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

Case No. ADJ1435798 (ANA 0370618)
Regular
May 21, 2014

Byron Nunez vs. KRISPY CREAM, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The Workers' Compensation Appeals Board denied a Petition for Removal in the case of Byron Nunez v. Krispy Kreme, et al. The administrative law judge's report, which the Board adopted, found that the claims administrators, Specialty Risk Services (SRS) and Sedgwick Claims Management Services, Inc. (Sedgwick CMS), had a duty to know the identity of their insurance carrier and when it was liquidated. The settlement entered into was deemed a unilateral mistake by SRS and Sedgwick CMS. Therefore, the petition was denied based on these failures.

Workers' Compensation Appeals BoardPetition for RemovalWCJ reportSpecialty Risk ServicesSedgwick Claims Management Servicesinsurance carrierliquidationLumberman's Mutualsettlementlien claimant
References
2
Case No. ADJ7219588
Regular
Oct 07, 2011

NOEMI MENDOZA vs. AMERICAN APPAREL, SRS

Lien claimants sought reconsideration of a Notice of Intent to Disallow their claims due to non-appearance. The Board dismissed the petition for reconsideration, finding the Notice of Intent was not a final order. However, the Board granted removal and rescinded the Notice of Intent to allow the lien claimants to proceed at the trial level.

Lien claimantsPetition for ReconsiderationNotice of Intent to Issue Order of DisallowancePetition for RemovalDecision After RemovalRescindedFinal OrderSubstantive RightsLiabilityWCAB
References
4
Case No. LAO 831546
Regular
Jul 30, 2007

CYNTHIA WINCHESTER vs. TENET/USC UNIVERSITY HOSPITAL, C/O SRS

The Workers' Compensation Appeals Board denied Cynthia Winchester's petition for reconsideration in Case No. LAO 831546. The Board adopted the WCJ's report for denial, but ordered further proceedings on the defendant's petition to set aside the order approving compromise and release. These proceedings will commence upon return of the file to the trial level without further action by the parties.

Petition for ReconsiderationWorkers' Compensation Appeals BoardDenying ReconsiderationWorkers' Compensation Administrative Law JudgeWCJ reportPetition to set asideCompromise and ReleaseTrial level proceedingsOfficial Address RecordService by Mail
References
0
Case No. ADJ7157224
Regular
Sep 12, 2011

NORMA NERI vs. KRISPY KREME DOUGHNUTS, TWIN CITY FIRE INSURANCE, SEDGWICK CMS/SRS

This case involves Norma Neri's pro per petition for reconsideration of an approved Compromise and Release agreement. Her petition was dismissed by the Workers' Compensation Appeals Board because it was unverified, unsigned, and failed to state the grounds for reconsideration. The Board noted that Labor Code section 5902 requires verification of such petitions and that applicant had not cured this defect despite notice. Therefore, the Board found good cause to dismiss the petition.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationCompromise and Releaseunverified petitionunsigned petitionLabor Code section 5902verification defectLucena v. Diablo Auto Bodygrounds for reconsiderationmaterial evidence
References
1
Case No. ADJ809010 (LAO 0877737)
Regular
Feb 28, 2012

Jessica Leaser vs. Washington Mutual, Zurich North America, SRS/SEDGWICK Claims Management Services

The Appeals Board dismissed the lien claimant's petition for reconsideration as untimely, as it was filed three days after the statutory deadline. Although the administrative law judge (WCJ) issued a notice of intent to sanction the lien claimant for proceeding to trial without a legal basis, the Board granted removal on its own motion. The Board rescinded the sanctions, finding the WCJ's assessment of "no factual or legal basis" unsupported on the current record, and returned the case to the trial level for further proceedings.

Workers' Compensation Appeals BoardPetition for ReconsiderationUntimely PetitionJurisdictional Time LimitsRemoval on Board MotionMonetary SanctionsNotice of Intention to Impose SanctionsRescinded SanctionsLien ClaimantClaims Administrator
References
4
Case No. ADJ353115 VNO 0507183 ADJ3815018 VNO 0507186 ADJ2106065 VNO 0507185
Regular
Mar 22, 2011

FERNANDO GOMEZ vs. DESICCARE, INC., FREMONT INSURANCE in liquidation by CIGA, REDLAND INSURANCE and STATE COMPENSATION INSURANCE FUND, STRATEGIC OURSOURCING, TWIN CITY FIRE administered by SRS

This Workers' Compensation Appeals Board order denies Fernando Gomez's petition for reconsideration. The Board adopted the workers' compensation administrative law judge's report, which provided the reasons for denial. The specific grounds for the denial are not detailed in this order but are incorporated by reference from the judge's report. This decision upholds the original ruling in Gomez's case against multiple defendants and insurers.

WORKERS' COMPENSATION APPEALS BOARDDESICCAREINC.FREMONT INSURANCECIGAREDLAND INSURANCESTATE COMPENSATION INSURANCE FUNDSTRATEGIC OURSOURCINGTWIN CITY FIRESRS
References
0
Case No. ADJ2398835 (LAO 0799123)
Regular
Mar 26, 2010

LETICIA FERNANDEZ vs. MOUNT ST. MARY'S COLLEGE, CONVERIUM INSURANCE COMPANY/SRS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, SEDGWICK, INC., LEGION INSURANCE COMPANY, VILLANOVA INSURANCE COMPANY

Converium Insurance Company sought reconsideration of a decision denying its claim for reimbursement from the California Insurance Guarantee Association (CIGA). Converium had paid workers' compensation benefits to Leticia Fernandez, but later argued these payments were made in error due to applicant's denial of a specific injury. The Arbitrator recommended denying reconsideration, finding that CIGA statutes, particularly Insurance Code Sections 1063.1(c)(5) and (9), prohibit reimbursement to solvent insurance carriers for claims that are not "covered claims" or are made by assignees or subrogated parties. The Workers' Compensation Appeals Board adopted the Arbitrator's report, denying Converium's petition for reconsideration.

California Insurance Guarantee AssociationCIGAConverium Insurance CompanySRSLegion Insurance CompanyVillanova Insurance Companyliquidationreconsiderationarbitrator's reportspecific injury
References
9
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