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

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
Case No. ADJ8128282
Regular
Jan 23, 2014

ANGELA EGBIKUADJE vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings. The defendant, California Department of Corrections and Rehabilitation, argued that the applicant's psychiatric injury claim was preempted by the ADA and not proven under Labor Code section 3208.3. The Board found the original decision lacked proper analysis regarding predominant industrial causation and the good faith personnel action defense. Therefore, the case was remanded for further development of the record, including expert medical opinion on these issues.

Workers' Compensation Appeals BoardAngela EgbikuadjeCalifornia Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8128282Van Nuys District OfficeReconsiderationFindings and AwardIndustrial cumulative trauma injury
References
Case No. ADJ6523994
Regular
Oct 19, 2010

ROSALBA TOLOZA vs. DOLAN FOSTER ENTERPRISES, Dba TACO BELL; PENNSYLVANIA MANUFACTURERS ASSOCIATION

The employer sought reconsideration of a Workers' Compensation Appeals Board (WCAB) decision awarding total temporary disability benefits. The WCAB rescinded the prior award, finding that the applicant's termination for taking $3.65 from the cash register to pay for a taxi was for cause. However, the Board remanded the case for further proceedings to develop the record regarding the applicant's medical condition and potential total temporary disability after her termination. The WCAB clarified that an employer can be liable for temporary disability even after termination if good cause is not established.

Workers' Compensation Appeals BoardTotal Temporary DisabilityTermination for CauseModified DutyCash Handling PolicyIndustrial InjuryEmployer MisconductMedical EvidenceGood Cause for TerminationStipulated Facts
References
Case No. SJO 0258641
Regular
May 19, 2008

JANICE M. DOUGLAS vs. COUNTRYWIDE FINANCIAL CORPORATION, ACE USA, ESIS

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award of temporary disability indemnity. The Board found the applicant's termination for cause, specifically for sending inappropriate emails despite prior warnings, was tantamount to refusing suitable modified work. Therefore, the applicant was not entitled to temporary disability benefits from her termination date until the date she was later found temporarily totally disabled.

Workers Compensation Appeals BoardReconsiderationTemporary Disability IndemnityExpedited HearingAgreed Medical EvaluatorEmployee Counseling FormsFinal Written CounselingTermination of EmploymentInappropriate EmailsOdd Lot Doctrine
References
Case No. ADJ11622311
Regular
Oct 14, 2019

MATTHEW GOOSEV vs. CALIFORNIA DEPARTMENT OF FORESTRY FORESTRY & FIRE PROTECTION; legally uninsured STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES adjusting agent

This case involves a firefighter injured on June 13, 2018, who received temporary disability payments and was terminated by his employer. The employer sought reconsideration of the award, arguing the employee was not entitled to payments because modified work would have been offered but for his termination. The Board denied reconsideration, finding the employer failed to prove the termination was for good cause, a necessary prerequisite to ceasing temporary disability payments. The employer did not sufficiently demonstrate that the employee's alleged misconduct warranted termination under company policy.

Temporary disability indemnityPetition for ReconsiderationFindings of Fact and AwardFirefighterMotor vehicle accidentUnsafe drivingFalse statementsEmployment applicationTermination for causeGood faith termination
References
Case No. ADJ10570712
Regular
Dec 22, 2017

ANTHONY RUSSELL vs. TNT INDUSTRIAL CONTRACTORS, INC., TRAVELERS INSURANCE COMPANY

This case concerns an applicant seeking temporary disability indemnity after sustaining a left foot injury. The applicant was offered modified duty but was terminated from that assignment due to making inappropriate and offensive comments to colleagues. The Appeals Board granted reconsideration, rescinded the prior award of temporary disability, and ruled that the applicant was not entitled to indemnity for the period in question. This decision was based on the finding that the applicant's termination for cause relieved the employer of the obligation to pay temporary total disability, as established by case law.

Temporary Disability IndemnityModified DutyTermination for CausePetition for ReconsiderationFindings of Fact and AwardWork Status ReportTransition to WorkReEmployAbility programOffensive CommentsHarassment
References
Case No. ADJ8385599
Regular
Oct 17, 2014

Joseph Toscano vs. Westlake Health Center, Seabright Insurance Company

This case involves an admitted industrial back injury sustained by applicant Joseph Toscano. The defendant seeks reconsideration of the WCJ's award, arguing the judge improperly relied on the primary treating physician's report over the PQME's and erred in awarding a 15% permanent disability increase due to alleged termination for cause. The Appeals Board granted reconsideration, affirming the original award except for deferring the issue of the section 4658(d) increase. This deferral is necessary pending resolution of a potential Labor Code section 132a claim regarding whether applicant was terminated in retaliation for filing a workers' compensation claim, which would impact eligibility for the increase.

WCABindustrial injurynursing assistantlow backtemporary disabilitypermanent disabilityprimary treating physicianPQMELabor Code section 4658(d)reconsideration
References
Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ10678861
Regular
Aug 27, 2018

FERNANDO BEDOYA vs. ASHLEY FURNITURE INDUSTRIES, INC., HARTFORD ACCIDENT AND INDEMNITY COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration regarding temporary disability benefits. The Board found that the applicant, who had industrial injuries and was laid off due to plant closure, was entitled to temporary disability indemnity. The defendant failed to prove the applicant was terminated for cause (misconduct) or that suitable modified work was unavailable. Therefore, the applicant's diminished earning capacity was a direct result of his industrial injury and the employer's actions.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings & Awardtemporary disability indemnitytermination for causeodd lot doctrinequalified medical examiner (QME)maximum medical improvement (MMI)primary treating physician (PTP)work restrictions
References
Case No. ADJ10517190
Regular
Dec 27, 2017

BERTHA GUERRERO vs. COMMUNITY HEALTH SYSTEMS, INC., ICW GROUP/ EXPLORER INSURANCE COMPANY, AMTRUST NORTH AMERICA

The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration, upholding the award of temporary total disability benefits to Bertha Guerrero. The Board found that the applicant's termination for cause did not preclude benefits because the employer failed to prove suitable modified work would have been available. Furthermore, the Board admonished defense counsel for failing to accurately represent the evidence and serve co-counsel, citing violations of Appeals Board rules.

Petition for ReconsiderationWCJ ReportAppeals Board Rule 10842(a)Appeals Board Rule 10510(b)Temporary Total Disability BenefitsModified WorkTermination for CauseGood CauseAffirmative MisconductCUIAB Decision
References
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