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

Case No. 2017 NY Slip Op 07023 [154 AD3d 1037]
Regular Panel Decision
Oct 05, 2017

Matter of Passero v. Uninsured Employers' Fund

The claimant, Edmund Passero, a bricklayer, filed a workers' compensation claim in 2011 for an occupational disease resulting from repetitive stress. A Workers' Compensation Law Judge (WCLJ) initially established the claim against DeSpirit Mosaic & Marble Co. and later apportioned liability among three employers, including J. William Pustelak Inc., found to be uninsured. The Uninsured Employers' Fund (UEF) sought administrative review, but the Workers' Compensation Board denied the appeal as untimely. The Appellate Division, Third Department, reversed the Board's finding on the timeliness of UEF's application, holding that UEF would not have incurred an obligation until the WCLJ's December 2014 decision which apportioned liability. The case was remitted to the Workers' Compensation Board to consider the merits of UEF's appeal.

Workers' CompensationOccupational DiseaseUntimely AppealAdministrative ReviewLiability ApportionmentUninsured EmployerDate of DisablementThird DepartmentAppellate DivisionClaimant Benefits
References
5
Case No. LAO 0784069
Regular
Feb 11, 2008

RICARDO LOPEZ vs. HYON SEOP KIM, Individually and dba H.B. CONSTRUCTION, AARON SONG, an Individual, Illegally Uninsured, THE DIRECTOR OF INDUSTRIAL RELATIONS, As Administrator of THE UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Uninsured Employers Benefits Trust Fund (UEBTF) was not liable for a penalty on an attorney's fee award due to unreasonable delay. However, Labor Code section 3716.2 obligates the UEBTF to seek such penalties in civil enforcement actions against uninsured employers. Therefore, the Appeals Board amended the award to clarify that while UEBTF is not directly liable for the penalty, it remains part of the underlying award that UEBTF must pursue from the uninsured employers.

Uninsured Employers Benefits Trust FundUEBTFAttorney's fee awardLabor Code section 5814Labor Code section 3716.2Civil suitReconsiderationFindings and AwardWCJPenalty
References
1
Case No. MISSING
Regular Panel Decision

Employers Casualty Co. v. Dyess

This case addresses the subrogation rights of a workers' compensation carrier (Employers Casualty Co.) in relation to the employer's uninsured motorist coverage provided by Northbrook Property and Casualty Co. Carl L. Dyess, Jr., an employee, received workers' compensation benefits from Employers after being struck by an uninsured driver, Felipe Mendoza, during his employment. Dyess then sought recovery under his employer's uninsured motorist policy with Northbrook. Employers intervened, asserting statutory, contractual, and equitable subrogation rights for the benefits paid. The trial court granted summary judgment against Employers, ruling its subrogation rights did not extend to uninsured motorist coverage. The appellate court reversed, holding that statutory subrogation rights are not limited to third-party tortfeasors and that policy clauses attempting to abrogate these statutory rights are invalid. The case was remanded for further proceedings consistent with the opinion, emphasizing the carrier's right to reimbursement to prevent double recovery by the employee.

Workers' CompensationSubrogation RightsUninsured Motorist CoverageSummary JudgmentStatutory InterpretationContractual LiabilityEquitable SubrogationInsurance LawTexas LawThird-Party Tortfeasor
References
38
Case No. ADJ1543435
Regular
Feb 04, 2013

Sergio Cordero vs. Michael Bernier dba Pacific Services, Stellrecht Company, State Compensation Insurance Fund, Uninsured Employers Benefit Trust Fund

The Workers' Compensation Appeals Board denied reconsideration, upholding the finding that the applicant was injured in the course and scope of employment with an unlicensed contractor, Michael Bernier. The Board gave great weight to the Workers' Compensation Judge's credibility determination regarding the employer's testimony. The applicant's injury occurred while he was directed by Bernier to remove solar panels from a property owned by Stellrecht Company. The Board clarified the distinction between "course of employment" and "scope of employment" in workers' compensation law to affirm the decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ credibilitycourse and scope of employmentunlicensed contractoruninsured contractorgeneral-special relationshipLabor Code §2750.5B&P §7125.2Blew v. Horner
References
5
Case No. 13-17-00346-CV
Regular Panel Decision
May 09, 2019

Audrey Nickerson v. Julio Pineda and Unique Employment, LLC, Unique Employment Services, Unique Employment I, LTD, D/B/A Unique Employment Services

Audrey Nickerson, an employee of the City of Corpus Christi, sued Julio Pineda, a temporary worker, and Unique Employment Services for negligence after Pineda, operating a City-owned backhoe, caused an injury. Appellees filed a plea to the jurisdiction, which the trial court granted. The appellate court affirmed the dismissal of claims against Pineda, determining he qualified as a government employee under the Texas Tort Claims Act and was therefore immune from suit. However, the court reversed the dismissal of claims against Unique Employment Services, concluding that the borrowed-employee doctrine, on which Unique relied, is an affirmative defense to liability and not a jurisdictional matter properly addressed in a plea to the jurisdiction. The case against Unique was remanded for further proceedings.

Plea to the JurisdictionGovernmental ImmunityTexas Tort Claims ActElection of RemediesBorrowed Employee DoctrineNegligenceTemporary StaffingVicarious LiabilityAppellate ReviewSubject Matter Jurisdiction
References
35
Case No. ADJ843966 (SDO 0338705)
Regular
Dec 13, 2013

Reed Thomas Kirby vs. Arthur Gonzales, STATE FARM INSURANCE COMPANY, KEITH PATRICK DONNELLY, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to amend a prior award. The WCAB affirmed the finding that the applicant sustained an injury while employed as a tree trimmer by an uninsured employer, Keith Patrick Donnelly. However, the WCAB amended the award to reflect that liability rests solely with the uninsured employer, not the Uninsured Employers Benefits Trust Fund (UEBTF), as UEBTF's liability is derivative. The WCAB rejected arguments that the City of San Diego was also responsible and confirmed the applicant is entitled to benefits from Donnelly.

Uninsured Employers Benefits Trust FundUEBTFKeith Patrick DonnellyTarzan Tree SpecialistsArthur GonzalesState Farm Insurance Companytree trimmerderivative defendantLabor Code section 3352(h)City of San Diego
References
2
Case No. LAO 0722567
Significant

Daniel Milbauer, Applicant vs. Erez Boostan, Uninsured Employers Fund

The Appeals Board affirms a judge's finding on the correct legal identity of an uninsured employer and establishes procedures to ensure the Uninsured Employers Fund (UEF) actively assists in identifying employers in future cases to avoid significant delays.

Uninsured Employers FundEn Banc DecisionJurisdictional IssueEmployer IdentityService of ProcessSubstantial EvidenceGood Faith EffortProvisional AppearanceDirector of Industrial RelationsLabor Code Section 3716(d)(4)
References
13
Case No. ADJ387954 (OXN 0145858) ADJ2973719 (OXN 0145147)
Regular
Oct 27, 2017

FRANCISCO PRIETO vs. O.C. CONTRACTING, INC., AMERICAN INTERNATIONAL GROUP, INC., UNINSURED EMPLOYERS BENEFITS TRUST FUND

This case concerns a Petition for Reimbursement filed by Granite State Insurance Company against the Uninsured Employers Benefits Trust Fund (UEBTF). Granite State mistakenly paid workers' compensation benefits to an employee injured while working for an uninsured employer. The Workers' Compensation Appeals Board (WCAB) rescinded a prior order granting reimbursement, holding that UEBTF is not statutorily liable to reimburse insurance carriers for erroneous payments. The WCAB emphasized that UEBTF's purpose is to provide benefits to injured workers of uninsured employers, not to indemnify insurers. A dissenting opinion argued for amending the order to allow reimbursement to Granite State through applicant from funds UEBTF owes the applicant.

Uninsured Employers Benefits Trust FundGranite State Insurance CompanyPetition for ReimbursementLabor Code sections 37153716mistaken paymentillegally uninsured employerLabor Code section 4909creditdirect reimbursement
References
0
Case No. LAO 0722567
En Banc
Dec 18, 2003

Daniel Milbauer vs. Erez Boostan dba American Runner Attorney Service, Uninsured Employers Fund

The Appeals Board affirms a WCJ's finding on the correct legal identity of an uninsured employer and establishes procedures to ensure the Uninsured Employers Fund's (UEF) early and active participation in identifying such employers in future cases.

UEFEmployer IdentityService of ProcessJurisdictionReconsiderationEn Banc DecisionLabor CodeUninsured EmployerIndustrial InjuryPermanent Disability
References
13
Case No. ADJ13090134
Regular
Aug 14, 2025

OLIVIA RAMIREZ vs. ISIDRO A. MEJIA, ZINDER JANITORIAL CO., UNINSURED EMPLOYERS BENEFITS TRUST FUND, BOURBON PUB/PARADIES LAGARDERE, SENTRY INSURANCE

Applicant Olivia Ramirez sustained an injury to her knee and ankle on November 17, 2019, while employed by Isidro A. Mejia and Zinder Janitorial Co., who were uninsured for workers' compensation. The Uninsured Employers Benefits Trust Fund (UEBTF) successfully joined Paradies Lagardere as a co-defendant, alleging joint employer status. The Workers' Compensation Administrative Law Judge (WCJ) initially found Paradies to be a joint employer in Findings of Fact issued on May 15, 2025. Paradies sought reconsideration, disputing the joint employer finding and the injury arising out of and in the course of employment (AOE/COE). The Appeals Board reviewed the petition, the UEBTF's answer, and the WCJ's report, ultimately granting reconsideration but deferring a final decision on the merits, indicating further review of the record and applicable law is necessary. The decision also clarified that Labor Code sections 2775 and 2776, related to employee classification, do not apply retroactively to the date of injury in this case.

Joint employerUninsured employersParadies LagardereZinder JanitorialIsidro MejiaWCJPetition for ReconsiderationAOE/COELabor Code section 5909EAMS
References
17
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