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Case No. OXN 131251

Regular

Dec 05, 2007

DORIS STOCKS vs. THE URBAN GROUP dba THE GABLES OF OJAI, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, INTERCARE INSURANCE SERVICES, LEGION INSURANCE

The Appeals Board rescinded a penalty against CIGA for delayed temporary disability payments, finding penalties are not covered claims. The Board also amended the award to apportion one-third of the applicant's permanent disability to pre-existing degenerative disease, reducing the awarded permanent disability based on Dr. Berman's opinion. Consequently, the applicant's awarded permanent disability is reduced to 51%.

Workers' Compensation Appeals BoardDORIS STOCKSTHE URBAN GROUPTHE GABLES OF OJAICALIFORNIA INSURANCE GUARANTEE ASSOCIATION (CIGA)INTERCARE INSURANCE SERVICESLEGION INSURANCEOpinion and Decision After ReconsiderationTemporary DisabilityPermanent Disability

References

Case No. MISSING

Regular Panel Decision

Jan 23, 1986

In re the Claim of Gable

The claimant, a vice-president and co-owner of ABC Body Company, sought unemployment insurance benefits after his business closed in November 1983 due to severe financial decline. Initially, the Unemployment Insurance Appeals Board disqualified him, ruling he voluntarily left employment without good cause. The appellate court reviewed evidence detailing the company's substantial losses, including the loss of major accounts and unsuccessful efforts to secure profitable new business, which led to an inability to pay rent or insurance. Citing precedents that economic necessity constitutes good cause for business closure, the court found a compelling reason for the claimant's departure. Consequently, the Board's decision was reversed, the claim for benefits granted, and the matter remitted for further proceedings.

Unemployment BenefitsBusiness ClosureGood CauseVoluntary QuittingEconomic HardshipAppellate DivisionUnemployment Insurance LawBoard Decision AppealClaimant DisqualificationReversal of Decision

References

Case No. ADJ7937794

Regular

Sep 25, 2012

RUTH CORONA vs. AUTUMN YEARS AT OJAI, PATRIOT RISK SERVICES

The Workers' Compensation Appeals Board denied Ruth Corona's Petition for Reconsideration, affirming the Administrative Law Judge's (ALJ) decision. The denial was based on a faulty verification in the petition and a credibility assessment of the applicant's testimony regarding a specific injury. The ALJ found the applicant's account of a specific injury to be inconsistent and not supported by evidence, suggesting a cumulative trauma injury instead. The Board gave great weight to the ALJ's credibility findings and incorporated the ALJ's report into their order.

Workers' Compensation Appeals BoardOrder Denying ReconsiderationPetition for ReconsiderationWCJ ReportCredibility FindingGarza v. Workmen's Comp. Appeals Bd.Petitioners' ContentionApplicant's TestimonyDefendant's WitnessesProcedural Error

References

Case No. ADJ9527444

Regular

May 23, 2018

, REYES P. HERNANDEZ, vs. , QUALI RUN RANCH; STATE COMPENSATION INSURANCE FUND; OMA OJAI PACIFIC; ZENITH INSURANCE COMPANY; ACE USA INSURANCE COMPANY, Administered By ESIS; MICHAEL AND JODY CROMER, Homeowners; STATE FARM INSURANCE,

The Workers' Compensation Appeals Board granted ESIS's Petition for Removal because the WCJ's order denying ESIS a panel Qualified Medical Evaluator (PQME) evaluation was found to cause significant prejudice and irreparable harm. ESIS was not a party to the original Agreed Medical Examiner (AME) agreement between the applicant and SCIF, and the WCJ's decision unfairly bound ESIS to the AME's findings and effectively closed ESIS's discovery rights. The Board rescinded the WCJ's decision and ordered a PQME evaluation for ESIS, recognizing the denial violated ESIS's due process rights.

Petition for RemovalQualified Medical EvaluatorAgreed Medical ExaminerDue ProcessSignificant PrejudiceIrreparable HarmDiscoveryFindings and OrderWorkers' Compensation Appeals BoardCumulative Trauma

References

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DORIS STOCKS vs. THE URBAN GROUP dba THE GABLES OF OJAI, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, INTERCARE INSURANCE SERVICES, LEGION INSURANCE

In re the Claim of Gable

Unemployment BenefitsBusiness ClosureGood CauseVoluntary QuittingEconomic HardshipAppellate DivisionUnemployment Insurance LawBoard Decision AppealClaimant DisqualificationReversal of Decision

RUTH CORONA vs. AUTUMN YEARS AT OJAI, PATRIOT RISK SERVICES

, REYES P. HERNANDEZ, vs. , QUALI RUN RANCH; STATE COMPENSATION INSURANCE FUND; OMA OJAI PACIFIC; ZENITH INSURANCE COMPANY; ACE USA INSURANCE COMPANY, Administered By ESIS; MICHAEL AND JODY CROMER, Homeowners; STATE FARM INSURANCE,

Petition for RemovalQualified Medical EvaluatorAgreed Medical ExaminerDue ProcessSignificant PrejudiceIrreparable HarmDiscoveryFindings and OrderWorkers' Compensation Appeals BoardCumulative Trauma