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Case Law Database

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

Case No. ADJ9356348

Regular

Jul 03, 2018

ALEJANDRO GONZALEZ vs. JAGUAR ENTERPRISES, INC., CALIFORNIA INSURANCE, APPLIED RISK SERVICES, INC., SOUTHERN INSURANCE, CONDOR, INC., WESTCO INSURANCE, AMTRUST INSURANCE, INDEMNITY INSURANCE COMPANY OF NORTH AMERICA, ESIS, SOUTHERN INSURANCE, U.S. ADMINISTRATOR CLAIMS, LIBERTY MUTUAL INSURANCE, OLD REPUBLIC INSURANCE, ZURICH INSURANCE COMPANY

This case involves determining the applicant's date of injury for an occupational disease. Initially, the Workers' Compensation Judge (WCJ) determined the date of injury to be December 13, 2013, based on medical records suggesting work-related causation. However, the Appeals Board granted reconsideration, finding that the applicant credibly testified that his physician first linked his condition to his employment on May 13, 2013. Therefore, the Board amended the findings to establish May 13, 2013, as the date of injury pursuant to Labor Code section 5412.

Workers' Compensation Appeals BoardDate of InjuryPetition for ReconsiderationWCJ ReportMedical EvidencePneumoniaBronchitisPulmonary FibrosisHypersensitivity PneumonitisBOOP

References

Case No. ADJ7682218

Regular

Aug 05, 2015

RICHARD ROSSI vs. BINKS MANUFACTURING COMPANY, TIG INSURANCE COMPANY, ZENITH [RIVER STONE GROUP], HARTFORD INSURANCE, ACE INSURANCE COMPANY, COMMERCE AND INDUSTRY INSURANCE, AIG DOMESTIC CLAIMS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, INTERCARE INSURANCE SERVICES, AMERICAN MOTORISTS INSURANCE COMPANY, AMERICAN MANUFACTURERS MUTUAL INSURANCE COMPANY, LUMBERMEN'S MUTUAL CASUALTY, ILLINOIS TOOL WORKS, FINISHING BRANDS, ZURICH AMERICAN INSURANCE COMPANY, BROADSPIRE

The Appeals Board granted reconsideration to address applicant's contentions regarding the admissibility of vocational expert reports and his disability level. The Board reversed the exclusion of applicant's vocational expert reports, finding they should have been admitted into evidence despite CIGA's claims of insufficient notice. Issues regarding applicant's permanent disability exceeding 79%, entitlement to additional attorney's fees, and CIGA's liability for the vocational expert's costs were deferred. The case was returned to the trial level for further proceedings and decisions on these deferred issues.

CIGAvocational expertpermanent disabilityindustrial injurycancerlatency perioddue processsubstantial evidenceadmissibilityreconsideration

References

Case No. ADJ4629950

Regular

Dec 21, 2012

JOHNNY BETTENCOURT vs. DONALD WILLIAMS, SAFECO INSURANCE COMPANY, UNINSURED EMPLOYERS' BENEFIT TRUST FUND DEPARTMENT OF INDUSTRIAL RELATIONS

The Uninsured Employers' Benefit Trust Fund (UEBTF) sought reconsideration, arguing Safeco's policy covered the applicant's injury. The Arbitrator previously ruled Safeco had no liability as its policy with Donald Williams did not include "comprehensive personal liability" insurance as required by Insurance Code section 11590. The Appeals Board affirmed this decision, finding the Safeco policy explicitly limited coverage to premises liability and lacked the necessary language for comprehensive personal liability coverage. Therefore, Safeco was correctly found not liable for the applicant's injury.

Uninsured Employers' Benefit Trust Fundcomprehensive personal liability insuranceLabor Code section 3351(d)Labor Code section 3352(h)Insurance Code section 11590premises liability insuranceSafeco Insurance CompanyDonald WilliamsJohnny Bettencourtworker's compensation coverage

References

Case No. SRO 0088351

Significant

Cheryl Coldiron, Applicant vs. Compuware Corporation, California Insurance Guarantee Association

The Appeals Board affirmed a prior award, substituting the correct insurance carrier for the employer and establishing that third-party administrators must disclose their client's identity in all proceedings.

Third-party administrator disclosureInsurance Guarantee AssociationReliance National Insurance CompanyCompuware CorporationGallagher Bassett ServicesInc.High self-insured retentionPolicy provisionsLabor Code section 5813 sanctionsInsurance Code sections 11650 et seq.

References

Case No. POM 248928

Significant

Mar 28, 2003

Mark Miceli, et al. vs. Jacuzzi, Inc., Remedy Temp, Inc., American Home Assurance Co., Reliance National Indemnity Co. (In Liquidation), California Insurance Guarantee Association

The Appeals Board affirmed that when a temporary staffing agency's insurer becomes insolvent, the special employer's insurance policy constitutes 'other insurance,' making that insurer liable for the injured temporary employee's claim and relieving the California Insurance Guarantee Association (CIGA) of responsibility.

Workers Compensation Appeals BoardEn BancGeneral EmployerSpecial EmployerTemporary Staffing AgencyAlternate Employer EndorsementInsolvencyCalifornia Insurance Guarantee Association (CIGA)Covered ClaimOther Insurance

References

Case No. SRO 0088351

Significant

Mar 20, 2002

Cheryl Coldiron vs. Compuware; Permissibly Self-Insured, by And through Gallagher Bassett Services, Inc., Adjusting Agent

The board issues a notice of intent to sanction a third-party administrator for failing to disclose the correct insurance carrier for over six years and schedules a conference to clarify the employer-insurer relationship.

Workers' Compensation Appeals BoardEn BancPetition for ReconsiderationFindings and AwardPermissibly Self-InsuredThird-Party AdministratorHigh Self-Insured RetentionSanctionsLabor Code Section 5813Excusable Error

References

Case No. ADJ7286848

Regular

Aug 03, 2015

EMANUAL DAVIS vs. ATLANTA HAWKS, FEDERAL INSURANCE (CHUBB GROUP OF INSURANCE COMPANIES), TIG INSURANCE COMPANY, HOUSTON ROCKETS, SEATTLE SUPERSONICS, LIBERTY MUTUAL INSURANCE COMPANY

This case concerns a professional basketball player's cumulative injury claim against former employers and their insurers. The Workers' Compensation Appeals Board (WCAB) affirmed an award to the applicant, finding California had jurisdiction based on the applicant's games played in the state and, potentially, a contract of hire in California. Defendants argued California lacked jurisdiction, citing *Federal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)*, which held that a single game did not create a substantial connection. However, the WCAB distinguished this case, finding the applicant's California exposure more than "de minimis" and noting the applicant's testimony about an injury sustained in California. One commissioner dissented, arguing the applicant's California games constituted less than 8% of his career and thus did not establish a "legitimate and substantial connection" for jurisdiction under *Johnson*.

WCABcumulative industrial injuryprofessional basketball playerextraterritorial provisionsde minimiscontract of hirejurisdiction14th Amendmentdue processliability

References

Case No. ADJ7539480

Regular

Sep 20, 2011

GARY KREFT vs. CELESTRON, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, COMPWEST INSURANCE COMPANY, HARTFORD INSURANCE COMPANY, AMERICAN CLAIMS MANAGEMENT, STATE COMPENSATION INSURANCE FUND, Everest National Insurance Co.

This case concerns a cumulative injury claim where the Workers' Compensation Appeals Board (WCAB) granted Everest National Insurance Co.'s Petition for Removal. The WCAB amended a prior order joining Everest and other carriers, clarifying that Labor Code section 5500.5(a) limits liability for cumulative injuries to employers/insurers covering the year immediately preceding the date of injury or last exposure. As the date of injury/exposure was not yet determined and appeared to be the last day of employment, only the carriers covering that final year (CompWest and Hartford) were ordered joined. Everest was removed as a party defendant pending further determination.

Petition for RemovalLabor Code section 5500.5(a)cumulative injurylast injurious exposurejoinder of partiesWorkers' Compensation Appeals Boarddate of injuryrepetitive job dutiesCalifornia Insurance Guarantee AssociationCIGA

References

Case No. ADJ7432904

Regular

Sep 24, 2012

NEDA MOTAVAKEL vs. FANTASTIC SAM'S, TOWER SELECT INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, STAR INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, ENDURANCE WORKERS' COMPENSATION, SOUTHERN INSURANCE CO., FIRSTCOMP OMAHA

This case involves an appeal by Star and Tower Insurance Companies regarding a workers' compensation award. The primary issue is the applicant's average weekly earnings, specifically the inclusion of tip income, which was not adequately substantiated by documentary evidence. The Appeals Board found the initial decision lacked substantial evidence regarding earnings and rescinded the award. The matter is remanded for further proceedings to properly develop the evidentiary record on earnings and insurance coverage dates before a new decision is issued.

Workers' Compensation Appeals BoardNeda MotavakelFantastic Sam'sTower Select Insurance CompanyStar Insurance CompanyIllinois Midwest Insurance AgencyLLEndurance Workers' CompensationSouthern Insurance CompanyFirstComp Omaha

References

Case No. ADJ1316438

Regular

Sep 12, 2008

MARK SHORT vs. MISTRAL, EVEREST NATIONAL INSURANCE CO., AMERICAN COMMERCIAL CLAIM ADMINISTRATORS, VILLANOVA INSURANCE CO., TORTILLA FLATS, WASAU INSURANCE CO., CORNERSTONE CUTLERY, EVEREST NATIONAL INSURANCE CO., 21 OCEAN FRONT RESTAURANT, EVEREST NATIONAL INSURANCE CO., SUPERIOR NATIONAL INSURANCE CO.

The Appeals Board dismissed SCIF's petition for reconsideration, granted removal, and dismissed SCIF as a party defendant because SCIF did not insure Mistral during the relevant period nor any of the employers joined in the Order.

Workers Compensation Appeals BoardPetition for ReconsiderationRemovalSCIFFinal OrderSubstantive RightLiabilityProcedural OrderLabor Code Section 5310Cumulative Trauma Period

References

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Updated Daily

Case Law Database

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

Case No. ADJ9356348

Regular

Jul 03, 2018

ALEJANDRO GONZALEZ vs. JAGUAR ENTERPRISES, INC., CALIFORNIA INSURANCE, APPLIED RISK SERVICES, INC., SOUTHERN INSURANCE, CONDOR, INC., WESTCO INSURANCE, AMTRUST INSURANCE, INDEMNITY INSURANCE COMPANY OF NORTH AMERICA, ESIS, SOUTHERN INSURANCE, U.S. ADMINISTRATOR CLAIMS, LIBERTY MUTUAL INSURANCE, OLD REPUBLIC INSURANCE, ZURICH INSURANCE COMPANY

Workers' Compensation Appeals BoardDate of InjuryPetition for ReconsiderationWCJ ReportMedical EvidencePneumoniaBronchitisPulmonary FibrosisHypersensitivity PneumonitisBOOP

References

Case No. ADJ7682218

Regular

Aug 05, 2015

RICHARD ROSSI vs. BINKS MANUFACTURING COMPANY, TIG INSURANCE COMPANY, ZENITH [RIVER STONE GROUP], HARTFORD INSURANCE, ACE INSURANCE COMPANY, COMMERCE AND INDUSTRY INSURANCE, AIG DOMESTIC CLAIMS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, INTERCARE INSURANCE SERVICES, AMERICAN MOTORISTS INSURANCE COMPANY, AMERICAN MANUFACTURERS MUTUAL INSURANCE COMPANY, LUMBERMEN'S MUTUAL CASUALTY, ILLINOIS TOOL WORKS, FINISHING BRANDS, ZURICH AMERICAN INSURANCE COMPANY, BROADSPIRE

CIGAvocational expertpermanent disabilityindustrial injurycancerlatency perioddue processsubstantial evidenceadmissibilityreconsideration

References

Case No. ADJ4629950

Regular

Dec 21, 2012

JOHNNY BETTENCOURT vs. DONALD WILLIAMS, SAFECO INSURANCE COMPANY, UNINSURED EMPLOYERS' BENEFIT TRUST FUND DEPARTMENT OF INDUSTRIAL RELATIONS

References

Case No. SRO 0088351

Significant

Cheryl Coldiron, Applicant vs. Compuware Corporation, California Insurance Guarantee Association

References

Case No. POM 248928

Significant

Mar 28, 2003

Mark Miceli, et al. vs. Jacuzzi, Inc., Remedy Temp, Inc., American Home Assurance Co., Reliance National Indemnity Co. (In Liquidation), California Insurance Guarantee Association

References

Case No. SRO 0088351

Significant

Mar 20, 2002

Cheryl Coldiron vs. Compuware; Permissibly Self-Insured, by And through Gallagher Bassett Services, Inc., Adjusting Agent

References

Case No. ADJ7286848

Regular

Aug 03, 2015

EMANUAL DAVIS vs. ATLANTA HAWKS, FEDERAL INSURANCE (CHUBB GROUP OF INSURANCE COMPANIES), TIG INSURANCE COMPANY, HOUSTON ROCKETS, SEATTLE SUPERSONICS, LIBERTY MUTUAL INSURANCE COMPANY

WCABcumulative industrial injuryprofessional basketball playerextraterritorial provisionsde minimiscontract of hirejurisdiction14th Amendmentdue processliability

References

Case No. ADJ7539480

Regular

Sep 20, 2011

GARY KREFT vs. CELESTRON, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, COMPWEST INSURANCE COMPANY, HARTFORD INSURANCE COMPANY, AMERICAN CLAIMS MANAGEMENT, STATE COMPENSATION INSURANCE FUND, Everest National Insurance Co.

References

Case No. ADJ7432904

Regular

Sep 24, 2012

NEDA MOTAVAKEL vs. FANTASTIC SAM'S, TOWER SELECT INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, STAR INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, ENDURANCE WORKERS' COMPENSATION, SOUTHERN INSURANCE CO., FIRSTCOMP OMAHA

References

Case No. ADJ1316438

Regular

Sep 12, 2008

MARK SHORT vs. MISTRAL, EVEREST NATIONAL INSURANCE CO., AMERICAN COMMERCIAL CLAIM ADMINISTRATORS, VILLANOVA INSURANCE CO., TORTILLA FLATS, WASAU INSURANCE CO., CORNERSTONE CUTLERY, EVEREST NATIONAL INSURANCE CO., 21 OCEAN FRONT RESTAURANT, EVEREST NATIONAL INSURANCE CO., SUPERIOR NATIONAL INSURANCE CO.

Workers Compensation Appeals BoardPetition for ReconsiderationRemovalSCIFFinal OrderSubstantive RightLiabilityProcedural OrderLabor Code Section 5310Cumulative Trauma Period

References

Showing 1-10 of 9,692 results

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