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

Case No. ADJ10574205
Regular
Sep 09, 2019

AMNER ALVAREZ vs. SCM ENTERPRISES, TIMBERS STRATA 23-LP, FOWLER PROPERTY MANAGEMENT, STRATA EQUITY GROUP, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA, EMPLOYERS COMPENSATION INSURANCE COMPANY, INSURANCE COMPANY OF THE WEST, MARKEL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded the arbitrator's decision because SCM Enterprises claimed it did not receive timely notice of the hearing and decision. The Board found the petition for reconsideration to be timely filed as the statutory period does not run until actual receipt of the decision when service is defective. The case is returned to the arbitrator for further proceedings and a new decision. This order is not a final decision on the merits.

Petition for ReconsiderationArbitration HearingArbitrator's DecisionDefective ServiceTimelinessJurisdictional Time LimitRescinded DecisionFurther ProceedingsWorkers' Compensation Appeals BoardLab. Code
References
6
Case No. MISSING
Regular Panel Decision

Claim of Muszynski v. Dennis Puricelli Masonry & Concrete, Inc.

The Workers’ Compensation Board's decision, filed March 3, 1982, regarding a carrier's cancellation of a workers' compensation insurance policy was appealed. The appellate court found that the Board applied an incorrect standard by requiring the production of a return receipt to prove notice of cancellation, as the statute only requires the notice to be sent with a return receipt *requested*. Consequently, the decision imposing liability on the carrier and discharging the Uninsured Employers Fund was reversed. The matter is remitted to the Board for further proceedings to consider other grounds, specifically the employer's proof of mailing, which the Board did not initially address.

Workers' Compensation LawInsurance Policy CancellationNotice of CancellationCertified MailReturn Receipt RequestedStatutory InterpretationAppellate ReviewRemandUninsured Employers FundBurden of Proof
References
0
Case No. MISSING
Regular Panel Decision

In re the Claim of Tijani

After beginning unemployment insurance benefits, the claimant's benefits were reduced due to concurrent receipt of workers' compensation benefits. An Administrative Law Judge sustained this reduction. The claimant's subsequent appeal to the Unemployment Insurance Appeal Board was dismissed as untimely. The appellate court affirmed the Board's decision, noting the claimant's concession that the benefit reduction was proper and that he had no obvious reason to appeal the initial ALJ decision. The court also stated that any claims regarding later adjustments to unemployment benefits due to workers' compensation suspension were beyond the current record's scope and must be pursued before the agency.

Unemployment InsuranceWorkers' Compensation BenefitsBenefit AdjustmentUntimely AppealAdministrative DecisionsJudicial ReviewConcession of FactAppellate ProcedureScope of ReviewLabor Law
References
2
Case No. ADJ1124701 (OAK 0304697)
Regular
Jan 25, 2010

GENE THOMAS vs. SLEEP TRAIN MATTRESS CENTER, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) rescinded a prior decision favoring the applicant's spinal surgery, finding that proper procedural steps were not followed. The employer's utilization review (UR) had denied the surgery, but neither party followed the required second-opinion process under Labor Code section 4062(b). The WCAB returned the case to the trial level, allowing the employer ten days from receipt of the decision to object to the surgery and initiate the second-opinion process. This decision aligns with the WCAB's en banc ruling in *Cervantes*, which clarified the procedures for handling spinal surgery disputes after UR denials.

Workers' Compensation Appeals BoardUtilization ReviewLabor Code section 4062(b)Spinal SurgerySecond OpinionCervantes v. El Aguila Food ProductsACOEM GuidelinesExperimental TreatmentEn Banc DecisionAdministrative Director Rules
References
4
Case No. MON 0237705 MON 0232099 MON 0222730
Regular
Apr 07, 2008

LEONARD MAGALLANES vs. MATHESON FAST FREIGHT, STATE COMPENSATION INSURANCE FUND, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, INTERCARE INSURANCE SERVICES, RELIANCE INSURANCE COMPANY

The Workers' Compensation Appeals Board rescinded the previous award, finding that the administrative law judge erred by not properly apportioning permanent disability to each industrial injury, as required by the *Benson* en banc decision. The Board also addressed the timeliness of CIGA's petition, finding it timely filed due to CIGA's sworn declaration of late receipt. The case is returned to the trial level for further proceedings and decision on apportionment.

CIGAMatheson Fast FreightState Compensation Insurance FundReliance Insurance CompanyliquidationreconsiderationFindings of Fact and Awardpermanent disabilityapportionmentBenson v. Permanente Medical Group
References
9
Case No. MISSING
Regular Panel Decision

Claim of Cassata v. General Motors Powertrain

The employer sought reimbursement from the Special Funds Conservation Committee for workers' compensation benefits paid to a claimant, alleging a timely filing of Form C-250. The Workers’ Compensation Board ruled against the employer, finding the C-250 form, filed in 2007, was untimely, as no prior record of its filing existed. The employer argued that a 2001 pretrial conference worksheet indicated a November 30, 2000 filing date. However, the Board concluded that this worksheet did not prove receipt by the Board and affirmed the Workers’ Compensation Law Judge's decision. The claimant then appealed this decision. The appellate court affirmed the Board's decision, stating it was supported by substantial evidence.

Workers' Compensation LawSpecial Funds Conservation CommitteeForm C-250Timely FilingReimbursement ClaimPermanent Partial DisabilitySecond Injury LawSubstantial EvidenceAppellate ReviewWorkers' Compensation Board
References
7
Case No. MISSING
Regular Panel Decision

Claim of Buchanon v. Adirondack Steel Casting Co.

The Workers' Compensation Board's decision and amended decision, which found that the claimant did not have a total industrial disability, were affirmed on appeal. The employer's argument regarding the untimeliness of the claimant's supplemental notice of appeal was rejected due to lack of proof of service for the amended decision. The Board's plenary authority to modify previous decisions was upheld, as no facts indicated arbitrary or capricious action in amending its prior decision. The court concluded that the Board's finding of no total industrial disability was supported by substantial evidence, noting that the case involved a conflict of medical opinion, which is a factual matter for the Board to resolve. All remaining arguments by the claimant were considered and dismissed.

Workers' Compensation Law § 23Industrial DisabilityAppellate ReviewBoard Decision AffirmationMedical Opinion ConflictSubstantial EvidenceTimeliness of AppealArbitrary and Capricious StandardFactual DisputeClaimant's Appeal
References
4
Case No. MISSING
Regular Panel Decision
Dec 21, 1992

Claim of Stokes v. Permanente

The Workers' Compensation Board initially ruled that the claimant sustained a compensable injury after being struck by a car while crossing a street from a parking lot to her workplace. This decision and an amended decision were subsequently appealed. The appellate court found substantial evidence to support the Board's finding that the injury occurred while the claimant was entering the employment premises, thus arising out of and in the course of her employment. Consequently, the court affirmed the Board's decision and amended decision.

Workers' CompensationEmployment InjuryCompensable InjuryGoing and Coming Rule ExceptionParking Lot InjuryAppellate ReviewBoard Decision Affirmed
References
0
Case No. ADJ2471707 (OAK 0325825) ADJ1760066 (OAK 0325826)
Regular
Apr 11, 2012

KASSONDRA MORELAND vs. CITY OF UNION CITY, CITY OF SUNNYVALE

This case concerns contribution between two employers for a cumulative trauma injury. The Workers' Compensation Appeals Board (WCAB) amended an arbitrator's decision regarding the date of injury. The WCAB found the date of injury to be December 5, 2005, when the applicant first suffered a wage loss due to medical restrictions. This decision shifts liability for contribution to the employer who employed the applicant during the year preceding this date. A dissenting commissioner argued the date of injury should be later, correlating with the applicant's surgery and receipt of temporary disability benefits.

Cumulative TraumaDate of InjuryLabor Code Section 5412Labor Code Section 5500.5WCABReconsiderationContributionConcurrent EmploymentCity of Union CityCity of Sunnyvale
References
0
Case No. MISSING
Regular Panel Decision

Claim of Farcasin v. PDG, Inc.

Claimant, a director of research and publications, developed neck and shoulder pain radiating to his arms and hands after working for the employer for a month, attributing it to a lack of an ergonomically designed workstation and an outdated computer. A Workers’ Compensation Law Judge initially found he suffered an occupational disease. The Workers’ Compensation Board affirmed this decision, but later amended it, ruling that claimant suffered an accidental injury. The employer appealed both decisions. The Court affirmed the Board's decision, finding no abuse of discretion in amending the prior decision and that substantial evidence supported the finding of an employment-related accidental injury, which can be established by medical evidence of repetitive acts causing debilitating injury, even if symptoms accrued gradually.

Workers' CompensationAccidental InjuryOccupational DiseaseRepetitive Strain InjuryErgonomicsAppellate ReviewBoard DecisionJurisdictionMedical EvidenceGradual Injury
References
7
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