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

Case No. ADJ3470129 (SAC 0343138)
Regular
Jun 19, 2009

Refugio Hidalgo vs. Falcon Roofing

This case concerns applicant Refugio Hidalgo's appeal of a workers' compensation award for injuries sustained in 2004. The primary dispute involves whether to apply the 2005 or 1997 Permanent Disability Rating Schedule, with applicant arguing exceptions exist due to pre-2005 medical reports indicating disability and employer notice failures. The Board granted reconsideration to address the applicant's diminished future earning capacity (DFEC) claim and agreed to use a corrected occupational group number. However, a dissenting commissioner argued that the pre-2005 medical reports on file met the criteria to use the 1997 schedule, disagreeing with the majority's deferral of this issue.

Refugio HidalgoFalcon RoofingADJ3470129SAC 0343138Workers' Compensation Appeals BoardAmended Findings and AwardTMJspinal injurychin injuryupper extremity injury
References
5
Case No. 532689
Regular Panel Decision
Oct 27, 2022

In the Matter of the Claim of Monica Patricia Hidalgo Bernal (Poncefarfan, (dec'd) Otto)

Monica Patricia Hidalgo Bernal filed a claim for workers' compensation death benefits after her spouse, a cab driver, was fatally stabbed while dispatched by New York Apple Car Service (NYACS). NYACS, a member of the Independent Livery Driver Benefit Fund (ILDBF), controverted the claim, contending the decedent was a black car operator, thus making the New York Black Car Operators Injury Compensation Fund (NYBCOICF) liable. The Workers' Compensation Board found the decedent to be an independent livery driver, holding NYACS and its ILDBF carrier responsible. The Appellate Division affirmed the Board's decision, referencing Matter of Cisnero v Independent Livery Driver Benefit Fund, and reiterated that the vehicle's affiliation with NYBCOICF does not negate liability when the dispatch originated from an independent livery base.

Workers' CompensationDeath BenefitsIndependent Livery Driver Benefit Fund (ILDBF)New York Black Car Operators Injury Compensation Fund (NYBCOICF)Livery DriverBlack Car OperatorStatutory InterpretationExecutive LawWorkers' Compensation LawAppellate Review
References
1
Case No. ADJ8667280
Regular
Apr 17, 2013

JOSE REFUGIO BLANCO vs. METROPOLITAN AUTOMOTIVE WAREHOUSE, CALIFORNIA INSURANCE CO.

This Workers' Compensation Appeals Board case involves an applicant, Jose Refugio Blanco, and defendants Metropolitan Automotive Warehouse and California Insurance Co. The applicant filed a Petition for Removal, but the Board has denied this petition. The denial is based on the findings and reasoning presented in the administrative law judge's report, which the Board has adopted and incorporated. Therefore, the Petition for Removal has been formally denied by the Workers' Compensation Appeals Board.

Petition for RemovalWorkers' Compensation Appeals BoardAdministrative Law Judge ReportDenying RemovalMetropolitan Automotive WarehouseCalifornia Insurance Co.Applied Risk ServicesADJ8667280Marina del Rey District OfficeAlfonso J. Moresi
References
0
Case No. ADJ7785974
Regular
Mar 20, 2019

REFUGIO JOSE ALFARO (Deceased) vs. INTERSTATE HOME SERVICES, INSURANCE COMPANY OF THE WEST GROUP

This case involved a worker's compensation claim for death benefits after Refugio Alfaro died from a myocardial infarction. The defendant contested that the death was industrially caused, challenging the qualified medical examiner's (QME) opinion. The Appeals Board affirmed the finding of industrial causation, finding the QME's opinion substantial evidence supported by deposition testimony. However, the Board rescinded the award and returned the case for further proceedings to identify and determine eligibility of dependents, as the original applicant spouse was deceased.

AOE/COEmyocardial infarctiondeath benefitsQMEsubstantial evidencereconsiderationWCJindustrial causationdependencyaggravated condition
References
8
Case No. ADJ10640336
Regular
Jul 30, 2018

Refugio Gonzalez vs. Swift Transportation, Gallagher Bassett

The Workers' Compensation Appeals Board granted reconsideration to amend a prior finding, extending the applicant's cumulative psychiatric injury date to her termination on October 7, 2016. The Board affirmed the finding of industrial injury, clarifying that Labor Code section 3208.3(e) applies, not general post-termination provisions, and that the applicant's prior medical treatment satisfied an exception. Furthermore, the Board found that the employer failed to prove the termination was a good faith personnel action, as the investigation into alleged alcohol possession was not objectively reasonable given a negative test and a disgruntled accuser.

Workers' Compensation Appeals Boardpsychiatric injurycumulative injurypost-termination defensegood faith personnel actionLabor Code section 3208.3(e)notice of terminationobjective reasonablenesscausationdate of injury
References
7
Case No. ADJ1350252
Regular
Nov 28, 2011

REFUGIO PEREZ vs. ORANGE PLASTICS, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant who suffered an industrial injury resulting in permanent disability and a life pension. The applicant's attorney petitioned for reconsideration, arguing that attorney fees were not awarded for the life pension benefits. The Workers' Compensation Appeals Board granted reconsideration, agreeing that fees are due on the life pension. The Board amended its prior decision to defer the attorney fees issue for the life pension to the trial level for further determination. The matter is returned to the trial judge for this specific purpose.

Workers' Compensation Appeals BoardRefugio PerezOrange PlasticsState Compensation Insurance FundReconsiderationPermanent DisabilityLife PensionAttorney FeesCost of Living AdjustmentsBaker v. Workers' Comp. Appeals Bd.
References
1
Case No. ADJ9023782
Regular
Sep 20, 2019

REFUGIO PACAS vs. BARON HR. LLC, ZURICH AMERICAN INSURANCE

The Workers' Compensation Appeals Board granted reconsideration of a decision that denied new and further disability for the applicant's November 25, 2012 injury. While the Board found no new disability for the left wrist and lumbar spine, it identified potential new and further disability in the applicant's left knee. The matter is returned for further development of the record, specifically to clarify the applicant's left knee impairment with the agreed medical evaluator. The Board requires clarification on the rating methodology used for the left knee and whether it deviates from the AMA Guides.

Petition to ReopenNew and Further DisabilityStipulated AwardAgreed Medical EvaluatorRange of MotionWhole Person ImpairmentDiagnosis Related EstimateGait DerangementMuscle AtrophyArthritis
References
1
Case No. ADJ9772365 (MF) ADJ10082338
Regular
Dec 06, 2016

Leonel Hidalgo vs. Hilbert Property Management, Technology Insurance Company

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's Petition for Reconsideration, treating it instead as a Petition for Removal. The WCAB granted removal, rescinded the Joint Findings of Fact, and returned the matter for further proceedings. This action was based on the Medical Director applying the incorrect standard when determining that an orthopedic QME panel was in the applicant's medical interest. The WCAB found that the Medical Director should have first determined if the applicant's chosen chiropractic specialty was medically or otherwise inappropriate, as required by Administrative Director Rule 31.5(a)(10).

Workers' Compensation Appeals BoardQualified Medical EvaluatorQME panelspecialty determinationorthopedicschiropracticMedical DirectorAdministrative Director RuleLabor CodePetition for Reconsideration
References
9
Case No. ADJ6771140
Regular
Dec 13, 2013

YESENIA HIDALGO vs. RED CHAMBER COMPANY, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA, CHARTIS CLAIMS, INC.

This case involves a lien claimant's petition for reconsideration of a discovery order to produce records, which was dismissed by the Workers' Compensation Appeals Board. The Board ruled that discovery orders are interlocutory and not final decisions, thus not subject to reconsideration. Furthermore, the petition was deemed untimely. The Board also denied the lien claimant's request for removal and warned their attorney against frivolous filings.

WCABPetition for ReconsiderationDismissalDenial of RemovalFinal OrderInterlocutory OrderDiscovery RulingOrder to Produce RecordsLien ClaimantPre-trial Conference
References
6
Case No. ADJ13332737, ADJ15218980, ADJ12640295
Significant
Jun 17, 2024

ABEL HIDALGO, et al. vs. ROMAN CATHOLIC ARCHBISHOP, permissibly self-insured, administered by SEDGWICK, et al.

The Workers' Compensation Appeals Board consolidates three cases to address sanctions against attorney Susan Garrett and hearing representative Lance Garrett for filing petitions for reconsideration with the intent to disrupt or delay trial proceedings, issuing a notice of intent to impose sanctions and costs.

En BancSanctionsCostsAttorney's FeesLabor Code 5813Willful IntentImproper MotiveFrivolousDelay TacticsPetition for Reconsideration
References
13
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