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

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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. 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. 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. ADJ8606333
Regular
Jan 03, 2018

TYLER HASTEN, Deceased vs. PACIFIC AUTO CENTER, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for ULLICO CASUALTY COMPANY, in liquidation

This case concerns a petition for removal filed by an applicant regarding the death of Tyler Hasten. The Workers' Compensation Appeals Board (WCAB) denied the petition, finding that removal is an extraordinary remedy granted only when substantial prejudice or irreparable harm will occur if not granted. The WCAB adopted the reasoning of the administrative law judge and determined that the petitioner failed to demonstrate such harm or that reconsideration would be inadequate. Therefore, the petition for removal was denied.

Petition for RemovalExtraordinary RemedySubstantial PrejudiceIrreparable HarmReconsiderationWCJ's ReportAdopt and IncorporateDeny RemovalWorkers' Compensation Appeals BoardULLICO Casualty Company
References
Case No. ADJ8464400
Regular
Jan 13, 2017

BLANCA HERNANDEZ vs. PALM RETIREMENT CENTER, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, administered by FACILITY INTERCARE for ULLICO CASUALTY COMPANY, in liquidation

The Workers' Compensation Appeals Board dismissed Blanca Hernandez's Petition for Reconsideration because it was filed significantly after the deadline, making it untimely. Additionally, the petition lacked the required verification, and the petitioner failed to cure this defect within a reasonable time after notice. Therefore, the Board found it had no authority to consider the petition.

Petition for ReconsiderationUntimely FilingUnverified PetitionJurisdictional Time LimitWCABWorkers' Compensation Administrative Law JudgeLabor Code Section 5902Verification DefectLucena v. Diablo Auto BodyMaranian v. Workers' Comp. Appeals Bd.
References
Case No. ADJ 528016 (LAO 0797447) ADJ 4708211 (LAO 0831457)
Regular
May 08, 2016

JORGE PAREDES vs. COASTCAST CORPORATION, STATE COMPENSATION INSURANCE FUND, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for SUPERIOR NATIONAL INSURANCE COMPANY, CALIFORNIA COMPENSATION INSURANCE COMPANY, LEGION INSURANCE COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., REPUBLIC INDEMNITY COMPANY, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board has granted reconsideration of a prior decision concerning Jorge Paredes and multiple defendant insurers. This grant is a procedural step to allow the Board to thoroughly review the complex factual and legal issues presented in the case. The Board intends to conduct further study and potentially additional proceedings to reach a just and reasoned decision. All future filings related to the petition for reconsideration must be submitted directly to the Board's Commissioners' office, not district offices or via e-filing in EAMS.

WORKERS' COMPENSATION APPEALS BOARDPETITION FOR RECONSIDERATIONGRANT OF RECONSIDERATIONSTATUTORY TIME CONSTRAINTSOFFICE OF THE COMMISSIONERSELECTRONIC ADJUDICATION MANAGEMENT SYSTEMEAMSWCJDECISION AFTER RECONSIDERATIONLIQUIDATION
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. ADJ8157719
Regular

NICOLAS MERCADO vs. CO-WEST COMMODITIES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ULLICO CASUALTY COMPANY

In this workers' compensation case, Nicolas Mercado filed a Petition for Removal. The Workers' Compensation Appeals Board reviewed the petition and the administrative law judge's report. Finding no grounds for removal, the Board denied the petition, adopting the judge's reasoning.

Petition for RemovalWorkers' Compensation Appeals BoardCalifornia Insurance Guarantee AssociationULLICO Casualty CompanyliquidationPatriot Risk Servicesadministrative law judgeADJ8157719denial of removalBerman More & Gonzalez
References
Case No. ADJ8751227
Regular
Nov 16, 2015

GLORIA ACOSTA vs. BALANCE STAFFING SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ULLICO CASUALTY COMPANY

The Workers' Compensation Appeals Board (WCAB) has dismissed a Petition for Reconsideration filed by Balance Staffing Services. The petitioner voluntarily withdrew their petition. The WCAB noted that even if not withdrawn, the petition would have been dismissed as untimely and lacking in substance. Furthermore, the WCAB would have denied the petition on its merits based on the Workers' Compensation Judge's report.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissedUntimelySkeletalWCJ's ReportBalance Staffing ServicesCalifornia Insurance Guarantee AssociationPatriot Risk ServicesULLICO Casualty Company
References
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