERISA preemptionLabor Code section 132agroup health benefitsdiscrimination claimadverse actionemployee welfare benefit planworkers' compensationindustrial injuriesemployer contributionstemporary disability
References
Case No. ADJ8801352
Regular
Jun 06, 2014

Robert Coon vs. Swift Transportation, Gallagher Bassett Services, Inc.

This case involves a student truck driver attacked while on a dinner break, sustaining severe injuries including partial quadriplegia. The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, upholding the finding that the injury arose out of and in the course of employment. The Board applied the "commercial traveler" rule and the "personal comfort" doctrine, finding the employee's actions were incidental to his employment. Crucially, the Board determined the attack was a "neutral risk" as there was no evidence of personal motive for the assault.

AOE/COECommercial Traveler RulePersonal Comfort DoctrineNeutral Risk DoctrineThird-Party AssaultUnknown MotiveUnprovoked AttackLong Haul TruckerStudent DriverMentor
References
Case No. ADJ15229971
Regular
Mar 17, 2023

GRANT ELLISON vs. CITY OF SAN BUENAVENTURA, ATHENS ADMINISTRATORS

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration of an award to an employee injured by a COVID-19 vaccine. The Board found the injury arose out of and in the course of employment, citing the "dual purpose" rule where the employer strongly encouraged vaccination to reduce employee absences. The Board also applied the "personal convenience" doctrine, stating acts for comfort and convenience while at work are incidental to employment. Therefore, the employee's vaccine injury was deemed work-related, and the employer is liable.

Workers' Compensation Appeals BoardGrant EllisonCity of San BuenaventuraAthens AdministratorsCOVID-19 vaccinationarising out of employmentcourse of employmentdual purpose rulepersonal convenience doctrinework-related injury
References
Case No. ADJ2423806
Regular
Jun 07, 2010

BASIL PERKINS vs. CITY OF LOS ANGELES

In this workers' compensation case, the applicant, Basil Perkins, sought reconsideration after his claim for an industrial injury was denied. Perkins argued he was denied due process and that his injury was compensable under several doctrines, including positional and special risk, while also asserting employment motivation for the assault. The Appeals Board admitted a security bulletin provided by the applicant but found it irrelevant as it described tactics dissimilar to the applicant's shooting and was issued over two years after the injury. Ultimately, the Board affirmed its prior decision denying the applicant's claim.

Workers' Compensation Appeals BoardReconsiderationIndustrial InjuryDue ProcessPositional Risk DoctrineSpecial Risk DoctrineSecurity BulletinAnimal Rights GroupsEmployment-Related AssaultInference of Motivation
References
Case No. FRE 0197989, FRE 0200410
Regular
Feb 04, 2008

SANDRA LaPLANTE vs. WAL-MART, AMERICAN HOME ASSURANCE, AIG, FRANK GATES SERVICE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, finding that the WCJ erred by not applying the *Benson* doctrine on apportionment of permanent disability based on causation. The Board remanded the case for further proceedings to determine the percentage of permanent disability attributable to each industrial injury and pre-existing conditions, as required by Labor Code sections 4663 and 4664. The *Benson* doctrine dictates that the prior *Wilkinson* doctrine, allowing combined awards in successive injury cases, is no longer generally applicable due to the legislative intent for causation-based apportionment.

Wilkinson doctrineBenson v. The Permanente Groupapportionmentcausationsuccessive industrial injuriescumulative traumaspecific injurypermanent disability ratingmedical examiner reportcompensable consequence
References
Case No. ADJ7303543
Regular
Apr 08, 2013

JUAN RAMOS vs. SCI TEK STAFFING, CHARTIS

This case involves a workers' compensation claim where the Appeals Board granted reconsideration. The prior WCJ decision was found inconsistent with *Enriquez v. Couto Dairy*, which established that the Appeals Board can find preemption of Administrative Director (AD) Rule 9789.70, specifically the Official Medical Fee Schedule for air ambulance services. The Board clarified that the Airline Deregulation Act may preempt this rule if the air ambulance provider qualifies as an "air carrier" and has the burden of proving this status. Therefore, the matter was returned to the trial level for further proceedings and a new decision consistent with *Enriquez*.

Workers' Compensation Appeals BoardEnriquez v. Couto DairyArticle III section 3.5 California ConstitutionLabor Code section 5307.1preemptionAdministrative Director Rule 9789.70Official Medical Fee ScheduleOMFSair ambulance servicesAirline Deregulation Act
References
Case No. SAC 306565, SAC 306566, SAC 310519
Regular
Mar 18, 2008

GILBERT A. JONES, SR. vs. TRANSITIONAL COMMUNITY LIVING CENTER, STATE COMPENSATION INSURANCE FUND

This case involves an applicant who sustained industrial injuries in 2001 and 2002. The WCJ initially ruled to combine all injuries under the Wilkinson Doctrine for permanent disability, but the defendant sought reconsideration. The Appeals Board affirmed the WCJ's decision except for the findings on permanent disability and apportionment, remanding these issues for further development and application of the Benson decision, which replaced the Wilkinson Doctrine with a causation-based apportionment regime.

Workers' Compensation Appeals BoardReconsiderationPermanent DisabilityApportionmentWilkinson DoctrineLabor Code Sections 4663Labor Code Sections 4664Brodie DecisionFuentes DecisionBenson Decision
References
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