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Case Law Database

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

Case No. ADJ8551992
Regular
Jan 17, 2014

ANTHONY BRUGLIERA vs. YRC FREIGHT, GALLAGHER BASSETT

The Workers' Compensation Appeals Board denied the defendant's Petition for Removal. The Board found the defendant failed to demonstrate significant prejudice or irreparable harm, and that reconsideration would not be an adequate remedy. The Administrative Law Judge had only set aside the order approving the Compromise and Release, not the agreement itself, and the applicant's petition for reconsideration was timely filed. Therefore, removal was deemed unnecessary as the underlying settlement remains subject to the applicant's burden of proof.

Petition for RemovalWorkers' Compensation Appeals BoardCompromise and ReleasePetition for ReconsiderationOrder Approving CompromiseSet Aside OrderGood CauseSignificant Panel DecisionIrreparable HarmReinstatement
References
1
Case No. ADJ7678424
Regular
Dec 05, 2013

ROGELIO ORTIZ ROSALES vs. HYDRO SCAPE PRODUCTS, INC., ZURICH NORTH AMERICA CLAIMS

The Workers' Compensation Appeals Board denied the defendant's petition for removal while granting it on its own motion. This action stemmed from the defendant's violation of Rules of Practice and Procedure by attaching 77 pages of previously admitted exhibits to their petition. Consequently, sanctions of $275 were imposed jointly and severally on the defendant's insurer, their legal firm, and the attorney for bad faith actions and tactics that caused unnecessary burden. The sanctions were subsequently paid by the defendant's legal firm.

Workers' Compensation Appeals BoardPetition for RemovalWCJDiscoveryAbuse of DiscretionSanctionsLabor Code section 5813Rules of Practice and ProcedureBad Faith ActionsFrivolous Tactics
References
0
Case No. ADJ2691374 (LAO 0855825) ADJ2333516 (LAO 0883088)
Regular
Jun 27, 2013

ENRIQUE FELIX vs. CAPITAL DRYWALL, AIG, administered by CHARTIS, QUICK SERVE CARPET, REDWOOD FIRE AND CASUALTY INSURANCE COMPANY, administered by BERKSHIRE HATHAWAY, ENDURACE INSURANCE COMPANY, administered by FIRSTCOMP OF OMAHA, HAMMOND AND MASING, OLD REPUBLIC GENERAL INSURANCE COMPANY, administered by GALLAGHER BASSETT

The Workers' Compensation Appeals Board denied reconsideration of a judge's order finding statute of limitations and lack of jurisdiction defenses viable in one case, while confirming another case remained pending. The Board adopted the judge's report, denying the petition to reopen. Additionally, the Board issued a notice of intention to impose sanctions against applicant's attorney for violating procedural rules by attaching extraneous documents to the petition, creating an unnecessary burden on Board resources.

Workers' Compensation Appeals BoardStatute of LimitationsJurisdictionPetition to ReopenPetition for ReconsiderationWCJWCAB Rule 10842(c)Labor Code Section 5813SanctionBad Faith Actions
References
2
Case No. ADJ1470421 (LBO 0386338) ADJ4674188 (LBO 0386339)
Regular
Jan 20, 2015

JESUS HERNANDEZ vs. MB LANDSCAPING AND NURSERY, ZENITH INSURANCE COMPANY

This case concerns lien claimants' petition for reconsideration after an administrative law judge denied their claim for payment for medical treatment provided to the applicant. The lien claimants argued the judge failed to provide adequate grounds for the decision and that the defendant did not prove the treatment was unreasonable or unnecessary. The Workers' Compensation Appeals Board denied the petition, adopting the judge's report and clarifying that the burden of proof regarding the reasonableness and necessity of treatment rests with the lien claimant. The Board also addressed the eligibility of the lien claimants' representative to appear before the Board.

Lien claimantsPetition for ReconsiderationReasonable and Necessary TreatmentBurden of ProofLabor Code Section 3202.5Labor Code Section 5705Appeals Board Rule 10779Opinion on DecisionCompromise and ReleaseIndustrial Injury
References
8
Case No. MISSING
Regular Panel Decision

West Broward Group, LLC v. Independence Community Bank Corp.

The case revolves around a plaintiff, a Florida corporation, suing defendant Bayonne Bridge, Inc., also a Florida corporation, in New York over a forged $100,000 check. Initially, New York was chosen due to the funds being deposited in a local bank, Independence Community Bank, which later released the funds to the defendant. The plaintiff sought to dismiss the New York action based on forum non conveniens, citing its inability to gain jurisdiction over its own Florida-based bank, Union Planters Bank, and the existence of related litigation in Florida. The court, presided over by Justice Louis B. York, granted the dismissal without prejudice, applying the Economos v Zizikas standard. It determined Florida was the more appropriate forum given the parties' residency, the situs of the underlying action, the location of witnesses, and the ongoing related actions in Florida, thereby alleviating an unnecessary burden on the New York court to adjudicate a case with negligible New York connection and interpret Florida law.

Forged CheckForum Non ConveniensDismissal Without PrejudiceInterstate LitigationContract DisputeWorkers' CompensationJurisdictionFlorida LawNew York CourtsBanking Fraud
References
3
Case No. MISSING
Regular Panel Decision

Henneberry v. ING Capital Advisors

Virginia Henneberry was terminated from her employment with ING Furman Selz Asset Management, LLC and ING Capital Advisors, LLC. She initiated arbitration, challenging the burden of proof and arguing arbitrator misconduct after the arbitrator reversed his initial ruling on the burden of proof. Both the Supreme Court and the Appellate Division upheld the arbitration award. This court affirmed those decisions, finding that the arbitrator's procedural error in shifting the burden of proof did not deprive Henneberry of a fundamentally fair arbitration or exceed his authority, especially since he concluded the employer would have prevailed regardless of who bore the burden.

ArbitrationEmployment AgreementTerminationBurden of ProofArbitrator MisconductDue ProcessFundamental FairnessCPLR 7511Judicial ReviewAppellate Practice
References
4
Case No. ADJ8120854
Regular
Aug 29, 2017

MENG TU vs. GLOBE COMMUNICATIONS, SUSSEX INSURANCE

The Workers' Compensation Appeals Board granted reconsideration, reversing a prior award to lien claimant Rehab Solutions. The Board found that lien claimant bears the burden to prove the reasonableness and necessity of its services, and this burden was not met. Partial payments by the defendant did not constitute authorization or shift the burden of proof, and the utilization review denial of the key treatment remained unchallenged by appeal. Therefore, lien claimant is entitled to no further payment.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings and AwardUtilization ReviewMedical TreatmentReasonableness and NecessityBurden of ProofLabor Code Section 4909Official Medical Fee Schedule
References
8
Case No. ADJ859639
Regular
Jul 30, 2018

TERESA BONILLA vs. CHILDREN'S INSTITUTE, INC., UNITED STATES FIRE INSURANCE

In this workers' compensation case, the applicant sustained multiple injuries. The Appeals Board granted reconsideration to clarify the burden of proof for the Labor Code section 4658(d)(2) 15% permanent disability increase. The Board found that while the applicant has an initial burden to show no modified work offer was made, the employer bears the burden of proving they offered modified work or have fewer than 50 employees. Consequently, the case is returned to the trial level for further development of the record on these specific issues.

Labor Code section 4658(d)(2)Petition for Reconsiderationpermanent disability increaseburden of proofemployer employee countmodified work offeraffirmative defensevocational rehabilitationpermanent and stationary dateapportionment
References
11
Case No. ADJ10257811
Regular
Dec 18, 2020

JORGE ANDRADE vs. CECILIO ARREDONDO TERREZAS, STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board affirmed the judge's decision finding the applicant was not an employee at the time of injury, concluding he failed to meet his burden of proof. The applicant did not provide evidence establishing an employment relationship with the labor contractor or its associated individuals, and evidence indicated he paid for his own transportation. A dissenting opinion argued the board and judge incorrectly shifted the burden of proof, stating the applicant is presumed an employee and the employer must prove otherwise. The dissent would have rescinded the decision for failure to meet the employer's burden.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and OrderEmployee StatusLabor ContractorBurden of ProofEmployment RelationshipPresumption of EmployeeLabor CodeRebuttal of Presumption
References
5
Case No. ADJ10341378, ADJ10341435
Regular
Mar 23, 2018

MARIA AKA MARTHA PUGA AKA GONZALEZ vs. UNITED ONE STAFFING, TRAVELERS PROPERTY AND CASUALTY COMPANY OF AMERICA

This case involves an interpreter service provider petitioning for reconsideration after an administrative law judge denied their request for costs and sanctions against the defendant. The judge found the interpreter service failed to meet their burden of proof regarding the defendant's liability. The Appeals Board granted reconsideration, finding the judge misapplied the burden of proof. Specifically, the Board determined that the defendant's failure to pay an interpreter's invoice within 60 days, without objection, violated a regulation and shifted the burden to the defendant to prove their delay was due to excusable neglect, which they failed to do. The matter was returned to the trial level for further proceedings.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactAdministrative Law JudgePetition for SanctionsLabor Code Section 5811Interpreter FeesMandatory Settlement ConferenceCompromise and ReleaseAdministrative Director Rule 9795.4
References
2
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