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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
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
Case No. ADJ8411218
Regular
Jul 07, 2014

Rafael Becerra vs. PV MART dba BUY LOW MARKET, INC., EMPLOYERS COMPENSATION INSURANCE CO., KEYANOOSH GHAMARI dba CODE 3 SECURITY, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board denied the Uninsured Employers Benefits Trust Fund's petition for reconsideration. Applicant's petition was granted to amend the original Findings and Order. The Board found that PV Mart dba Buy Low Market, Inc. was not a special employer of the applicant, Rafael Becerra. Consequently, PV Mart and its insurer were dismissed as party defendants, and the applicant was deemed an employee of Keyanoosh Ghamari dba Code 3 Security at the time of injury.

Workers' Compensation Appeals BoardUninsured Employers Benefits Trust FundSpecial Employment RelationshipGeneral EmploymentBorrowing EmployerLending EmployerRight to ControlCredibility DeterminationBuy Low MarketCode 3 Security
References
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
Case No. ADJ7125024
Regular
Apr 07, 2014

JOSHUA INGMAN vs. GRANT'S BOBCAT AND HAULING, R4CORPORATION, INC., LABOR READY, CITY OF SACRAMENTO, UNINSURED EMPLOYERS BENEFITS TRUST FUND, CASTLEPOINT NATIONAL INSURANCE, NEW HAMPSHIRE INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the Uninsured Employers Benefit Trust Fund's (UEBTF) Petition for Removal. The Board found that the UEBTF failed to demonstrate substantial prejudice or irreparable harm from the WCJ's decision. Furthermore, the Board noted that reconsideration would be an adequate remedy if an adverse decision ultimately issued. Given the significant delay in the applicant receiving benefits, the ongoing insurance coverage arbitration, and the UEBTF's available remedies for recovery, removal was deemed an inappropriate extraordinary remedy.

RemovalUninsured Employers Benefit Trust FundUEBTFSubstantial PrejudiceIrreparable HarmReconsiderationInsurance CoverageArbitrationLabor Code Section 2750.5Meier case
References
Case No. ADJ8556609
Regular
Jul 01, 2018

LUIS ROBLES vs. THE ESTATE OF VICKY BLEAZARD, dba BLEAZARD COMPANY, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The WCAB granted the applicant's petition for removal, reversing the WCJ's decision that denied joinder of the employer's estate and the Uninsured Employers Benefits Trust Fund (UEBTF). The Board clarified that Labor Code § 5306 permits workers' compensation claims against a deceased uninsured employer's estate, irrespective of probate presentation. Furthermore, the Board found UEBTF properly joined due to the Estate's general appearance and service of a special notice of lawsuit. Consequently, the case is returned for further proceedings with both the Estate and UEBTF joined as defendants.

Workers Compensation Appeals BoardPetition for RemovalEstate of Vicky BleazardUninsured Employers Benefits Trust FundLabor Code § 3715Labor Code § 5306general appearancespecial notice of lawsuitprobate courtstatute of limitations
References
Case No. ADJ749878 (ANA 0384761)
Regular
Dec 15, 2010

ENRIQUE GUTIERREZ vs. FRANCISCO ORDONEZ, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Uninsured Employers Benefits Trust Fund (UEBTF) sought reconsideration of an award based on stipulated facts concerning an industrial injury to applicant. The Board granted reconsideration because there was no proof that the alleged uninsured employer was properly served with notice of the stipulations and the WCJ's intention to issue an award. The employer was not afforded the statutorily required time to object before the award was issued. Consequently, the Board rescinded the award and returned the case for further proceedings, emphasizing proper service and objection periods.

Uninsured Employers Benefits Trust FundPetition for ReconsiderationStipulations With Request For AwardLabor Code section 3715(e)Notice of Intention to Approve StipulationsProof of ServiceAlleged Uninsured EmployerRescind AwardDeclaration of Readiness to ProceedMandatory Settlement Conference
References
Case No. ADJ4413699 (SDO 0272634)
Regular
Jul 26, 2018

ROMINA FATURECHI vs. JOSEPH CAPPS, UNINSURED EMPLOYERS BENEFITS TRUST FUND, OCEAN'S ELEVEN CASINO, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for SUPERIOR NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board overturned a prior decision, finding that the applicant was jointly employed by Joseph Capps and Ocean's Eleven Casino. This determination was based on evidence that the Casino exercised control over the applicant's work, including directing when games started and stopped, providing meals, and having the ability to influence her hiring and termination. The Court emphasized that the legality of the Casino employing the applicant was not the decisive factor. Therefore, both Capps and the Casino are considered dual employers for the purposes of workers' compensation.

Dual employmentSpecial employment relationshipJoint employmentControl of employee activitiesCasino bankerPropositional playerUninsured employerCalifornia Insurance Guarantee AssociationUninsured Employers Benefits Trust FundBorello test
References
Case No. ADJ3045197 (LAO 0818234)
Regular
Oct 07, 2011

DIOMEDES QUINONEZ vs. CHECKMATE STAFFING, INC., BUCKEYE CLAIMS, J.C. PENNEY, INC., AIG CLAIM SERVICES, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Uninsured Employers Benefits Trust Fund (UEF) sought reconsideration of a prior award against Checkmate Staffing, arguing an automatic bankruptcy stay invalidated it. The Board denied the UEF's petition, finding it lacked jurisdiction to rescind an award over seven years old. California Labor Code Section 5804 strictly limits rescission or alteration of awards to five years post-injury. The Board emphasized that rescinding the award would contravene the legislative intent behind the UEF to protect workers injured by illegally uninsured employers.

Uninsured Employers Benefits Trust FundPetition for ReconsiderationFindings and AwardBankruptcy Automatic StayLabor Code Section 5804Jurisdictional LimitationRescind AwardContinuing JurisdictionLegally Uninsured EmployerDate of Injury
References
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