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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ1234371 (LAO 0785447) ADJ2536321 (LAO 0863778)
Regular
Sep 17, 2012

JOSE AGUILAR vs. DAVALAN SALES, VIRGINIA SURETY COMPANY, CLARENDON NATIONAL INSURANCE COMPANY, GOLDEN EAGLE INSURANCE COMPANY

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration due to a failure to properly serve Clarendon National Insurance Company. This procedural defect, specifically the lack of a required proof of service, is grounds for dismissal under California regulations. Had the petition not been dismissed, the Board would have denied it based on the administrative law judge's original findings. The applicant had sought reconsideration of findings regarding industrial injuries and disability assessments for multiple injury dates and insurers.

Workers' Compensation Appeals BoardJoint Findings and AwardPetition for Reconsiderationindustrial injurylow backlaborerwarehousemaninsurance coverageVirginia Surety CompanyClarendon National Insurance Company
References
Case No. ADJ1817205 (RIV 0076837) ADJ2824273 (RIV 0076838)
Regular
Jul 02, 2014

SONNY LOVELESS vs. NEWPORT FARMS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ZURICH AMERICAN INSURANCE CO., VIRGINIA SURETY INSURANCE COMPANY

This case involves a dispute over reimbursement for workers' compensation benefits paid by CIGA. The Appeals Board affirmed an arbitrator's decision granting CIGA full reimbursement from Virginia Surety and Zurich for benefits paid to the applicant. Virginia Surety's arguments that the cumulative trauma periods should be reevaluated and that CIGA was liable for the first period were rejected. The Board found Virginia Surety is bound by prior stipulations establishing two cumulative trauma periods, making its coverage "other insurance" under Insurance Code § 1063.1(c)(9) and thus excluding CIGA's liability for those benefits.

Workers' Compensation Appeals BoardSonny LovelessNewport FarmsCalifornia Insurance Guarantee Association (CIGA)Superior NationalZurich American Insurance Co.Virginia Surety Insurance Companycumulative traumastipulated awardreimbursement
References
Case No. ADJ7516108
Regular
Jun 06, 2011

ANGELICA CROTTE vs. UFO, INC., ILLINOIS MIDWEST INSURANCE AGENCY, VIRGINIA SURETY COMPANY, INC.

The Workers' Compensation Appeals Board (WCAB) dismissed Virginia Surety's petition for removal because it was unverified, violating WCAB Rule 10843(b). The WCAB also noted the petition's excessive length and improper attachments, which violated multiple rules, including CA Rule 10232(a)(10) and WCAB Rule 10842(c). Based on these egregious violations, the WCAB issued a notice of intention to impose a $500 sanction on Virginia Surety's counsel, Sophia E. Martinez, pursuant to Labor Code section 5813.

Petition for RemovalUnverified PetitionWCAB RulesLabor Code 5813SanctionsFrivolousWillful Failure to ComplyWCJAdministrative Law JudgeVirginia Surety Company
References
Case No. ADJ3366924 (MON 0344712) ADJ1413399 (VNO 0343360)
Regular
Nov 18, 2014

RICHARD MARQUEZ vs. CO-OPPORTUNITY CONSUMERS, INC., VIRGINIA SURETY COMPANY, ILLINOIS MIDWEST INSURANCE AGENCY, THE KROGER COMPANY

The Workers' Compensation Appeals Board (WCAB) granted Co-Opportunity Consumers, Inc.'s petition for reconsideration of a prior decision. This decision was made after an initial review of the record, recognizing the need for further study of the factual and legal issues. The WCAB intends to fully understand the case to issue a just and reasoned decision after reconsideration. All future communications regarding this case must be filed in writing with the WCAB Commissioners' office, not with any district office or via e-filing.

Workers' Compensation Appeals BoardPetition for ReconsiderationStatutory time constraintsFactual and legal issuesJust and reasoned decisionOffice of the CommissionersElectronic Adjudication Management SystemSelf-insuredCo-Opportunity ConsumersVirginia Surety Company
References
Case No. ADJ2849802 (MON 0335685) ADJ2615302 (MON 0335686)
Regular
Dec 07, 2012

FEDERICO PARDO vs. FELIX MANUFACTURING COMPANY, INC., VIRGINIA SURETY COMPANY, APPLIED RISK SERVICES

This case involves a worker injured in an industrial eye injury who also claims psychological injury and a consequential shoulder injury. The Appeals Board granted reconsideration to address the employer's challenge to the psychological injury finding, agreeing that the medical evidence for it was not substantial. The Board also noted that the award for reimbursement to EDD requires clarification due to the potential reduction in permanent disability. The matter is returned to the trial judge for further proceedings and a new final decision on these issues.

Workers' Compensation Appeals BoardFelix Manufacturing CompanyVirginia Surety CompanyApplied Risk ServicesFederico Pardoforklift operatorindustrial injuryleft eye injurypsyche injurycompensable consequence injury
References
Case No. ADJ207630 (VNO 0423900) ADJ4689357 (VNO 0462906)
Regular
Aug 19, 2014

MANUEL PASQUIER vs. VOLUTONE DISTRIBUTING COMPANY, VIRGINIA SURETY INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted the applicant's petition for reconsideration of a prior Joint Findings of Fact and Order. This action was taken due to statutory time constraints and an initial review indicating a need for further study of the factual and legal issues. The WCAB requires all future communications regarding this case to be filed in writing with the Office of the Commissioners, not with any district office or via e-filing. This reconsideration is intended to allow for a more complete understanding of the record and to issue a just decision.

Petition for ReconsiderationJoint Findings of Fact and OrderStatutory time constraintsFactual and legal issuesJust and reasoned decisionFurther proceedingsDecision After ReconsiderationOffice of the CommissionersElectronic Adjudication Management SystemVan Nuys District Office
References
Case No. ADJ3721868 (VNO 0540149), ADJ855172 (VNO 0540146), ADJ671254 (VNO 0540148)
Regular
Sep 05, 2018

AGUSTIN ZENDEJAS vs. CALABASAS GOLF & COUNTRY CLUB, EMPLOYERS COMPENSATION INSURANCE COMPANY, VIRGINIA SURETY COMPANY INC., FIRSTCOMP division of MARKEL SERVICE INC, dba MARKEL INSURANCE SERVICE

This case concerns appeals by defendants challenging an award of temporary disability benefits. The Appeals Board granted reconsideration, finding the award inconsistent with stipulated facts and medical evidence, particularly Dr. Alonso's report. The Board amended the findings to state the applicant is not owed temporary disability benefits after July 12, 2007. The issue of an overpayment credit was deferred to a WCJ for further proceedings.

Workers Compensation Appeals BoardAgustin ZendejasCalabasas Golf & Country ClubEmployers Compensation Insurance CompanyVirginia Surety CompanyFirstCompMarkel Service IncPetition for ReconsiderationFindings and AwardTemporary Disability Indemnity
References
Case No. FRE 186612
Regular
Mar 26, 2008

, Jose Maravilla, vs. , JOSE AND FLORENCIA ALVERNAZ and CIGA, by CAMBRIDGE INTERGRATE SERVICES for FREMONT INSURANCE COMPANY, in liquidation; LIBERTY MUTUAL INSURANCE COMPANY; CALIFORNIA INDEMNITY INSURANCE COMPANY, adjusted by GAB ROBINS

This case involves Liberty Mutual/Golden Eagle Insurance Company's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision finding applicant sustained a cumulative trauma injury to both knees. The WCAB denied reconsideration, finding the Statute of Limitations defense was waived and that the *Benson* case regarding allocation of disability cause was not applicable as there was only one industrial injury. The WCAB adopted the WCJ's report in its entirety for its denial.

Workers' Compensation Appeals BoardJose MaravillaJose and Florencia AlvernaCIGAFremont Insurance CompanyLiberty Mutual Insurance CompanyCalifornia Indemnity Insurance CompanyGAB RobinsFRE 186612Opinion and Order Denying Petition for Reconsideration
References
Case No. ADJ9090850
Regular
Jun 28, 2017

VINCE FERRAGAMO vs. ST. LOUIS RAMS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT INDEMNITY COMPANY, in liquidation, HOME INSURANCE COMPANY, in liquidation, BUFFALO BILLS, INC., GREEN BAY PACKERS, NORTHWESTERN NATIONAL INSURANCE COMPANY merged with HIGHLANDS INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) reversed a prior decision, finding that Vince Ferragamo's current claim for cumulative brain injury is not barred by a 1988 compromise and release agreement. The Board determined that the brain injury was unknown and not intended to be covered by the prior settlement, which focused on orthopedic and other known injuries. Therefore, the doctrine of res judicata did not preclude this new claim, and the case was returned for further proceedings.

Workers' Compensation Appeals BoardVince FerragamoSt. Louis RamsFremont Indemnity CompanyHome Insurance CompanyBuffalo BillsGreen Bay PackersNorthwestern National Insurance CompanyHighlands Insurance Companycumulative trauma
References
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