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

Case No. ADJ6701886

Regular

Oct 03, 2014

SAM NIJEM vs. WASTE MANAGEMENT COMPANY OF ALAMEDA, ACE AMERICAN INSURANCE COMPANY

This case involves a defendant's petition for reconsideration of a workers' compensation award, arguing the applicant committed fraud and is thus barred from benefits. The Board denied the petition, agreeing with the WCJ's finding that the applicant sustained an industrial injury to his right shoulder. While acknowledging a prior fraud conviction, the Board held, citing *Tensfeldt*, that this conviction does not automatically bar all future benefits but only those directly procured by fraud. The Board also denied disqualification of the WCJ as the petition was untimely filed.

Workers' Compensation Appeals BoardSam NijemWaste Management Company of AlamedaACE American Insurance CompanyGallagher BassettADJ6701886Opinion and Order Denying Petition for ReconsiderationPetition for DisqualificationFindings and Awardindustrial injury

References

Case No. ADJ4642991 (VNO 0556266)

Regular

Sep 09, 2011

## RICHARD ANTONETTE, vs. VOLT INFORMATION SCIENCES; MAJESTIC INSURANCE COMPANY, Administered by GALLAGHER BASSETT CLAIMS SERVICES

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to review a proposed $\$4,600$ compromise and release agreement. The agreement attempts to settle applicant Richard Antonette's claim, waiving future medical treatment and noting a substantial temporary disability overpayment, but the WCAB lacks sufficient information for approval. Citing *Tensfeldt v. WCAB*, the WCAB emphasizes that a fraud conviction does not automatically bar all future benefits, requiring an individualized assessment of the facts. Therefore, the case is returned to the trial level to determine the adequacy of the settlement and any necessary further proceedings.

Workers' Compensation Appeals BoardReconsiderationCompromise and ReleaseWorkers' Compensation FraudInsurance Code Section 1871.4(a)(1)Labor Code Section 3207Tensfeldt v. Workers' Comp. Appeals Bd.Case-by-case determinationIndustrial injuryMedical evidence

References

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SAM NIJEM vs. WASTE MANAGEMENT COMPANY OF ALAMEDA, ACE AMERICAN INSURANCE COMPANY

## RICHARD ANTONETTE, vs. VOLT INFORMATION SCIENCES; MAJESTIC INSURANCE COMPANY, Administered by GALLAGHER BASSETT CLAIMS SERVICES