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

Case No. ADJ302560
Regular
Jan 10, 2012

DAVID COE vs. PROFESSIONAL ASSOCIATION OF DIVING INSTRUCTORS, MISSION INSURANCE COMPANY, IN LIQUIDATION, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The Appeals Board granted reconsideration on its own motion to correct a clerical error in a prior decision regarding a Labor Code section 5710 attorney's fee. The original award of $1,903.75 was twice the applicant's attorney's requested fee of $1,093.75, which the WCJ and the Board's prior decision acknowledged. The Board corrected its decision to reflect the accurate attorney fee of $1,093.75, while reaffirming that CIGA has no liability for this fee due to a credit against the applicant's third-party recovery, which is reduced by the corrected fee amount.

Workers' Compensation Appeals BoardProfessional Association of Diving InstructorsMission Insurance CompanyCalifornia Insurance Guarantee Association (CIGA)Labor Code section 5710attorney's feeclerical errorpetition for reconsiderationthird-party recoverynet third party recovery
References
Case No. SAC 293290
Regular
Feb 21, 2008

WILLIAM MENDOZA vs. LEE CUNEO dba THE BODY SHOP, UNINSURED EMPLOYERS FUND

The Workers' Compensation Appeals Board granted reconsideration to address the Uninsured Employers Benefits Trust Fund's (UEBTF) contentions. While affirming the award of retroactive vocational rehabilitation maintenance allowance (VRMA) at the delay rate, the Board amended the original order to allow the UEBTF credit for wages earned by the applicant as a property manager and for his net recovery in a third-party civil action against the uninsured employer. This credit will reduce the UEBTF's liability for the VRMA.

UEBTFVRMAdelay ratecredit for wagescivil action recoveryLabor Code section 139.5Labor Code section 4909property manager earningsthird party actionnet recovery
References
Case No. ADJ3694053 (SJO 0239468) MF ADJ2554333 (SJO 0247822)
Regular
Jan 27, 2017

JAMES HARRIS vs. TRENDWEST RESORTS, INC./CENDANT CORPORATION, AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA

This case concerns whether a civil settlement for discrimination and harassment also resolved the applicant's workers' compensation claims and whether the defendant should receive credit for the civil recovery. The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for reconsideration. The WCAB affirmed the finding that the civil release did not settle workers' compensation rights, emphasizing that the release was not submitted for WCAB approval and the applicant credibly testified it did not cover industrial injuries. Citing precedent, the WCAB found that the defendant's wrongful conduct should not benefit from a credit.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderCivil Case SettlementGeneral ReleaseWorkers' Compensation BenefitsDouble RecoveryCredit for Civil RecoveryIndustrial InjuryCardiovascular System
References
Case No. ADJ2552389 (OAK 0301853), ADJ2702419 (OAK 0301854), ADJ350772 (OAK 0301856), ADJ3854894 (OAK 0321466)
Regular
Mar 26, 2012

BARBARA LIGE-DIXON vs. A.C. TRANSIT, SEDGWICK CMS, INC.

The defendant, AC Transit, sought reconsideration of an award finding four industrial injuries and three awards of permanent disability for Barbara Lige-Dixon. The primary dispute concerned whether the defendant could credit permanent disability advances made in one case (resulting in zero disability) against its liability in other cases. The Appeals Board granted reconsideration, finding equitable considerations supported allowing the credit across all cases due to overlapping injuries and evolving medical apportionment. The Board amended the award to permit the $12,930 advance credit, while deferring the issue of attorney fees against third-party recovery for further trial-level proceedings.

Workers' Compensation Appeals BoardPermissibly Self-InsuredJoint Findings Award and OrdersPermanent DisabilityPermanent Disability AdvancesCreditThird Party RecoveryEquitable ConsiderationsApportionmentAgreed Medical Examiner
References
Case No. ADJ7479989
Regular
Dec 18, 2015

CARMEN ANDRADE vs. VISITING NURSE & HOSPICE CARE SANTA BARBARA, ILLINOIS MIDWEST INSURANCE COMPANY

The applicant sought reconsideration of a decision that allowed the defendant a credit against her workers' compensation award for her full third-party settlement recovery. The applicant argued the credit should be limited to her net recovery of $2,449.62. The Appeals Board granted reconsideration, finding the applicant failed to prove resolution of the defendant's credit rights. The Board amended the decision to defer the exact credit amount, remanding for further proceedings to determine its value. The September 29, 2015 decision was otherwise affirmed.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and OrderThird Party CreditNet RecoveryLabor Code Section 3861Industrial InjuryCompromise and ReleaseLien ClaimEmployer Negligence
References
Case No. ADJ1416396 (OXN 0147357) ADJ7453200
Regular
Jul 08, 2011

, Applicant, RICHARD DAVIS, vs. , BOTTLING GROUP LLC dba PEPSI BEVERAGES COMPANY; SEDGWICK CLAIMS MANAGEMENT for OLD REPUBLIC,

This case involved an employee who sustained two industrial injuries, one from a third-party's negligence and another cumulative trauma injury. The employer sought to apply a credit for the employee's net third-party recovery against the total workers' compensation award. The Appeals Board denied the employee's petition for reconsideration, upholding the employer's right to this credit. This decision affirmed that a third-party credit can be applied even when industrial injuries are intertwined and awarded jointly, to prevent the employee from obtaining a double recovery.

Petition for ReconsiderationThird-Party CreditJoint and Several AwardDouble RecoveryCumulative InjurySpecific InjuryAgreed Medical EvaluatorUnapportioned Permanent DisabilityBenson v. Permanente Medical GroupBenson v. Workers' Comp Appeal Bd.
References
Case No. ADJ7207727
Regular
Jul 30, 2013

LEE LUJAN vs. HOME LIVING SOLUTIONS, FIRST COMP

The Workers' Compensation Appeals Board denied reconsideration of a prior decision. The petition for reconsideration was filed by Lopez and Associates, a copy service, who contended their petition for costs was erroneously dismissed. The administrative law judge (ALJ) dismissed the petition based on the *Martinez* decision, which held that claims for medical-legal expenses cannot be filed as a petition for costs. The Board noted that Lopez and Associates may file a new petition under Labor Code 4622 for recovery of medical legal costs, potentially including penalties and interest.

WCABReconsiderationPetition for ReconsiderationMedical-legal costsLabor Code 4903.06Lien claimantCopy serviceEn Banc decisionMartinez decisionPetition for costs
References
Case No. ADJ14649906
Regular
Sep 08, 2025

JUAN CARLOS HERNANDEZ vs. YMCA OF THE FOOTHILLS, INSURANCE COMPANY OF THE WEST

The Workers' Compensation Appeals Board granted applicant Juan Carlos Hernandez's Petitions for Reconsideration and Removal. The Board aims to conduct a further review of the merits of the petitions and the entire record, citing concerns about the lack of evidence supporting the initial Findings and Orders by WCJ Bushin, which awarded a third-party credit of $147,625.51 to the defendants. The decision ensures due process and a comprehensive adjudication of factual and legal issues before a final ruling. The Board also noted the timeliness of its action in accordance with Labor Code section 5909(a) and admonished applicant's counsel for procedural violations.

Petition for ReconsiderationPetition for RemovalThird-Party CreditNet RecoveryDue ProcessSubstantial EvidenceLabor Code 5909EAMSWCJAppeals Board
References
Case No. ADJ4713554
Regular
Oct 19, 2010

JULIAN ARVIZU vs. COUNTY OF FRESNO

The Appeals Board rescinded the original award due to a factual error regarding the calculation of temporary disability indemnity and its interaction with Labor Code section 4656(c)(1). The case is remanded for the WCJ to re-determine the correct amount of the third-party credit and the overpayment of temporary disability indemnity. Crucially, any credit for overpayment of temporary disability indemnity must be applied before the third-party recovery credit to avoid double recovery. The WCJ must also reconsider whether credit against future medical treatment is appropriate based on case law.

Third-party recoverycredittemporary disability indemnityoverpaymentfuture medical treatmentLabor Code section 4850Labor Code section 4656(c)(1)permanent and stationary dateAgreed Medical Examinerrescinded decision
References
Case No. OAK 0313845
Regular
Jan 14, 2008

Michelle LaCentra vs. CAL STATE HAYWARD, OCTAGON RISK SERVICES

The Appeals Board granted reconsideration, reversing the WCJ's decision to allow the defendant credit for $19,000.00 recovered by the applicant in a third-party civil settlement. The Board found the settlement agreement stipulated the defendant's credit was limited to $19,000.00, and that the defendant was adequately reimbursed for permanent disability advances through the settlement of its lien. Therefore, the defendant is not entitled to further credit beyond the agreed-upon $19,000.00.

ReconsiderationThird Party RecoveryPermanent Disability AdvancesCivil SettlementDouble RecoveryLabor Code Section 3861Lien ClaimInterventionSubrogationMultiple Disabilities Table
References
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