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

Case No. ADJ3995122 (OAK 0343980)
Regular
Aug 13, 2013

ROSA GOMEZ vs. NOB HILL FOODS, YORK INSURANCE SERVICES

The Workers' Compensation Appeals Board granted removal to address the exclusion of sub rosa films and investigator testimony. The trial judge had excluded this evidence because it was disclosed late and not shown to treating doctors. However, the Board found that the defendant properly disclosed the evidence and investigators at the mandatory settlement conference per Labor Code § 5502(d)(3). The admissibility of the sub rosa films and investigator testimony is now deferred to the trial judge.

Sub rosa filmsremovalmandatory settlement conferencedisclosureevidence exclusioninvestigative reportsLabor Code section 5502petition for removalpetition for reconsiderationWorkers' Compensation Appeals Board
References
Case No. ADJ9793567
Regular
Aug 19, 2015

ROSA CAMACHO vs. RIVER RANCH FRESH FOODS, ZURICH NORTH AMERICA INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed Rosa Camacho's petition for reconsideration because it was not taken from a "final" order, as it only addressed an intermediate procedural or evidentiary issue. The WCAB also denied her petition for removal, an extraordinary remedy, finding no showing of substantial prejudice or irreparable harm if removal were denied. The WCAB adopted the judge's report, which detailed why the issues raised were not final determinations of substantive rights or threshold matters. Therefore, the petition for reconsideration was dismissed, and the petition for removal was denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFinal OrderSubstantive RightThreshold IssueInterlocutory DecisionExtraordinary RemedySubstantial PrejudiceIrreparable Harm
References
Case No. ADJ7300567
Regular
Oct 11, 2013

Rosa Perez vs. Melton Franchise Systems, Inc., Coverall Mountain & Pacific, Liberty Mutual Insurance Company

In this case, the Workers' Compensation Appeals Board reversed a lower judge's decision, finding that Rosa Perez was an employee of Melton Franchise Systems, Inc. (Coverall) when she sustained an injury on October 22, 2008. The Board determined that despite a "Janitorial Franchise Agreement" designating her as an independent contractor, Coverall exercised pervasive control over her work. Factors such as required use of Coverall's supplies, dictated cleaning procedures, and the integral nature of her janitorial work to Coverall's business demonstrated an employer-employee relationship. The Board concluded that Coverall failed to rebut the presumption of employee status.

Workers Compensation Appeals BoardRosa PerezMelton Franchise SystemsCoverall Mountain & PacificLiberty Mutual Insurance CompanyADJ7300567Opinion and Decision After ReconsiderationJanitorial Franchise Agreementindependent contractoremployee status
References
Case No. ADJ1959622 (AHM 0143618) ADJ3555484 (AHM 0143619)
Regular
Feb 14, 2011

KAI-SEN TSAI vs. SUN SALES LA, INC., UNINSURED EMPLOYERS BENEFIT TRUST FUND, Rosa Lam

The Workers' Compensation Appeals Board dismissed Rosa Lam's petition for reconsideration of an approved Compromise and Release because it was filed untimely. Lam, acting "in pro per" despite being represented by counsel, alleged fraud, non-industrial causes, witness credibility issues, and ineffective assistance of her attorney who allegedly coerced her into signing the settlement. The Board found the petition was filed 29 days after the order, exceeding the 20-day jurisdictional deadline. Even if timely, the Board would have denied it, as ineffective assistance of counsel is not grounds to set aside an order and no undue influence was demonstrated.

Workers' Compensation Appeals BoardSun Sales LAInc.Uninsured Employers Benefit Trust FundRosa LamPetition for ReconsiderationOrder Approving Compromise and ReleaseIn Pro PerFraudulent ClaimsNon-Industrial Causes
References
Case No. ADJ1036250 (LBO 0379542)
Regular
Jan 02, 2014

RAMON BAUTISTA vs. DE LA ROSA MANUFACTURING, INC., BERKSHIRE HATHAWAY HOMESTATE INSURANCE COMPANY AND CASUALTY INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed a Petition for Reconsideration filed by a lien claimant in the case of Bautista v. De La Rosa Manufacturing, Inc. The WCAB found the petition to be untimely because it was filed more than 25 days after the October 15, 2013 order, exceeding the statutory deadline. Additionally, the petition was dismissed for being unverified. Therefore, the WCAB ordered the Petition for Reconsideration dismissed.

Petition for ReconsiderationUntimely filingLabor Code section 5903Code of Civil Procedure section 1013DismissalUnverifiedWorkers' Compensation Appeals BoardAdministrative law judgeLien claimantDe La Rosa Manufacturing
References
Case No. ADJ4016007
Regular
Oct 05, 2009

ROSA ALVAREZ, ROSA ALVAREZ-GARAY vs. WATERWAY PLASTICS, US FIRE INSURANCE COMPANY

The petition for reconsideration is granted to allow sufficient opportunity to further study the factual and legal issues.

Petition for ReconsiderationWorkers' Compensation Appeals BoardWaterway PlasticsUS Fire Insurance CompanyMatrix Absence ManagementRosa AlvarezOpinion and OrderStatutory Time ConstraintsFactual and Legal IssuesDecision After Reconsideration
References
Case No. ADJ4707980 (VNO 0543260) ADJ3907003 (VNO 0543258) ADJ7500629
Regular
Apr 05, 2012

RAMON SALAZAR vs. CONSOLIDATED DISPOSAL SERVICE, ACE USA Administered By CANNON COCHRAN MANAGEMENT SERVICES INC.

The Appeals Board granted removal, rescinding the WCJ's order for a sanctions hearing and the appearance of the defendant's claims examiner. While acknowledging the duty to disclose evidence before a trial, the Board found no authority requiring pre-expedited hearing disclosure of sub rosa films, thus negating grounds for sanctions. The Board also determined an affidavit from the claims examiner would suffice, making her live appearance unnecessary. The order for the sub rosa films to be sent to the Agreed Medical Examiner was affirmed.

sub rosa filmsexpedited hearingsanctionsPetition for RemovalAgreed Medical Examinertemporary disability indemnitymedical treatmentclaims examineraffidavitLabor Code section 5813
References
Case No. ADJ1479326 (ANA 0411799) ADJ7233578
Regular
Oct 07, 2014

JONATHAN DUONG vs. AUTOMOBILE CLUB OF SOUTHERN CALIFORNIA, HARTFORD INSURANCE COMPANY OF THE MIDWEST

The Workers' Compensation Appeals Board overturned a WCJ's decision to exclude sub rosa surveillance video. The Board found no legal basis for excluding the video obtained in a mobile home park parking lot and a grocery store, as the applicant lacked a reasonable expectation of privacy in those public areas. The Board determined that the defendant would suffer significant prejudice from the exclusion, justifying removal of the case. Therefore, the sub rosa video was ruled admissible and may be provided to medical evaluators.

Sub rosa videoremovalreconsiderationadmissibilityinvasion of privacyreasonable expectation of privacycivil liabilityworkers' compensation fraudmedical-legal evaluatorworkers' compensation appeals board
References
Case No. ADJ4617752 (VNO 0390167), ADJ1668605 (VNO 0470519)
Regular
Nov 01, 2010

ROBERT SCHENCK vs. COLIN CLINTON, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, RELIANCE INSURANCE COMPANY, AFFORDABLE QUALITY MOVING & STORAGE, STATE COMPENSATION INSURANCE FUND

This case involves applicant Robert Schenck's petition for reconsideration of a workers' compensation award. Schenck argued the judge erred by admitting sub-rosa video evidence and by not finding total disability based on Dr. Lavi's opinion. The Board denied the petition, finding the sub-rosa evidence was properly admitted and that Dr. Lavi's opinion lacked substantial evidentiary support for total disability. The Board affirmed the WCJ's reliance on defense medical reports finding permanent disability of 29% after apportionment.

SubrogationSub rosa evidenceMandatory Settlement ConferencePermanent DisabilityApportionmentWorkers' Compensation JudgeReconsiderationSubstantial EvidenceQualified Medical ExaminerDoctor-shopping
References
Case No. ADJ387595 (VNO 0552648)
Regular
Jul 12, 2016

JOEL CARDENAS vs. ML ELECTRIC WORKS, INC, ZURICH AMERICAN INSURANCE COMPANY, ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board granted the defendant's petition for removal, modifying a prior order by an administrative law judge. The Board removed the issues of penalty, costs, and sanctions related to the disclosure of sub rosa video and surveillance logs from trial consideration. However, the Board affirmed the remainder of the judge's order, which had compelled the defendant to serve the sub rosa materials and produce the claims adjuster and documents at trial. This decision aimed to prevent further discovery beyond the mandatory settlement conference cutoff while still requiring disclosure of the surveillance evidence.

Sub rosa videoPetition for RemovalMandatory Settlement ConferenceDiscovery cut-offDue processIrreparable harmClaims adjusterLabor Code section 5502(d)(3)PenaltySanctions
References
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