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

Case No. ADJ8878991
Regular
Jan 31, 2014

JAY SCHETTLER vs. ALLIED BEVERAGES, INC.; CYPRESS INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration of the administrative law judge's finding of injury. The applicant, a route salesman, claimed he stepped on glass, injuring his left foot, which was corroborated by medical records showing a cut and the applicant's delayed awareness due to diabetic neuropathy. Defense witness testimony also supported the applicant's claim of cutting his toe at work. The Board found the applicant's testimony credible and the medical evidence sufficient to establish the injury arose out of and in the course of employment.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Factterritory route salesmanmechanism of injurydiabetic neuropathycredibilitymedical recordsReport and Recommendationurgent care
References
Case No. ADJ8365866
Regular
May 02, 2014

CESAR MARTIN vs. STUDIO CHAMELEON LLC, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration, affirming the finding that the applicant's injury arose out of and occurred in the course of employment. The Board found the applicant's stop at a friend's house to retrieve a phone charger benefited the employer by enabling continued communication. Additionally, the auto accident occurred after the applicant left his friend's house and was en route back to the employer's premises on a normal route, thus concluding any deviation. The Board also clarified the legal distinction between "scope of employment" (a tort concept) and "course of employment" (a workers' compensation term of art).

Workers' Compensation Appeals BoardPetition for Reconsiderationdeniedcourse of employmentscope of employmentmotor vehicle accidentmaterial deviationemployer's instructionsapplicant's benefitpersonal comfort
References
Case No. ADJ1421850 (FRE0216376)
Regular
Aug 17, 2009

BILL CUSTER vs. SARA LEE BAKERY GROUP

The Workers' Compensation Appeals Board granted reconsideration to review a finding of serious and willful misconduct by the employer, Sara Lee Bakery Group. The applicant sustained a knee and groin injury due to a broken bread tray, and the initial finding of misconduct was based on testimony about past practices. However, the Board found no evidence that the employer's executive or managing officers knew serious injury was probable or acted with reckless disregard for consequences. Consequently, the prior award finding serious and willful misconduct was rescinded, and a new decision was issued stating the injury was not caused by the employer's serious and willful misconduct.

Workers' Compensation Appeals BoardSerious and Willful MisconductLabor Code § 4553Findings and AwardReconsiderationRescindedApplicantDefendantRoute SalesmanIndustrial Injury
References
Case No. ADJ7021596
Regular
Aug 02, 2010

PAMELA MENDES vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board denied Pamela Mendes' petition for reconsideration of an order regarding her claim against the County of Los Angeles. The Board adopted the WCJ's report, which found Mendes not credible due to inconsistencies in her testimony about her route and the purpose of her travel at the time of her accident. The WCJ determined that Mendes had significantly deviated from her employment duties, and there was no substantial evidence to support her claim that the injury arose out of and occurred in the course of employment.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ credibility determinationGarza v. Workmen's Comp. Appeals Bd.Lamb v. Workmen's Comp. Appeals Bd.communications systems analystcourse of employmentdeviation from routeMapQuestPomona Valley Chrysler Jeep v. WCAB (Scovill)
References
Case No. ADJ10204167
Regular
Oct 17, 2017

MARTIN POIRIER vs. MERCY HOUSING, INC., TRAVELERS PROPERTY CASUALTY COMPANY

This case involves a workers' compensation claim where the applicant suffered injuries from an automobile accident. The defendant sought reconsideration of the original finding that the injuries arose out of and in the course of employment. The Appeals Board granted reconsideration solely to admit the police report and applicant's recorded statement into evidence. While acknowledging issues with applicant's credibility, the Board affirmed the original finding, concluding that deviations from the commute route were minor and foreseeable. A dissenting opinion argued that the applicant's inconsistent statements and significant unaccounted-for time constituted a substantial deviation, thus abandoning employment.

AOE/COEgoing and coming rulerequired vehicle exceptionsubstantial deviationabandonment of employmentcredibility assessmentpolice reportrecorded statementcustom routeincidental personal acts
References
Case No. ADJ3190120
Regular
Dec 05, 2008

RICK HAVENS vs. VERIZON WIRELESS, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board (WCAB) dismissed Rick Havens' petition for reconsideration. The WCAB adopted the WCJ's recommendation to dismiss the petition as untimely, meaning it was filed after the statutory deadline. Even if considered on its merits, the WCAB would have denied the petition, as it found no error in the original order denying a psyche injury claim AOE/COE.

AOE/COEpsyche injurygood faith personnel actionspetition for reconsiderationuntimelyFindings and OrderWCJWorkers' Compensation Appeals Boardadministrative law judgeReport and Recommendation
References
Case No. ADJ6818376 ADJ6818374 ADJ7135107
Regular
Feb 07, 2011

DAVID CARRASCO vs. NAMCO CYBERTAINMENT, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

This case concerns David Carrasco's workers' compensation claim for industrial injuries sustained while employed by Namco Cybertainment. The Workers' Compensation Appeals Board denied Carrasco's petition for reconsideration, affirming the Administrative Law Judge's findings. The Board found that Carrasco failed to prove his claimed injuries by a preponderance of evidence, citing a lack of credible testimony and substantial medical evidence. Additionally, the employer's failure to post notices did not create a presumption of injury, and Carrasco did not meet the requirements of Labor Code section 3600(a)(10) for claims filed after layoff.

Workers' Compensation Appeals BoardIndustrial InjuryRoute ManagerPreponderance of EvidenceLabor Code Section 5401Labor Code Section 3550Labor Code Section 3551Reconsideration DeniedCumulative TraumaSection 3600(a)(10)
References
Case No. ADJ2800461 (VNO 0521396)
Regular
Dec 23, 2008

WON JAE LEE vs. HYOUNG KOOK LEE dba GLENDALE NEWS SERVICES, KOREAN CENTRAL DAILY NEWS, REDWOOD FIRE AND CASUALTY, UNINSURED EMPLOYERS BENEFITS TRUST FUND

This case involves a dispute over whether the applicant was an employee of Korean Central Daily News (Daily) or an independent contractor of Hyoung Kook Lee (HKL) when injured while delivering newspapers. The Workers' Compensation Appeals Board affirmed the WCJ's finding that the applicant was an employee of Daily. The Board found that Daily exercised sufficient control over the applicant's work, including providing the newspapers, customers, and delivery instructions, despite HKL's role as a purported manager.

Workers' Compensation Appeals BoardIndustrial InjuryNewspaper CarrierEmployee StatusIndependent Business OwnerAgencyControl of WorkEmployer LiabilityUninsured Employers Benefit Trust FundReconsideration Denied
References
Case No. ADJ2401554
Regular
Apr 02, 2013

JOSHUA GROSSMAN vs. ARAMARK UNIFORM SERVICE, ACE AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding its prior decision to grant the lien claimant's claim for medical treatment costs. The Board found that the defendant failed to properly notify the applicant of their Medical Provider Network (MPN) and that the applicant's attempts to secure an MPN physician were unsuccessful. Defendant's failure to provide sufficient assistance in transferring care was deemed a neglect to provide reasonable medical treatment, making them liable for self-procured treatment. The Board also found the lien claimant's treatment reasonable and consistent with the Agreed Medical Examiner's recommendations.

MPNMedical Provider NetworkLien ClaimantReconsiderationSelf-Procured Medical TreatmentAgreed Medical ExaminerPrimary Treating PhysicianLabor Code Section 4600Substantial Medical EvidenceIndustrial Injury
References
Case No. SAL 0116965
Regular
Nov 06, 2007

Valentine Ushakoff vs. MONTEREY GOURMET FOODS, SENTRY CLAIMS COMPANY, SENTRY CLAIMS SERVICE

The applicant sought reconsideration, arguing a total disk replacement constituted an amputation and thus entitled them to extended temporary disability benefits beyond the 104-week limit. The Appeals Board affirmed the WCJ's finding that the surgery was not an amputation under Labor Code section 4656(c)(2)(C), as it involved internal body parts. The Board deferred issues regarding credit for overpayment of temporary disability and an EDD lien for further determination.

Workers' Compensation Appeals BoardOpinion and Decision After Reconsiderationindustrial injuryroute driverthoracolumbar spineCharité total disk replacementamputationLabor Code section 4656(c)(2)(C)temporary disability indemnitydeferred issues
References
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