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

Case No. ADJ9651491
Regular
Aug 22, 2016

JUDITH DIAZ vs. EXCELL SECURITY, INC., XL STAFFING, INC., XL CONSTRUCTION STAFFING; CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for ULLICO CASUALTY COMPANY, in liquidation by its servicing facility, SEDGWICK CLAIMS MANAGEMENT SERVICES; SPARTA INSURANCE COMPANY by GALLAGHER BASSETT

The Workers' Compensation Appeals Board affirmed a prior finding that Sparta Insurance Company provided workers' compensation coverage for Judith Diaz. The Board found that Sparta's policy with Excell Security, Inc. did not exclude Diaz from coverage, despite Excell also having a policy with Ullico Casualty Company. Therefore, Sparta is considered "other insurance" and liable for applicant's benefits, upholding the Arbitrator's initial decision.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationFindings and OrderArbitratorother insuranceLabor Code section 1063California Insurance Guarantee AssociationCIGAULLICO CASUALTY COMPANYliquidation
References
Case No. ADJ7964733
Regular
May 29, 2018

JOSE LUIS MASTACHE vs. STAFFCHEX, INC., JESSIE LORD BAKERY; CALIFORNIA GUARANTEE ASSOCIATION for ULLICO CASUALTY COMPANY in Liquidation through its servicing facility SEDGWICK CMS; TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

This case involves a workers' compensation claim where CIGA seeks reconsideration of a prior decision. The core dispute centers on whether a Travelers insurance policy issued to Jessie Lord Bakery excludes coverage for special employees leased from Staffchex. The Appeals Board granted reconsideration, rescinded the prior decision, and found that the Travelers policy provided coverage, reasoning that the exclusion endorsement was invalid as it lacked the required written affirmation by the policyholder. Furthermore, the Board clarified that general and special employers remain jointly and severally liable for workers' compensation benefits, irrespective of agreements between them.

CIGAStaffchexJessie Lord BakeryTravelers Property Casualty CompanyUllico Casualty CompanySpecial EmployeeGeneral EmployerJoint and Several LiabilityLabor Code Section 3602(d)Limiting Endorsement
References
Case No. SRO 0067126
Regular
Jan 28, 2008

PATRICK LEAHY vs. FREDERICK MEISWINKEL, INC., MARYLAND CASUALTY COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, CALIFORNIA COMPENSATION AND FIRE COMPANY

The Workers' Compensation Appeals Board denied Maryland Casualty Company's (Maryland) petition for reconsideration, upholding an arbitrator's order requiring Maryland to reimburse CIGA for workers' compensation benefits paid to an injured employee. The Board found Maryland waived its objections regarding joinder and the date of injury by entering into a stipulation with CIGA. Furthermore, Maryland's argument for a summary of evidence was dismissed as no testimony was presented.

Workers' Compensation Appeals BoardFrederick MeiswinkelInc.Maryland Casualty CompanyCalifornia Insurance Guarantee AssociationCalifornia Compensation and Fire CompanyCIGAcovered claimsreimbursementcontribution
References
Case No. ADJ2834079 (SDO 0293027) ADJ2839895 (SDO 0358837)
Regular
Jun 25, 2009

THUAN CRIM-ROLFE vs. LA COSTA RESORT AND SPA, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for LEGION INSURANCE COMPANY, BROADSPIRE, SAFETY NATIONAL CASUALTY INSURANCE COMPANY

This case involves a clerical error in a prior Workers' Compensation Appeals Board (WCAB) decision. The WCAB previously ordered Safety National Casualty Insurance Company (SNCC) to reimburse the California Insurance Guarantee Association (CIGA) a specific amount for bill review charges. CIGA requested clarification, noting the amount ordered was incorrect. The WCAB affirmed its earlier decision that CIGA is entitled to reimbursement for bill review costs but amended the order nunc pro tunc. The corrected order now states SNCC must reimburse CIGA for bill review charges, with the exact amount to be determined by the parties or the arbitrator.

California Insurance Guarantee AssociationLegion Insurance CompanySafety National Casualty Insurance Companynunc pro tuncclerical errorbill review chargesliquidationcovered claimsreimbursementpetition for reconsideration
References
Case No. ADJ2834079 (SDO 293027) ADJ2839895 (SDO 358837)
Regular
Apr 10, 2009

THUAN CRIM-ROLFE vs. LA COSTA RESORT AND SPA, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for LEGION INSURANCE COMPANY, in liquidation, by BROADSPIRE, SAFETY NATIONAL CASUALTY INSURANCE COMPANY

This case concerns a dispute over the cumulative trauma period for an applicant's injury and reimbursement of bill review charges. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, affirming the arbitrator's finding of a single cumulative trauma period ending October 9, 2001. However, the WCAB overturned the arbitrator's denial of reimbursement, ruling that CIGA is entitled to recover $768.53 in bill review charges from Safety National Casualty Insurance Company. The WCAB found that CIGA, as a statutorily mandated entity, could recover these costs incurred in administering the claims.

CIGAcumulative traumadate of injurybill review chargescontributionLegion Insurance CompanySafety National Casualty Insurance CompanyLa Costa Resort and Spareconsiderationarbitration decision
References
Case No. ADJ1504736 (RDG 094722) ADJ2325354 (RDG 0122147)
Regular
Jun 30, 2011

CYNTHIA CADLE vs. CHICO CREEK HEALTH CARE, CONTINENTAL CASUALTY COMPANY, CNA CLAIMS PLUS, FREMONT MEMORIAL HOSPITAL, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

In Case ADJ1504736, the Board granted reconsideration, finding applicant sustained industrial injury to her right knee as a compensable consequence of her left knee injury from February 2, 2000, remanding for determination of benefits. In Case ADJ2325354, the Board denied reconsideration and removal, affirming the WCJ's findings regarding injury on May 19, 2005, including the 18% permanent disability award and apportionment of benefits. The Board found applicant waived arguments regarding new discovery and the *Almaraz/Guzman* standard by failing to raise them timely. The WCJ's apportionment of permanent disability for the 2005 injury was upheld based on medical reports and deposition testimony.

Workers' Compensation Appeals BoardCynthia CadleChico Creek Health CareContinental Casualty CompanyCNA Claims PlusFremont Memorial HospitalTravelers Property Casualty Company of AmericaPetition for ReconsiderationPetition for RemovalJoint Findings Award and Order
References
Case No. ADJ10838822
Regular
Jan 03, 2020

ERNESTO NORIEGA vs. ROYAL CABINETS, TRAVELERS PROPERTY CASUALTY COMPANY, INSURANCE COMPANY OF THE WEST, ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Ernesto Noriega's petition for reconsideration. The Board found that the medical opinions of Drs. Levine and Harris were not substantial evidence. These opinions failed to adequately support a finding of injury arising out of and occurring in the course of employment due to being based on incorrect facts, history, or legal theories. Therefore, the prior decision stands.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeSubstantial EvidenceMedical OpinionAOE/COEInjuryRoyal CabinetsTravelers Property Casualty CompanyInsurance Company of the West
References
Case No. ADJ7495216 ADJ7495729 ADJ7497171
Regular
Sep 11, 2013

FRANK ALLEN vs. ATLAS TRANSFER AND STORAGE COMPANY, REDWOOD FIRE & CASUALTY INSURANCE, BERKSHIRE HATHAWAY HOMESTATE COMPANIES, STAR INSURANCE COMPANY, MEADOWBROOK INSURANCE GROUP

Defendants sought reconsideration of an award finding Frank Allen an employee entitled to temporary disability and medical treatment. They argued Allen was an independent contractor, and that temporary disability should be limited to 104 weeks due to insufficient evidence of chronic lung disease. The Appeals Board granted reconsideration, amended the temporary disability finding, and affirmed the award otherwise, returning the case to the trial level.

WORKERS' COMPENSATION APPEALS BOARDATLAS TRANSFER AND STORAGE COMPANYREDWOOD FIRE & CASUALTY INSURANCESTAR INSURANCE COMPANYBERKSHIRE HATHAWAY HOMESTATE COMPANIESMEADOWBROOK INSURANCE GROUPFRANK ALLENPetition for ReconsiderationFirst Amended Joint Findings of FactAward & Orders
References
Case No. FRE 186612
Regular
Mar 26, 2008

, Jose Maravilla, vs. , JOSE AND FLORENCIA ALVERNAZ and CIGA, by CAMBRIDGE INTERGRATE SERVICES for FREMONT INSURANCE COMPANY, in liquidation; LIBERTY MUTUAL INSURANCE COMPANY; CALIFORNIA INDEMNITY INSURANCE COMPANY, adjusted by GAB ROBINS

This case involves Liberty Mutual/Golden Eagle Insurance Company's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision finding applicant sustained a cumulative trauma injury to both knees. The WCAB denied reconsideration, finding the Statute of Limitations defense was waived and that the *Benson* case regarding allocation of disability cause was not applicable as there was only one industrial injury. The WCAB adopted the WCJ's report in its entirety for its denial.

Workers' Compensation Appeals BoardJose MaravillaJose and Florencia AlvernaCIGAFremont Insurance CompanyLiberty Mutual Insurance CompanyCalifornia Indemnity Insurance CompanyGAB RobinsFRE 186612Opinion and Order Denying Petition for Reconsideration
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
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