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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. VNO 0470470
Regular
May 12, 2008

GERARDO RAMIREZ vs. WILLIAM ALONSO, UNINSURED EMPLOYERS FUND

The Workers' Compensation Appeals Board granted reconsideration to further develop the record concerning applicant Gerardo Ramirez's employment status at the time of his injury. The Board rescinded the previous findings, finding the evidence insufficient to support dual employment and needing clarification on whether applicant was a casual employee, which might affect his eligibility for benefits. The case was returned to the trial level for additional evidence gathering, including a review of the defendant's insurance policy for the property where the injury occurred.

Workers' Compensation Appeals BoardUninsured Employers Fundindustrial injuryright major extremitydefendant's contentiondual employmentthreshold issueemployment relationshippresumption of employmentjoint venture
References
Case No. ADJ10009703 ADJ10043837
Regular
Feb 19, 2019

ZULAY DAVILA vs. EMPLOYERS RESOURCE GROUP, VENSURE HR, INC., LCF LIBERTY JR, LLC/SECURITY NATIONAL INSURANCE COMPANY, AMTRUST NORTH AMERICA, PROPORTION FOODS, LLC/REDWOOD FIRE AND CASUALTY INSURANCE COMPANY, BERKSHIRE HATHAWAY HOMESTATE COMPANIES

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the WCJ's decision due to a due process violation. The WCJ had determined employment by ERG without providing ERG notice and an opportunity to be heard. The WCAB returned the case to the trial level for further proceedings to determine employment status. Issues of insurance coverage will be subject to mandatory arbitration once employment is established.

Workers' Compensation Appeals BoardVENSURE HRSecurity National Insurance CompanyProportion FoodsLLCREDWOOD FIRE AND CASUALTY INSURANCE COMPANYBERKSHIRE HATHAWAY HOMESTATE COMPANIESAMTRUST NORTH AMERICAEMPLOYMENT RESOURCES GROUPINC.
References
Case No. ADJ11968759
Regular
Apr 13, 2023

JESUS ORTEGA GONZALEZ vs. MAJOR TRANSPORTATION SERVICES, INC., BALJINDER S. GILL, PEOPLEASE LLC, NATIONAL INTERSTATE RICHFIELD.

This case involves an applicant injured while employed by both Major Transportation Services and Peoplease, a Professional Employer Organization (PEO). Peoplease sought reconsideration of a finding that they jointly employed the applicant on the date of injury, arguing payroll was not processed through them. The Board denied reconsideration, adopting the WCJ's reasoning that a co-employment relationship existed. The WCJ found that despite Peoplease's argument about payroll timing, evidence showed Peoplease benefitted from the applicant's work and their actions were inconsistent with strict contract adherence, akin to precedent in Gulam v. Patel. Ultimately, Peoplease's arguments regarding payroll timing were deemed coverage issues subject to arbitration and not grounds to deny the finding of co-employment.

Professional Employer OrganizationPEOdual employmentgeneral employerspecial employerco-employmentclient policyLabor Code section 3602(d)presumption of employmentsubstantial evidence
References
Case No. ADJ7264969
Regular
Feb 22, 2011

Richard Warner vs. COUNTY OF LOS ANGELES, INTERCARE INSURANCE SERVICES

Applicant Richard Warner, a firefighter on Catalina Island, sustained injuries while trimming wisteria at his home, which he was required to maintain as a condition of employment and from which he sometimes worked. The Board denied reconsideration, affirming the WCJ's finding that the injury was not arising out of and occurring in the course of employment (AOE/COE). The applicant's home was not considered employer premises under the bunkhouse rule as he owned and maintained it personally, receiving a stipend instead of provided housing. Although working from home was sometimes necessary, trimming wisteria was deemed a purely personal act unrelated to employment duties.

AOE/COEbunkhouse ruleemployer premisessecondary jobsitecourse of employmentperforming serviceproximate causepersonal taskincidental to employmentstipend
References
Case No. ADJ8411218
Regular
Jul 07, 2014

Rafael Becerra vs. PV MART dba BUY LOW MARKET, INC., EMPLOYERS COMPENSATION INSURANCE CO., KEYANOOSH GHAMARI dba CODE 3 SECURITY, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board denied the Uninsured Employers Benefits Trust Fund's petition for reconsideration. Applicant's petition was granted to amend the original Findings and Order. The Board found that PV Mart dba Buy Low Market, Inc. was not a special employer of the applicant, Rafael Becerra. Consequently, PV Mart and its insurer were dismissed as party defendants, and the applicant was deemed an employee of Keyanoosh Ghamari dba Code 3 Security at the time of injury.

Workers' Compensation Appeals BoardUninsured Employers Benefits Trust FundSpecial Employment RelationshipGeneral EmploymentBorrowing EmployerLending EmployerRight to ControlCredibility DeterminationBuy Low MarketCode 3 Security
References
Case No. ADJ4413699 (SDO 0272634)
Regular
Jul 26, 2018

ROMINA FATURECHI vs. JOSEPH CAPPS, UNINSURED EMPLOYERS BENEFITS TRUST FUND, OCEAN'S ELEVEN CASINO, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for SUPERIOR NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board overturned a prior decision, finding that the applicant was jointly employed by Joseph Capps and Ocean's Eleven Casino. This determination was based on evidence that the Casino exercised control over the applicant's work, including directing when games started and stopped, providing meals, and having the ability to influence her hiring and termination. The Court emphasized that the legality of the Casino employing the applicant was not the decisive factor. Therefore, both Capps and the Casino are considered dual employers for the purposes of workers' compensation.

Dual employmentSpecial employment relationshipJoint employmentControl of employee activitiesCasino bankerPropositional playerUninsured employerCalifornia Insurance Guarantee AssociationUninsured Employers Benefits Trust FundBorello test
References
Case No. ADJ7796275
Regular
Sep 01, 2015

MORTEN ANDERSEN vs. NEW ORLEANS SAINTS, Atlanta Falcons, New York Giants, Kansas City Chiefs, Minnesota Vikings

The Workers' Compensation Appeals Board (WCAB) affirmed California's subject matter jurisdiction over Morten Andersen's cumulative injury claim as a professional athlete, due to sufficient work performed in the state. However, the WCAB rescinded the prior finding that liability related back to the New Orleans Saints, Andersen's first employer. This was because Labor Code section 5500.5 mandates liability be allocated to employers during the year preceding the last date of injurious exposure, and the Saints did not employ Andersen during that period. The case was returned to the trial level to join subsequent employers and properly allocate liability under section 5500.5.

Workers' Compensation Appeals BoardSubject Matter JurisdictionIndustrial InjuryProfessional AthleteCumulative InjuryRelation Back DoctrineLabor Code Section 5500.5EmployersLiability AllocationInjurious Exposure
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
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