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

Case No. SJO 0265682
Regular
Aug 15, 2008

WILBERT LEE vs. COCA-COLA BOTTLING CO., Permissibly Self-Insured, Adjusted by SEDGWICK CMS

The Workers' Compensation Appeals Board (WCAB) granted Wilbert Lee's petition for reconsideration of a prior decision. This reconsideration is necessary to allow the WCAB further time to thoroughly study the factual and legal issues presented in the case. The WCAB aims to issue a just and reasoned decision after this comprehensive review and potential further proceedings. All future communications should be directed to the WCAB's Reconsideration Unit.

Workers' Compensation Appeals BoardPetition for ReconsiderationGranting ReconsiderationStatutory Time ConstraintsFactual IssuesLegal IssuesJust and Reasoned DecisionFurther ProceedingsDecision After ReconsiderationReconsideration Unit
References
0
Case No. SJO 181617 SJO 181469 SJO 187564 SJO 187565
Regular
Sep 17, 2007

ANITA BLICK vs. TOWN OF ATHERTON, CITIES INSURANCE GROUP

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award because the applicant's criminal conviction, which was the basis for restitution, had been vacated. The Board determined that restitution claims are intrinsically linked to the vocational rehabilitation benefits claim. Therefore, the case is returned to the trial level for a new WCJ to decide both issues after the applicant's criminal proceedings are finally resolved.

Vocational RehabilitationVRMARestitutionPenal Code section 550(b)(3)FraudCriminal ConvictionVacated ConvictionReconsiderationAppeals BoardWCJ
References
0
Case No. ADJ4606826 (SJO 0265682)
Regular
Jul 01, 2009

WILBERT LEE vs. COCA-COLA BOTTLING CO., Permissibly Self-Insured, Adjusted By SEDGWICK CMS

In this workers' compensation case, the Board rescinded its prior decision and found the applicant entitled to temporary total disability indemnity. This indemnity is awarded for the period between November 21, 2007, and January 28, 2008, when the applicant was medically deemed unable to work. However, the applicant is estopped from receiving temporary disability indemnity for periods of temporary partial disability due to refusing modified work without good cause. The Board affirmed its finding that the applicant is not entitled to temporary disability for periods of partial disability for the reasons stated in its earlier opinion.

Workers' Compensation Appeals BoardReconsiderationTemporary Disability IndemnityModified WorkEstoppelAgreed Medical EvaluatorPrimary Treating PhysicianTemporary Total DisabilityTemporary Partial DisabilityOdd Lot Doctrine
References
4
Case No. SJO 0245864, SJO 0245865, SJO 0245866
Regular
Jul 14, 2008

ANITA REXINGER vs. ELECTROLUX CORPORATION, WAUSAU INSURANCE COMPANIES

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The Board found that the applicant waived the jurisdictional argument regarding the Rehabilitation Unit's determination by not raising it at trial. The applicant's arguments regarding the interpretation of *Gamble* were also rejected, though the Board noted a pending Supreme Court review in a similar case that may impact future proceedings.

Workers' Compensation Appeals BoardElectrolux CorporationWausau Insurance CompaniesVocational Rehabilitation Temporary Disability (VRTD)concurrent employmentDetermination of the Rehabilitation UnitLabor Code section 5804Gamble v. Workers' Comp. Appeals Bd.Medrano v. Workers' Comp. Appeals Bd.writ of review
References
2
Case No. SJO 0258370; SJO 0258371; SJO 0264287
Regular
Oct 22, 2007

SHERI COSBY vs. M. E. FOX & CO., ACCLAMATION INSURANCE MANAGEMENT SYSTEMS [AIMS]

The Appeals Board dismissed the applicant's petition for reconsideration of a denial to withdraw from a QME due to it not being a final order. However, the Board granted removal and rescinded the judge's order, allowing the applicant to withdraw from the QME due to the defendant's improper submission of non-medical information post-examination, violating Labor Code section 4062.3. While acknowledging the applicant's delay in raising the issue, the Board found no waiver or laches, ordering a new QME evaluation.

QME withdrawalLabor Code 4062.3improper communicationnon-medical informationpro per applicantattorney representationpetition for reconsiderationremoval motionAppeals Boardstatutory violation
References
3
Case No. SJO 0245865 SJO 0245864 SJO 0245866
Regular
Apr 22, 2008

ANITA REXINGER vs. ELECTROLUX CORPORATION, WAUSAU INSURANCE COMPANIES

The Appeals Board granted reconsideration to clarify vocational rehabilitation temporary disability (VRTD) benefits, holding that earnings from subsequent employment may offset VRTD if the applicant was not concurrently employed at the time of injury. The Board also directed that VRTD benefits should be reduced by unemployment insurance paid for the same period and affirmed the applicant's 1997 W-2 as the basis for calculating average weekly earnings. Finally, the Board rescinded the prior award and returned the matter for further proceedings, including potential reconsideration of the unreasonable delay penalty.

VOCATIONAL REHABILITATIONRECONSIDERATIONSTIPULATIONSPERMANENT DISABILITYREHABILITATION UNITDELAY RATEAVERAGE WEEKLY WAGEATTORNEY FEESCREDIT FOR EARNINGSUNREASONABLE DELAY
References
2
Case No. SJO 238655 SJO 238656 SJO 238657
Regular
Apr 02, 2008

JAMES BEENE vs. ANDERSON CHEVROLET/AUTONATION, INC., ACE-USA, UNIVERSAL UNDERWRITERS GROUP

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award because the Agreed Medical Examiner's opinion was based on an incorrect legal theory regarding industrial causation. The Board found that the AME's opinion that the applicant's vascular condition was not industrially caused or aggravated was not substantial evidence, requiring further development of the record. Therefore, the case was returned to the trial level for the AME to provide a supplemental opinion on whether the vascular condition was industrially caused or a consequence of the admitted injury.

workers compensationindustrial injuryvascular systemagreed medical evaluatorAMEreconsiderationtemporary disability indemnityTDIlien claimsubrogation
References
15
Case No. ADJ1825244 (SJO 0218090) ADJ409934 (SJO 0218091) ADJ2092501 (SJO 0243094) ADJ2437045 (SJO 0226020)
Regular
Feb 04, 2011

FESSAHAIE TESFAGIORGIS vs. LIFESCAN/JOHNSON & JOHNSON, OLD REPUBLIC Adjusted By BROADSPIRE

This case involves applicant Fessahaine Tesfagiorgis seeking reconsideration of a workers' compensation award. The defendant, Lifescan/Johnson & Johnson, also petitioned for reconsideration. The Appeals Board granted the defendant's petition and denied the applicant's, amending the original award. Specifically, the psychiatric impairment rating was reduced, resulting in a lower overall permanent disability award of 60% totaling $58,862.50. The applicant's attorney's fee was adjusted to 20% of this revised award, totaling $11,772.50, which the Board found to be reasonable given the case's complexity and the attorney's efforts.

WCABReconsiderationFindings and AwardIndustrial InjuryBilateral FeetRight ShoulderRight WristNeckPsychePermanent Disability
References
0
Case No. ADJ746026 (SJO 0221595) ADJ1315805 (SJO 0221596) ADJ2490198 (SJO 0221597) ADJ1525795 (SJO 0234303)
Regular
Feb 03, 2010

GILBERT GASKA vs. EAST SIDE UNION HIGH SCHOOL, ACE/USA, CALIFORNIA INSURANCE GUARANTEE ASSOCATION

This case involves claims for reimbursement between two insurers covering applicant's industrial injuries. CIGA, representing an insolvent insurer, sought reimbursement from ACE/USA for medical benefits paid. The arbitrator initially awarded CIGA approximately $105,000, later amended to $138,555.15 due to a clerical error. ACE/USA petitioned for reconsideration, arguing CIGA's claim was untimely and improperly based on contribution or subrogation. The Board dismissed CIGA's petition as moot because the corrected award had already been issued. The Board denied ACE/USA's petition, clarifying CIGA's claim was for reimbursement under Insurance Code section 1063.1, not untimely contribution or subrogation, and that ACE/USA was liable due to providing "other insurance" for the same injuries.

Workers' Compensation Appeals BoardCalifornia Insurance Guarantee AssociationCIGAACE/USAFremont Compensation Insurance Companyinsolvencycumulative injuryspecific injuryreimbursementcontribution
References
3
Case No. ADJ2844570 (SJO 0266373) ADJ4420741 (SJO 0267631) ADJ3297316 (SJO 0267632)
Regular
Jan 04, 2013

VERNA PARKS vs. BRADDOCK & LOGAN, SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board has dismissed Verna Parks' Petition for Reconsideration. The petitioner formally withdrew the petition, rendering it moot. Consequently, the Board issued an order dismissing the reconsideration of the October 17, 2012 decision. This action concludes the reconsideration phase of this case.

Petition for ReconsiderationDismissedWithdrawnWorkers' Compensation Appeals BoardApplicantDefendantsCase NosOrderDecisionConcur
References
0
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