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

Case No. ADJ10258281
Regular
Dec 22, 2020

MARIA VASQUEZ, KAYLYN VASQUEZ vs. SUN HEALTHCARE GROUP DBA PARK WEST CARE & REHAB CENTER, NATIONAL UNION INSURANCE COMPANY

In this case, the WCAB granted reconsideration after the WCJ initially denied the applicants' claim that Hernan Vasquez's death from prostate cancer was work-related. Following a settlement conference, the parties agreed to a compromise and release for $30,000. The WCAB found the settlement adequate and in the applicants' best interest. Consequently, the WCAB rescinded the original Findings and Order and approved the Compromise and Release agreement.

Hernan VasquezMaria VasquezKaylyn VasquezSun Healthcare GroupPark West Care & Rehab CenterNational Union Insurance CompanyBroadspireProstate CancerIndustrial InjuryCompromise and Release
References
Case No. ADJ7817081
Regular
Jul 25, 2013

RUBY VARGAS vs. PEDIATRIC PARTNERS, ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Ruby Vargas' petition for reconsideration, upholding the WCJ's finding that she did not sustain a compensable injury. The employer successfully argued Labor Code section 3600(a)(10) because Vargas failed to report her alleged injury prior to receiving notice of her termination. The Board found the WCJ's credibility determinations, favoring the employer's witnesses who testified Vargas did not report an injury, were supported by the record. Furthermore, Vargas' attempt to introduce newly discovered witness testimony was rejected as it could have been discovered with reasonable diligence prior to the hearing.

Workers' Compensation Appeals BoardRuby VargasPediatric PartnersZurich American Insurance CompanyGallagher BassettADJ7817081Opinion and Order Denying Petition for ReconsiderationLabor Code section 3600(a)(10)Affirmative DefensePost-Termination Notice
References
Case No. ADJ7505154
Regular
Nov 18, 2011

LATONYA SIMS vs. LOS ANGELES COUNTY METROPOLITAN TRANSPORTATION AUTHORITY

The Workers' Compensation Appeals Board granted reconsideration to rescind an earlier finding that applicant LaTonya Sims sustained an injury arising out of and in the course of employment. The Board determined that the robbery and assault were not sufficiently connected to her employment as a bus operator. Citing case law, the Board concluded that personal assaults, such as this robbery for the applicant's purse and cash, do not arise out of employment when the employment merely provides a stage for the event and the assailant's motive is purely personal. Therefore, the applicant's claim was denied.

Workers' Compensation Appeals BoardLatonya SimsLos Angeles County Metropolitan Transportation Authoritybus operatorinjury arising out of employmentinjury in course of employmentpersonally motivated robberygoing and coming rulethird-party assaultbunkhouse rule
References
Case No. ADJ6894399
Regular
Jun 16, 2010

URIEL DE AVILA vs. BRENT REDMOND TRANSPORTATION, NOVAPRO RISK SOLUTIONS, CALIFORNIA TRUCKERS SAFETY ASSOCIATIONS

In *De Avila v. Brent Redmond Transportation*, the applicant, Uriel De Avila, sought removal in a workers' compensation case. The Workers' Compensation Appeals Board reviewed the petition and the accompanying administrative law judge's report. Finding no grounds for removal, the Board denied the petition. This decision means the case will proceed without the requested removal.

Workers' Compensation Appeals BoardPetition for RemovalDeniedBrent Redmond TransportationNovapro Risk SolutionsCalifornia Truckers Safety AssociationsUriel de AvilaAdministrative Law JudgeRecord ReviewIncorporation by Reference
References
Case No. ADJ9332041
Regular
Mar 08, 2019

ANA VILLANUEVA vs. TEVA FOODS, TRAVELERS INSURANCE COMPANY

This case concerns whether lien claimant Firstline Health, Inc.'s lien should be subject to a stay under Labor Code section 4615 due to alleged control by criminally charged providers. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, finding the applicant's due process rights were violated. The WCAB rescinded the previous order and returned the case for further proceedings, specifically to allow Firstline an opportunity to rebut evidence of Dr. Uwaydah's de facto control. This decision emphasizes the need for fair hearing and timely notice before imposing a stay on a lien claimant's claim.

Workers' Compensation Appeals BoardLabor Code section 4615Labor Code section 139.21criminally charged providerslien claimantde facto ownershipde facto controlfraudulent documentsconspiracyinsurance fraud
References
Case No. SJO 0235006
Regular
Apr 04, 2008

Geronimo Vasquez vs. RAMOS BUILDING MAINTENANCE, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board reconsidered a prior award for Geronimo Vasquez's back injury, adjusting the permanent disability. The Board found that 20% of the applicant's permanent disability should be apportioned to a pre-existing condition, reducing the overall award. The weekly indemnity rate was also corrected from $230.00 to $93.33.

Workers Compensation Appeals BoardGeronimo VasquezRamos Building MaintenanceState Compensation Insurance FundSJO 0235006ReconsiderationPermanent DisabilityApportionmentPre-existing ConditionQualified Medical Evaluator
References
Case No. ADJ9455826
Regular
Jan 08, 2016

SAUL VARGAS vs. DUO MAX ENTERPRISES, INC, AMTRUST on behalf of TECHNOLOGY INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed Saul Vargas's petition for reconsideration. The dismissal was based on the petition being filed on November 17, 2015, which was over 25 days after the WCJ's October 20, 2015 decision was served. California law mandates that petitions for reconsideration must be filed within 25 days of service, an extension is not granted for mailing. The WCAB lacks jurisdiction to consider untimely petitions.

Petition for ReconsiderationUntimely FilingJurisdictional LimitService by MailWCJ ReportAppeals BoardDismissalLabor CodeCalifornia Code of RegulationsTimeliness Extension
References
Case No. ADJ1582101
Regular
Jun 16, 2011

MARITHA DE WERK vs. COUNTY OF CONTRA COSTA

The County of Contra Costa petitioned for reconsideration of an award of total permanent disability for Maritha De Werk, arguing for apportionment to non-industrial factors and between separate injuries. The parties subsequently notified the Board of a tentative settlement agreement. To allow for settlement approval and potential further proceedings, the Appeals Board granted reconsideration. The matter is being held in abeyance pending settlement finalization.

Workers' Compensation Appeals BoardMaritha De WerkCounty of Contra CostaPermissibly Self-InsuredADJ1582101WCJ 0059766Opinion and Order Granting ReconsiderationNew and further disabilitySpecific injuryCumulative trauma injury
References
Case No. ADJ2419784 (LBO 0367096) ADJ2075423 (LBO 0367097) ADJ2337471 (LBO 0367098)
Regular
Jan 09, 2012

ANTHONY DE FAZIO vs. LOS ANGELES UNIFIED SCHOOL DISTRICT, SEDGWICK CMS

Applicant Anthony De Fazio petitioned for reconsideration of a Joint Findings and Award and Order. The Workers' Compensation Appeals Board has granted this petition, finding it necessary to further study the factual and legal issues. This reconsideration is intended to allow for a complete understanding of the record and a just decision. Further proceedings may be determined as appropriate.

Anthony De FazioLos Angeles Unified School DistrictSedgwick CMSPetition for ReconsiderationJoint Findings and AwardWorkers' Compensation Appeals BoardStatutory time constraintsFactual issuesLegal issuesDecision After Reconsideration
References
Case No. ADJ2419784 (LBO 0367096)
Regular
Oct 02, 2012

ANTHONY DE FAZIO vs. LOS ANGELES UNIFIED SCHOOL DISTRICT, SEDGWICK CMS

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to review the apportionment of permanent disability awards for applicant Anthony De Fazio. Applicant sustained three separate industrial injuries in 2002, 2003, and 2004, resulting in distinct permanent disability ratings. Applicant argued that all permanent disability should be awarded as a single lump sum due to intertwined work restrictions, citing *Benson v. Permanente Medical Group*. The WCAB rescinded the prior decision and returned the matter to the trial level. This was done to allow for new rating instructions that would apply the "common restriction" to each injury, with a specific instruction for the workers' compensation judge to consider any overlap in disability.

Workers' Compensation Appeals BoardAnthony De FazioLos Angeles Unified School DistrictSedgwick CMSReconsiderationJoint Findings and AwardPermanent DisabilityApportionmentBenson v. Permanente Medical GroupIndustrial Injuries
References
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