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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ9473670
Regular
Nov 02, 2020

SANDRA UYAGUARI GARCIA vs. CLAUDIA MENDOZA Dba SWEET MELODY EXPRESS, UEBTF

This case concerns an applicant seeking workers' compensation benefits for an injury sustained while cleaning a defendant's residence. The primary issue was whether the applicant was an employee of the defendant's business, Sweet Melody Express, or an independent residential employee. The Board affirmed the WCJ's finding that the applicant was not an employee of Sweet Melody Express at the time of the injury, deeming her services to the defendant's home to be sporadic and casual housecleaning for the individual, not the business. Therefore, her claim for workers' compensation was denied.

Workers' Compensation Appeals BoardReconsiderationEmployee StatusResidential EmployeeCasual EmploymentLabor Code Section 3351Labor Code Section 3352(a)(8)Burden of ProofCredibility FindingEmployer Capacity
References
Case No. ADJ6995425
Regular
Apr 27, 2012

SERGIO SANCHEZ vs. LIDA KOHANSAMEH, PACIFIC SPECIALTY INSURANCE

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior ruling finding the applicant an employee of Lida Kohansameh. While agreeing the applicant was not an employee of Pacific Great West Construction, the Board remanded the case for further proceedings. The trial judge must now determine if the applicant is excluded from workers' compensation coverage under Labor Code sections 3351(d) and 3352(h), specifically regarding residential or casual employment and hours worked. This decision avoids a final determination on employment status and focuses on potential statutory exclusions.

Workers' Compensation Appeals BoardLida KohansamehPacific Specialty InsuranceTristar Risk ManagementSergio SanchezFindings and OrderEmployee statusPacific Great West ConstructionReport and RecommendationPetition for Reconsideration
References
Case No. ADJ8190306
Regular
Jan 07, 2013

Silvestre Sanchez vs. Robert E. Town, Allied Insurance, A Nationwide Company

This case concerns whether an injured worker, Silvestre Sanchez, was an employee of Robert E. Town for workers' compensation purposes. The Board granted reconsideration to reverse the WCJ's finding of employment. The primary issue was whether Sanchez met the 52-hour work requirement within the 90 days preceding injury under Labor Code section 3352(h), which excludes certain residential employees. The Board found that based on conflicting testimony regarding a second payment, the applicant did not prove he worked over 52 hours, thus excluding him from coverage.

Workers' Compensation Appeals BoardSilvestre SanchezRobert E. TownAllied InsuranceLabor Code section 3352(h)excluded employeeresidential employee90-day perioddate of injuryFindings of Fact
References
Case No. ADJ7963742
Regular
May 01, 2018

JAMES MCDONALD vs. HAROLD HUTCHENS AND DORICA ANDERSON,INDIVIDUALS, HAL, HUTCHINS, HAROLD HUTCHENS AND DORICA ANDERSON INDIVIDUALS; INTERCARE

The Workers' Compensation Appeals Board denied reconsideration of an amended findings and award. The applicant sustained an industrial injury to his right leg while employed by the defendants. The defendants contended the applicant was not their employee and did not meet the 52-hour threshold for residential employees. The Board found the WCJ's determination that the applicant exceeded 52 hours of work was supported by substantial evidence, despite conflicting witness testimony. Additionally, the defendants failed to prove the applicant was employed by a third party rather than them.

Labor Code section 3351(d)Labor Code section 3352(h)residential employee52-hour thresholdindependent contractorindustrial injurypetition for reconsiderationWCJcredibility determinationcontradictory testimony
References
Case No. SJO 0210015
Regular
Mar 04, 2008

CARLOS SALAZAR vs. JOSE VIDRIO, LIBERTY MUTUAL INSURANCE COMPANY

This case concerns whether a comprehensive personal liability policy provided by Liberty Mutual to Jose Vidrio covered applicant Carlos Salazar's workers' compensation claim for injuries sustained while working at Vidrio's residence. The Appeals Board affirmed the arbitrator's decision, finding that Insurance Code section 11590 mandates such coverage for residential employees incidental to the dwelling's use, regardless of specific policy wording. The Board also confirmed Salazar met the statutory employee criteria of working over 52 hours and earning over $100 in the 90 days prior to injury.

Workers' Compensation Appeals BoardIndustrial InjuryResidential EmployeeComprehensive Personal Liability InsuranceLabor Code section 3351(d)Insurance Code section 11590Labor Code section 3352(h)Incidental DutiesDwelling MaintenanceUninsured Employers Benefits Trust Fund
References
Case No. ADJ8149660
Regular
Sep 19, 1943

Jeffrey Doty vs. Fred Stoke, dba Stoke Trust and Uninsured Employers Benefits Trust Fund

The Workers' Compensation Appeals Board granted reconsideration to amend findings, concluding applicant Jeffrey Doty was an employee because he performed work requiring a contractor's license without possessing one. However, the Board affirmed the denial of benefits, agreeing with the WCJ that Doty failed to prove he worked the requisite 52 hours within the 90 days preceding his injury. This failure to meet the statutory threshold for residential employees excluded him from benefits. Therefore, Doty is not entitled to workers' compensation despite being deemed an employee.

Workers' Compensation Appeals BoardFred StokeUninsured Employers Benefits Trust FundIndependent ContractorEmployee StatusContractor's LicenseLabor Code Section 2750.5Tree PruningResidential Dwelling Employee52-Hour Rule
References
Case No. ADJ7776766
Regular
Mar 22, 2012

ABELARDO MORALES vs. EVANGELINA NICHOLAS, INTERINSURANCE EXCHANGE OF THE AUTOMOBILE CLUB OF SOUTHERN CALIFORNIA, CORVEL

The Workers' Compensation Appeals Board granted reconsideration, reversing a prior award. The Board found the applicant was not an employee under Labor Code sections 3351(d) and 3352(h) because his work as a patio builder and roof repairer was considered incidental to the ownership and use of a dwelling, and he worked less than 52 hours for the homeowner. Therefore, the applicant was excluded from workers' compensation coverage.

Labor Code section 3351(d)Labor Code section 3352(h)incidental to dwelling usehomeowner employee exclusioncasual or minor activityremodeling workresidential dwellingworkers' compensation schemePetition for ReconsiderationFindings and Award
References
Case No. ADJ10531850
Regular
Aug 14, 2018

JORGE MACIEL IBARRA vs. TIM CAGLE, individually, doing business as TIM CAGLE DRYWALL, GREGORY AND BROOKE BAIRD, UNINSURED EMPLOYERS BENEFITS TRUST FUND (UEBTF), ALLIED SACRAMENTO

This Workers' Compensation Appeals Board case involves applicant Jorge Maciel Ibarra's claim for an industrial injury as a drywall installer. The primary issue is whether applicant was a household employee, as the Uninsured Employers Benefits Trust Fund (UEBTF) argues for exclusion. The Board rescinded the initial findings and remanded the case for the WCJ to first determine the identity of the employer and insurance status. If Tim Cagle Drywall is uninsured, the WCJ must then decide if the applicant, as an employee of an unlicensed contractor, meets the household employee wage and hour thresholds for coverage.

UEBTFPetition for ReconsiderationHousehold EmployeeLabor Code section 3352(h)Ultimate HirerUninsured ContractorLicensed ContractorSection 2750.5(c)Section 3351(d)Workers' Compensation Appeals Board
References
Case No. ADJ8475204
Regular
Aug 19, 2015

ABEL REYES GARCIA vs. LEE LAI, STATE FARM INSURANCE, UNINSURED EMPLOYERS BENEFIT TRUST FUND (UEBTF)

The Appeals Board affirmed the WCJ's decision finding the applicant excluded from workers' compensation coverage under Labor Code section 3352(h). The applicant was hired by Mr. Lai as a homeowner for less than 52 hours in the 90 days prior to his injury, and his duties were incidental to the maintenance of a residential dwelling, not Mr. Lai's business. The majority found that applicant's work at Mr. Lai's personal residence did not fall within the course of Mr. Lai's alleged business of managing rental properties. The dissenting opinion argued that Mr. Lai's management of multiple rental properties and arrangement of work for the applicant constituted a business, making the applicant an employee rather than an excluded casual residential employee.

Workers' Compensation Appeals BoardUninsured Employers Benefit Trust FundLabor Code Section 3352(h)Casual Residential EmployeeCourse of Trade Business Profession OccupationHomeowner's InsuranceIndependent Contractor PresumptionReconsiderationFindings of FactCredibility Determination
References
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