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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ10204439
Regular
Sep 02, 2016

JEFF SMITH vs. COUNTY OF RIVERSIDE

The Workers' Compensation Appeals Board denied the County of Riverside's petition for reconsideration. The Board found that Deputy Sheriff Jeff Smith's injury, sustained en route to mandatory employer-ordered training, fell under the "special mission" exception to the "going and coming rule." The training's deviation in location, time, and nature from Smith's regular duties satisfied the three-part test for a special mission. Therefore, Smith's injury was deemed to have arisen out of and occurred in the course of employment.

going and coming rulespecial mission exceptionspecial errand exceptionDeputy Sherifftraffic investigation classBen Clark Training Centermotor vehicle accidentcourse of employmentroutine dutiesemployer's benefit
References
Case No. ADJ7665162, ADJ7647930, ADJ7644904
Regular
Apr 11, 2014

MARTINA MONTANO vs. WEST COAST PLASTICS, INC., ZENITH INSURANCE CO., CYPRESS INSURANCE CO., INSURANCE CO. OF THE WEST

The Appeals Board granted reconsideration, rescinded dismissal orders for lien claimants LYG Professional Medical Group and Southern California Sports Rehabilitation, and returned the matter to the trial level. This was because the dismissal orders were not properly served on the lien claimants' agent of record, MBS Systems. Additionally, the record was unclear as to whether MBS Systems' representative appeared at the lien conference. Consequently, the Board found further proceedings necessary to determine the status of the liens.

Lien ClaimantsPetition for ReconsiderationSelf-Executing OrderLien ConferenceDismissal with PrejudiceRule 10500(b)Designated ServiceAgent of RecordRule 10510Proof of Service
References
Case No. ADJ10232182
Regular
Jul 07, 2017

JOSE SAENZ vs. WILLIAM STOESSER, CLAIRE WERNER, REBECCA B. PISCITELLI 2012 SPECIAL TRUST DATED 12/21/2012, ADAM W. BUCK 2012 SPECIAL TRUST Dated 12/21/2012, BENJAMIN C. BUCK 2012 SPECIAL TRUST Dated 12/21/2012, STATE FARM INSURANCE

This case involves a workers' compensation claim where the applicant, Jose Saenz, was injured on April 10, 2015. State Farm sought reconsideration of an arbitrator's finding that four of its insurance policies provided coverage. The Appeals Board granted reconsideration, finding the arbitrator's coverage determination premature. The Board rescinded the prior order and returned the matter to the trial level for a determination of who constitutes the applicant's employer(s) before insurance coverage issues can be addressed.

Workers Compensation Appeals BoardPetitions for ReconsiderationDecision After ReconsiderationWilliam StoesserClaire WernerRebecca B. Piscitelli 2012 Special TrustAdam W. Buck 2012 Special TrustBenjamin C. Buck 2012 Special TrustState Farm InsuranceHomeowner's Policy
References
Case No. ADJ2112759 (ANA 0406243)
Regular
Feb 22, 2009

Matt Todd vs. INTERNATIONAL TRANSPORTATION SERVICES, THE HARTFORD

The Workers' Compensation Appeals Board reversed a finding that applicant Matt Todd sustained an industrial injury during his commute. The Board determined that Todd's motorcycle accident en route from the Union Hall to the employer's premises was barred by the "going and coming" rule. Todd failed to establish that the trip was an extraordinary mission or that the commute involved a special risk distinct from the general public. Furthermore, the Board found insufficient evidence that the Union Hall acted as the employer's agent in dispatching Todd.

Workers' Compensation Appeals BoardReconsiderationIndustrial InjuryMotorcycle AccidentCommuteUnion HallCasual LaborerGoing and Coming RuleSpecial Mission DoctrineSpecial Risk Exception
References
Case No. OAK 0267949
Regular
Jul 14, 2008

MARIO VALDEZ vs. ITO CARIANI SAUSAGO CO., TOKIO MARINE FIRE INSURANCE, RANDSTAD/ACCUSTAFF BY CIGA THROUGH ITS SERVICING FACILITY BROADSPIRE ON BEHALF OF LEGION INSURANCE IN LIQUIDATION

This case concerns an industrial injury sustained by an employee loaned from a general employer (Randstad/Accustaff) to a special employer (Ito Cariani Sausage Co.). The Workers' Compensation Appeals Board denied reconsideration of a finding that Tokio Marine and Fire Insurance, the special employer's carrier, was liable, despite the general employer's original insurer becoming insolvent. The Board found no evidence of a valid agreement under Labor Code § 3602(d) shifting responsibility to the general employer's insurer, and thus Tokio remained liable as "other insurance" available to the claimant.

Special employmentGeneral employerSpecial employerTokio Marine Fire InsuranceRandstad AccustaffLegion InsuranceCIGAInsurance Code section 11663Labor Code section 3602(d)Joint and several liability
References
Case No. ADJ4521232 (MON 026903)
Regular
May 10, 2010

DELFINA MARTINEZ vs. TARRANT APPAREL dba FASHION RESOURCE, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for SUPERIOR NATIONAL INSURANCE COMPANY, BROADSPIRE

This case concerns applicant Delfina Martinez's psychiatric injury claim against Tarrant Apparel, which was initially denied due to less than six months of direct employment, as required by Labor Code section 3208.3(d). The Appeals Board granted reconsideration, finding that Martinez's prior employment as a special employee for Tarrant Apparel for over six months, through a staffing agency, satisfied the statutory requirement. The Board held that the time spent as a special employee counts towards the six-month employment period for the purpose of psychiatric injury claims. Therefore, the prior decision barring the claim was rescinded, and the case was returned for further proceedings.

Labor Code section 3208.3psychiatric injuryspecial employeegeneral employerspecial employerjoint employmentsix-month rulefashion resourcepersonnel plusindustrial injury
References
Case No. ADJ7987695 ADJ7987686
Regular
May 08, 2014

VANESSA BRUCE vs. VALLEY HEALTH SYSTEM/PHYSICIANS FOR HEALTHY HOSPITALS; CRUM & FORSTER AND TRISTAR RISK MANAGEMENT

The applicant, a licensed vocational nurse, sought workers' compensation for injuries sustained when she fell asleep driving home after working three extra hours off the clock due to a coworker's issue. The Workers' Compensation Appeals Board (WCAB) denied her petition for reconsideration. The WCAB found the injury did not arise out of or occur in the course of employment, as the "going and coming rule" applied and neither the "special mission" nor "special risk" exceptions were met. The applicant's decision to stay late was voluntary, not at the employer's request, and falling asleep while driving is a common risk, not a special employment-related hazard.

Workers' Compensation Appeals BoardLicensed Vocational NurseSpecific InjuryNeck InjuryBack InjuryHeadachesCumulative InjurySleep DisorderGoing and Coming RuleSpecial Mission Exception
References
Case No. ADJ8406544
Regular
May 26, 2017

TONY BUTLER vs. QUALITY PERSONNEL, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, BAXTER HEALTHCARE, OLD REPUBLIC INSURANCE COMPANY

This case concerns Baxter Healthcare's petition for reconsideration of a finding that applicant Tony Butler was a special employee of Baxter. The Workers' Compensation Appeals Board denied the petition, upholding the finding of special employment based on Baxter's significant control over Butler's work, including training, the ability to replace him, and negotiation of his pay rate. Baxter and its carrier, Old Republic, were ordered to administer the claim, with the Board finding that CIGA was not liable due to the existence of other insurance.

Special employeeBorrowing employerControlManner and meansQuality PersonnelBaxter HealthcareOld Republic Insurance CompanyCalifornia Insurance Guarantee Association (CIGA)Petition for ReconsiderationFindings and Order
References
Case No. ADJ2136789 (MON 0357209)
Regular
Feb 27, 2012

ROBERT FLORES vs. GARNET PROTECTIVE SERVICES AND SECURITY, INC., JOSEPH'S CAFE, INC., PENNSYLVANIA MANUFACTURERS' ASSOCIATION INSURANCE COMPANY, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the original decision, and found the applicant was solely employed by Garnet Protective Services, not Joseph's Cafe. The Board further determined the applicant did not sustain an industrial injury on July 12, 2007. The majority concluded the applicant's commute to an extra shift did not constitute a special mission and fell under the "going and coming" rule. A dissenting commissioner argued the extra shift constituted a special mission, making the injury compensable.

Workers' Compensation Appeals BoardGarnet Protective ServicesJoseph's CafePennsylvania Manufacturers' Insurance CompanyUninsured Employers Benefits Trust FundPetition for ReconsiderationArbitrator's DecisionEmployee StatusDual EmploymentSpecial Employer
References
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