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

Case No. GRO 0027359 GRO 0031626
Regular
May 14, 2008

TERESA FOSTER-KENNEDY vs. SANSUM SANTA BARBARA MEDICAL FOUNDATION, ARROWOOD INDEMNITY COMPANY, DYNAMIC CLAIM SERVICE

The Appeals Board granted reconsideration, affirming only the initial penalty and attorney's fee for the unreasonable delay in authorizing follow-up care with Dr. Billy. However, the Board reversed all other penalties and attorney's fees related to the payment of prior attorney's fees, finding those issues either rescinded, not properly presented, or mooted by settlement agreements. The employer is now liable for the initial penalty and associated attorney's fee regarding Dr. Billy, but not for any subsequent penalties or fees concerning attorney fee disputes.

Labor Code section 5814Labor Code section 5814.5unreasonable delayfollow-up careattorney's feespenalty petitionreconsiderationawardFindings of FactReport and Recommendation
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. ADJ352088 (MON 0360366)
Regular
Apr 12, 2011

NANCY MONTOYA vs. AUGUST CONSTRUCTION, INC., SEABRIGHT INSURANCE

This case concerns a clerical error in a workers' compensation award where the weekly temporary disability indemnity rate was inconsistently stated. The applicant, Nancy Montoya, incurred an industrial injury while employed by August Construction, Inc. The defendant petitioned for reconsideration to correct the typographical error in the Findings and Award, specifically regarding the stipulated temporary disability indemnity rate. The Workers' Compensation Appeals Board granted reconsideration, amended the award to reflect the agreed-upon rate of $833.33 per week, and returned the case for further proceedings.

Workers' Compensation Appeals BoardAugust ConstructionSeabright InsuranceFindings and AwardPetition for ReconsiderationTypographical ErrorTemporary Disability Indemnity RatePermanent Disability Indemnity RateStipulationReport and Recommendation
References
Case No. ADJ2500161 (BAK 0135729) ADJ3225816 (BAK 0135708) ADJ2766892 (BAK 0147317)
Regular
Mar 03, 2014

HECTOR GOMEZ vs. WATER WAYS IRRIGATION, GOLDEN EAGLE INSURANCE COMPANY

The Board granted reconsideration and rescinded the PWCJ's December 9, 2013 award. The PWCJ conceded errors in rating permanent disability for separate injuries and improperly amending a prior finding. The case is returned to the trial level for proper notice, further proceedings on all three injury claims, and a new decision. The PWCJ also needs to address the correct indemnity rate for the vocational rehabilitation hernia injury.

Workers' Compensation Appeals BoardPermanent Partial DisabilityVocational Rehabilitation InjuryApportionmentIndemnity RateFindings of FactOrder Amending Finding of FactRescindedReturned to Trial LevelIndustrial Injury
References
Case No. ADJ8663684
Regular
Jul 19, 2013

VICENTE URENA ANZALDO vs. REPUBLIC REFRIGERATION, HARTFORD INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to address the defendant's challenges regarding a finding of industrial injury and California jurisdiction. While agreeing with the finding of California jurisdiction, the Board rescinded the original and amended decisions due to procedural errors by the WCJ in addressing the industrial injury issue. The Board issued a new decision finding only that California has jurisdiction over the applicant's claimed injury.

ReconsiderationFindings of FactJurisdictionIndustrial InjuryAmended FindingsWCJ ErrorAppeals Board RulePolicy and Procedural ManualRescindSubstitute
References
Case No. ADJ3792824 (AHM 0116452) ADJ4206809 (AHM 0116457) ADJ143286 (AHM 0116470)
Regular
Jan 21, 2011

BRUCE SERVISS vs. RALPHS GROCERY COMPANY; Permissibly Self-Insured

The Workers' Compensation Appeals Board granted reconsideration of a prior award concerning an alleged late payment of benefits by Ralphs Grocery Company. The Board rescinded the original award, finding the administrative law judge's decision lacked specific findings on which benefits were delayed and the amounts involved. This matter is returned to the trial level for further proceedings and a new decision with specific findings, including whether penalties and attorney fees under Labor Code section 5814.5 are warranted.

WCABReconsiderationPenaltyUnreasonable DelayAttorney FeeSection 5814.5Findings AwardRescindedTrial LevelTimely Payment
References
Case No. ADJ4457532 (SAC 0348299)
Regular
Mar 04, 2014

TOMMY SEABROOKS vs. FRITO-LAY/PEPSICO, ACE AMERICAN INSURANCE COMPANY

This case involves Frito-Lay/PepsiCo contesting a 61% permanent disability award and future medical treatment for applicant Tommy Seabrooks. The original award found injury including aggravation of a pre-existing hernia and claimed injuries to various systems. The Workers' Compensation Appeals Board (WCAB) rescinded the award due to a significant error in the Findings of Fact. Specifically, the WCAB found the judge did not make an express finding that applicant's claimed injuries arose out of and occurred in the course of employment. The matter is returned to the trial level for a new decision with an express finding on industrial injury.

ADJ4457532Tommy SeabrooksFrito-Lay/PepsicoACE American Insurance CompanySedgwick CMSPermanent DisabilityAggravationPre-existing HerniaNeurologicPsychiatric
References
Case No. ADJ14015513
Regular
Feb 15, 2023

BRADEN NANEZ vs. 3 STONEDEGGS, INC., TECHNOLOGY INSURANCE COMPANY, AMTRUST NORTH AMERICA

The Appeals Board rescinded the initial Findings and Order, finding the applicant's petition for reconsideration was timely due to defective service. The Board applied the commercial traveler rule, determining the applicant's injury arose out of and in the course of employment. The claim is not barred by the going and coming rule or intoxication, and the applicant sustained a fractured right femur. Issues of traumatic brain injury and bruised lung are deferred for further proceedings.

Workers' Compensation Appeals BoardReconsiderationOpinion and DecisionFindings and OrderApplicantEmployerAdjustedAdjudication NumberRedding District OfficeInjury Arising Out of and In the Course of Employment (AOE/COE)
References
Case No. ADJ6895906
Regular
Sep 17, 2014

FELICIA CHECO vs. NORTHGATE GONZALEZ MARKET, ESIS

The Workers' Compensation Appeals Board (WCAB) rescinded a prior decision and returned the case for further proceedings. The WCJ failed to make findings on all presented issues, including the lien claimant's claim for medical treatment reimbursement. Specifically, the WCAB found the WCJ should have considered Labor Code section 5402(c) regarding reimbursement up to $10,000 for treatment provided before the claim's denial, irrespective of an AOE/COE finding. This section mandates reimbursement for treatment until the employer accepts or rejects the claim.

AOE/COELien ClaimantPetition for ReconsiderationFindings and OrderWorkers' Compensation Administrative Law JudgeDWC-1 Claim FormLabor Code section 5402(c)Medical TreatmentReimbursementCompromise and Release
References
Case No. ADJ3018378 (VNO 0540682)
Regular
Jul 05, 2011

JAMES HARRIS vs. CITY OF LOS ANGELES

The Workers' Compensation Appeals Board granted reconsideration of a prior award for applicant James Harris, a police officer injured in 2005. The Board rescinded the previous award and remanded the case for further proceedings to recalculate the life pension and attorney fees. The Board affirmed the finding of 72% permanent disability, finding the physician's opinion substantial evidence despite the defendant's challenges. The decision also addressed the timing of Cost of Living Adjustments (COLAs) for life pensions, adopting reasoning that applies them from the January 1st following the injury date.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardAmended Findings and AwardPolice OfficerIndustrial InjuryHeart InjuryGastrointestinal System InjuryHypertensionPermanent Disability
References
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