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

Case No. ADJ10443669
Regular
Oct 04, 2017

Donna Carter vs. Rose International Group, OneBeacon Insurance Group

The Appeals Board affirmed the Workers' Compensation Judge's finding that Donna Carter sustained an industrial injury to her right knee and left wrist on May 18, 2016. Despite inconsistencies in the applicant's testimony regarding a slip and fall incident, her account was corroborated by a witness who found her on the floor. Medical records from the day of the incident also supported the applicant's claim, establishing a clear mechanism of injury. The Board found that the common sense nature of a slip and fall does not require expert medical opinion to establish industrial causation for the incident itself.

ADJ10443669Rose International GroupOneBeacon Insurance GroupDonna CarterWorkers' Compensation Appeals BoardOpinion and Decision After Reconsiderationslip and fallindustrial injuryright kneeleft wrist
References
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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ4238124 (LBO 0384459)
Regular
Sep 14, 2012

LUIS ROMERO vs. CEDARS SINAI HEALTH SYSTEM

The Workers' Compensation Appeals Board affirmed a prior decision granting the defendant employer a $2,000,000 credit against future workers' compensation liability, representing the applicant's net recovery from a third-party lawsuit. The applicant's petition for reconsideration, arguing employer negligence, was denied. The Board found the applicant failed to prove employer negligence, particularly by not presenting expert evidence on the standard of care or causation. Testimony indicated the applicant was aware of and instructed to use safety equipment (outriggers) but proceeded without it, suggesting applicant's own negligence.

Third-party creditEmployer negligenceCivil lawsuit recoveryManlift operationOutriggersProximate causeStandard of careComparative negligenceWCAB reconsiderationFindings of Fact
References
Case No. ADJ7675972
Regular
Jan 07, 2013

Miguel Guzman vs. Girardi & Keese, Angelus Block Company, Inc., Integrated Claims

This case concerns an employer's lien for death benefits paid after an employee's death from an industrial injury. The employee's dependents settled a third-party lawsuit for $445,000, with a portion withheld pending determination of the employer's lien. A Superior Court found it lacked jurisdiction over the employer's reimbursement claim, and the WCJ similarly dismissed the matter, finding no pending workers' compensation issue. The Appeals Board, however, determined it has jurisdiction to adjudicate employer negligence and the amount of the lien, drawing parallels to its authority in credit claims. The matter is returned for trial at the WCAB level.

Workers' Compensation Appeals BoardDeath BenefitThird-Party ActionEmployer LienReimbursementDeclaratory ReliefSuperior Court JurisdictionCollateral EstoppelLabor Code Section 3856(b)Labor Code Section 3858
References
Case No. ADJ11880536
Regular
Aug 01, 2025

SERGIO AVILA vs. ADVANCED CONSTRUCTION, BITCO/OLD REPUBLIC GENERAL INSURANCE CORP.

The initial Findings and Order (F&O) from May 8, 2025, granted a credit to defendant Advanced Construction (ACS) from a third-party settlement. Applicant Sergio Avila sought reconsideration, arguing the WCJ erred in calculating ACS's comparative negligence and the total value of his case. The Appeals Board found the F&O lacked definite findings and identified evidentiary gaps concerning the net recovery, the WCJ's reliance on experts, and proof of benefits paid by ACS. Consequently, the Appeals Board rescinded the F&O and remanded the case for further proceedings consistent with its opinion.

Labor Code section 3861Third-party settlement creditComparative negligenceEmployer negligenceApplicant negligenceTotal damagesNet recoveryAllocation of faultPetition for ReconsiderationFindings and Order
References
Case No. ADJ10021120 ADJ8949346
Regular
Apr 14, 2017

ANTHONY BERNARD EDWARDS (Dec'd), CANDACE EDWARDS (Widow), ASHLEY EDWARDS (Daughter), ANTHONY EDWARDS, JR. (Son) vs. CITY OF LOS ANGELES; LOS ANGELES WORLD AIRPORTS, Permissibly Self-Insured

This case involves a workers' compensation death benefit claim for Anthony Bernard Edwards, who died in the course of his employment. The dependents seek death benefits and burial expenses, which were initially awarded by the WCJ. The employer, City of Los Angeles, sought reconsideration, arguing it should receive credit for a third-party settlement the dependents obtained from Kaiser Permanente. The Board agreed to reconsider the issue of credit, specifically whether Civil Code section 3333.1 bars such credit. The Board ultimately deferred the credit issue, affirming the death benefit award and returning the matter for further proceedings to determine the applicability of Civil Code section 3333.1 and potential employer negligence.

Workers' Compensation Appeals BoardADJ10021120ADJ8949346death benefitsLabor Code section 4702burial expensesCivil Code section 3333.1Medical Injury Compensation Reform ActMICRAthird-party settlement
References
Case No. ADJ1973537 (SRO 0141664)
Regular
Jun 24, 2019

KENT WARD vs. TIMEC COMPANY, INC., ZURICH AMERICAN INSURANCE COMPANY

The applicant sought reconsideration of an arbitration decision that found his employer, Timec, 25% comparatively negligent for his injury, reducing Timec's credit from a third-party settlement. The applicant argued for a higher employer negligence percentage to increase his potential workers' compensation benefits. The Board denied reconsideration, adopting the Arbitrator's findings and reasoning. The Board found the applicant failed to present evidence to overcome the Arbitrator's negligence determination.

Third-party creditComparative negligenceArbitrator's findingsPetition for reconsiderationLabor Code section 3861Employer's liabilityThird-party claim valueNet settlement amountCredit against workers' compensationEmployer's breach of duty
References
Case No. ADJ2671439 (AHM 0097527)
Regular
Jul 16, 2008

WILLIAM DAVID SCOTT vs. DOWNEY UNIFIED SCHOOL DISTRICT, SCRMA

This case concerns an applicant injured while employed as a utility worker who sustained industrial injuries to his back, pelvis, and internal systems. The Appeals Board granted reconsideration to clarify the employer's credit for benefits paid against a civil settlement, specifically amending the language to include benefits paid "directly to or on behalf of" the applicant. Ultimately, the employer must pay benefits until a $2,750,000 threshold is met before asserting a $500,000 credit, with all benefits paid to or for the applicant counting towards this threshold.

ReconsiderationDowney Unified School DistrictCid's TruckingUtility WorkerIndustrial InjuryBack InjuryPelvis InjuryInternal Systems InjuryNegligenceOrdinary Care
References
Case No. ADJ12014398
Regular
Mar 28, 2025

ROBERT JOLLEY vs. UNITED MECHANICAL, INC.; ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Robert Jolley's petition for reconsideration. Jolley, an applicant, sustained an industrial neck injury in 2019 while employed by United Mechanical, Inc. He filed a third-party negligence lawsuit against The Whiting Turner Contracting Company, which settled. The Workers' Compensation Judge (WCJ) found that United Mechanical, Inc. was not negligent and thus entitled to full credit against Jolley's workers' compensation liability from the civil settlement. Jolley challenged this, arguing employer negligence due to constructive notice of hazards and inadequate safety measures. The Appeals Board, adopting the WCJ's report, affirmed that Jolley failed to establish employer negligence, concluding that the employer did not know, nor should have reasonably known, of the dangerous condition prior to the injury.

Third-party creditEmployer negligenceConstructive noticePetition for reconsiderationFindings of Fact and OrdersLabor CodePermanent partial disabilityTemporary total disabilityCivil lawsuit settlementIncident report
References
Case No. VNO 0461030
Regular
Nov 30, 2007

CHRISTOPHER MENDEZ vs. GRAY LIFT, INCORPORATED, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board rescinded a prior award and returned the case for further proceedings to determine the general employer's (Lyon Lift, Inc.) potential liability for the applicant's injury. This is to address whether Lyon had duties under workplace safety laws (Labor Code sections 6400-6404) and if its negligence, if any, contributed to the injury caused by a defective saw provided by the special employer. The Board will then determine if Lyon is entitled to a third-party credit for the applicant's settlement based on its own negligence and established credit principles.

Workers' Compensation Appeals BoardThird-party creditGeneral employerSpecial employerImputation of negligenceLabor Code sections 6400-6404Workplace safetyPrimary employerSecondary employerDual employment
References
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