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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. SFO 0499272
Regular
Jul 07, 2008

Helen Miller vs. Green Gulch Farm and Zen Center, EVEREST NATIONAL INSURANCE

The Workers' Compensation Appeals Board affirmed the administrative law judge's finding that Helen Miller was an employee of Green Gulch Farm and Zen Center and sustained an industrial injury to her left ankle. The Board found Miller was not a volunteer due to the extensive benefits received and the employer's control, and her jogging injury during a lunch break was a reasonable expectancy of employment, not barred by Labor Code section 3600(a)(9). Therefore, her injury arose out of and occurred in the course of her employment.

Workers' Compensation Appeals BoardHelen MillerGreen Gulch Farm and Zen CenterEverest National InsuranceGallagher BassettSFO 0499272Opinion and Decision After ReconsiderationLabor Code Section 3351Labor Code Section 3352(i)Employee definition
References
Case No. ADJ9725488
Regular
Nov 13, 2015

Norris Hollie vs. Management Training Corporation, Zurich American Insurance Company, ESIS

The Workers' Compensation Appeals Board denied reconsideration for applicant Norris Hollie, upholding a finding that his right knee injury on April 27, 2014, did not arise out of or occur in the course of his employment. The Board agreed that Hollie's participation in a continuing medical education program, while necessary to maintain his license, was not a reasonable expectation of his employment as a physician. There was no evidence of employer mandate, knowledge, or encouragement of this specific off-duty educational activity. Therefore, the injury sustained during this program was not deemed industrial.

Continuing educationMedical license renewalOff-duty activityReasonable expectancy of employmentCourse of employmentArising out of employmentIndustrial injuryPetition for reconsiderationFindings and AwardWCJ Report
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ7264969
Regular
Feb 22, 2011

Richard Warner vs. COUNTY OF LOS ANGELES, INTERCARE INSURANCE SERVICES

Applicant Richard Warner, a firefighter on Catalina Island, sustained injuries while trimming wisteria at his home, which he was required to maintain as a condition of employment and from which he sometimes worked. The Board denied reconsideration, affirming the WCJ's finding that the injury was not arising out of and occurring in the course of employment (AOE/COE). The applicant's home was not considered employer premises under the bunkhouse rule as he owned and maintained it personally, receiving a stipend instead of provided housing. Although working from home was sometimes necessary, trimming wisteria was deemed a purely personal act unrelated to employment duties.

AOE/COEbunkhouse ruleemployer premisessecondary jobsitecourse of employmentperforming serviceproximate causepersonal taskincidental to employmentstipend
References
Case No. ADJ11968759
Regular
Apr 13, 2023

JESUS ORTEGA GONZALEZ vs. MAJOR TRANSPORTATION SERVICES, INC., BALJINDER S. GILL, PEOPLEASE LLC, NATIONAL INTERSTATE RICHFIELD.

This case involves an applicant injured while employed by both Major Transportation Services and Peoplease, a Professional Employer Organization (PEO). Peoplease sought reconsideration of a finding that they jointly employed the applicant on the date of injury, arguing payroll was not processed through them. The Board denied reconsideration, adopting the WCJ's reasoning that a co-employment relationship existed. The WCJ found that despite Peoplease's argument about payroll timing, evidence showed Peoplease benefitted from the applicant's work and their actions were inconsistent with strict contract adherence, akin to precedent in Gulam v. Patel. Ultimately, Peoplease's arguments regarding payroll timing were deemed coverage issues subject to arbitration and not grounds to deny the finding of co-employment.

Professional Employer OrganizationPEOdual employmentgeneral employerspecial employerco-employmentclient policyLabor Code section 3602(d)presumption of employmentsubstantial evidence
References
Case No. VNO 0470470
Regular
May 12, 2008

GERARDO RAMIREZ vs. WILLIAM ALONSO, UNINSURED EMPLOYERS FUND

The Workers' Compensation Appeals Board granted reconsideration to further develop the record concerning applicant Gerardo Ramirez's employment status at the time of his injury. The Board rescinded the previous findings, finding the evidence insufficient to support dual employment and needing clarification on whether applicant was a casual employee, which might affect his eligibility for benefits. The case was returned to the trial level for additional evidence gathering, including a review of the defendant's insurance policy for the property where the injury occurred.

Workers' Compensation Appeals BoardUninsured Employers Fundindustrial injuryright major extremitydefendant's contentiondual employmentthreshold issueemployment relationshippresumption of employmentjoint venture
References
Case No. ADJ10009703 ADJ10043837
Regular
Feb 19, 2019

ZULAY DAVILA vs. EMPLOYERS RESOURCE GROUP, VENSURE HR, INC., LCF LIBERTY JR, LLC/SECURITY NATIONAL INSURANCE COMPANY, AMTRUST NORTH AMERICA, PROPORTION FOODS, LLC/REDWOOD FIRE AND CASUALTY INSURANCE COMPANY, BERKSHIRE HATHAWAY HOMESTATE COMPANIES

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the WCJ's decision due to a due process violation. The WCJ had determined employment by ERG without providing ERG notice and an opportunity to be heard. The WCAB returned the case to the trial level for further proceedings to determine employment status. Issues of insurance coverage will be subject to mandatory arbitration once employment is established.

Workers' Compensation Appeals BoardVENSURE HRSecurity National Insurance CompanyProportion FoodsLLCREDWOOD FIRE AND CASUALTY INSURANCE COMPANYBERKSHIRE HATHAWAY HOMESTATE COMPANIESAMTRUST NORTH AMERICAEMPLOYMENT RESOURCES GROUPINC.
References
Case No. ADJ8334555
Regular
Apr 05, 2013

JOSE HERNANDEZ vs. BRYAN MIMAKI dba PACIFIC RIMS, PALMS; ZENITH INSURANCE COMPANY

This case concerns whether a knee injury sustained by an employee, Jose Hernandez, while playing basketball on company premises during lunch is compensable. The defendant argued the injury did not arise out of employment, as it stemmed from voluntary participation in an athletic activity not required by the employer. The Appeals Board denied reconsideration, affirming the finding that the injury was industrial. The majority found the employee's subjective belief of employer expectation was objectively reasonable, given the employer provided a court and balls and supervisors encouraged participation. Commissioner Lowe dissented, arguing the applicant failed to demonstrate an objectively reasonable belief of employer expectation, as he could opt out and faced no repercussions.

Workers' Compensation Appeals BoardIndustrial InjuryRight KneeField WorkerBasketball GameOff-Duty Recreational ActivityLabor Code Section 3600(a)(9)Reasonable Expectancy of EmploymentSubjective BeliefObjective Reasonableness
References
Case No. ADJ1688022 (VNO 0558018)
Regular
May 03, 2010

RONALD TORRES vs. FOREVER 21, FEDERAL INSURANCE COMPANY, CHUBB GROUP OF INSURANCE COMPANIES

This case involves a worker injured playing soccer off-duty on company property. The employer argued the injury was not compensable under Labor Code section 3600(a)(9) as it was voluntary recreational activity. The Board reversed the initial finding, holding that the worker's voluntary participation in the soccer game, which was not required by or a reasonable expectancy of employment, fell outside the scope of workers' compensation coverage. Therefore, the applicant's claim for benefits for his shoulder injury was denied.

Labor Code section 3600(a)(9)Ezzy v. Workers' Comp. Appeals Bd.off-duty recreational activityvoluntary participationreasonable expectancy of employmentexpressly or impliedly requiredsoccer game injuryindustrial injuryleft shouldercompensable injury
References
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