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

Case No. ADJ5806281
Regular
Jul 03, 2012

DEBBIE SCHLATER vs. NORTH COAST DRIVERS, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant's petition to reopen for new and further disability after an initial award became final. The Workers' Compensation Appeals Board (WCAB) granted removal to review an administrative law judge's denial of a voluntary arbitration request. The WCAB clarified that while arbitration is generally prohibited after testimony is taken, it is permissible for issues not decided in a final award. Therefore, the WCAB rescinded the denial, allowing the parties to arbitrate the new and further disability claim.

Petition for RemovalVoluntary ArbitrationWCAB Rule 10997Labor Code section 5275(b)Court Administrator Rule 10296(a)Findings and AwardNew and Further DisabilityReopen CaseDisability Evaluator TestimonyFinal Award
References
Case No. ADJ2653693
Regular
Jul 12, 2012

TIMETHY PORTEOUS vs. REAL ROCK INDUSTRIES, LUMBERMENS MUTUAL INSURANCE COMPANY

This case involves a dispute over voluntary arbitration after a prior Workers' Compensation Appeals Board (WCAB) award. The WCJ initially denied arbitration based on WCAB Rule 10997, which generally prohibits arbitration after testimony has been taken. However, the Appeals Board granted removal, reversing the WCJ's decision. They clarified that Rule 10997 only bars arbitration for issues previously decided in a final award after testimony, allowing parties to voluntarily arbitrate any *remaining, undecided* issues. Therefore, the parties were permitted to proceed with arbitration for outstanding matters.

Petition for RemovalVoluntary ArbitrationWCAB Rule 10997Labor Code section 5275(b)Court Administrator Rule 10296(a)Order Denying Request for Submittal to Voluntary ArbitrationFindings and Awardcumulative traumaindustrial injurytemporary disability indemnity
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. ADJ3591939 (LAO 07459514)
Regular
Jan 09, 2009

JUANA VENEGAS vs. X-CHANGE PERSONNEL SERVICES, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for SUPERIOR NATIONAL INSURANCE, in liquidation, by BROADSPIRE, MERLE NORMAN COSMETICS, AIG CLAIMS SERVICES, INC.

AIG Claims Services, Inc. (AIG) appeals the WCJ's October 20, 2008 determination that the issue of applicant's alleged special employment by Merle Norman Cosmetics must be submitted to arbitration. The Appeals Board dismisses the petition for reconsideration, grants the petition for removal, and rescinds the submission to arbitration.

Special employmentCIGAcovered claimsarbitrationremovalreconsiderationinterim orderfinal orderprejudiceLabor Code section 5275(a)
References
Case No. ADJ7286100; ADJ7286102
Regular
Apr 06, 2012

VILMA LAMBEY vs. MY OWN LIFE FOUNDATION, STATE COMPENSATION INSURANCE FUND, STATE FARM FIRE AND CASUALTY COMPANY, KHEESA SLAUGHTER

The Workers' Compensation Appeals Board granted reconsideration to determine the applicant's employer, as this issue was erroneously sent to arbitration. The Board found that the arbitrator lacked jurisdiction to decide employment status, which is a matter for the WCJ. Consequently, the prior arbitration order is rescinded and the case is returned to the trial level for a new decision on employer identity and coverage. The Board also directed that Kheesa Slaughter and State Farm be joined as defendants if not already properly done.

Workers' Compensation Appeals BoardReconsiderationArbitrationInsurance CoverageIdentity of EmployerAOE/COELabor Code Section 5275Labor Code Section 3300Labor Code Section 3351Labor Code Section 3357
References
Case No. ADJ10850096 ADJ10851592
Regular
Oct 25, 2018

MARIA FLORINA PADRON DE HERNANDEZ vs. MERCHANTS BUILDING MAINTENANCE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of an arbitrator's decision concerning Maria Padron de Hernandez's workers' compensation claim. The arbitrator had found a specific back injury, awarded temporary disability, denied future medical treatment, and imposed sanctions. The WCAB rescinded the arbitrator's decision, returning the matter for further proceedings. This action was based on the finding that the parties' Alternative Dispute Resolution (ADR) agreement stipulated arbitration under American Arbitration Association rules, which were not provided nor followed. Consequently, it could not be determined if the arbitration proceeded according to the agreed-upon rules, thus potentially violating due process.

Workers Compensation Appeals BoardAlternative Dispute ResolutionLabor Code section 3201.7Arbitrator's Findings and AwardCosts and SanctionsContinuing InjuryTemporary DisabilityOverpaymentFuture Medical TreatmentReconsideration
References
Case No. ADJ12096808
Regular
2020-01-33

LARRY REASNER vs. CASEY JOHNSON, dba ROCKIN CJ TRANSPORT COMMERCE & INDUSTRY INSURANCE COMPANY, AIG; NEW YORK MARINE AND GENERAL INSURANCE COMPANY

This case concerns a Petition for Removal filed by Commerce and Industry Insurance Company regarding an order to proceed to trial on an injury AOE/COE. The dispute arises from a prior Stipulated Award between the applicant and New York Marine and General Insurance Company for a cumulative trauma injury. Commerce and Industry argues that its contribution claim against New York Marine is subject to mandatory arbitration under Labor Code section 5500.5. The Appeals Board granted removal, rescinded the trial order, and found that the inter-insurer dispute over contribution must be arbitrated, as the applicant is not involved in this separate proceeding.

Petition for RemovalStipulated AwardCumulative TraumaPetition for ContributionMandatory ArbitrationLabor Code Section 5500.5Successive EmployersInsurers Jointly and Severally LiableContribution ProceedingsDe Novo
References
Case No. ADJ6940334
Regular
Jan 28, 2011

AURELIO RAMOS LOPEZ vs. JESUS AGUILAR dba C&A FRAMING et al.

The Workers' Compensation Appeals Board granted reconsideration, rescinded a deficient arbitrator's judgment, and returned the matter for further proceedings. The original "Judgment" failed to comply with statutory requirements for a decision, lacking an opinion and a signature. Defendant Granite argued denial of due process due to insufficient time for discovery after being joined as a party. Defendant C&A contended substantial evidence supported coverage by AIG on the date of injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationJudgmentArbitrationCoverageDate of InjuryDue ProcessDiscoverySubstantial EvidenceWaiver
References
Case No. ADJ7405264
Regular
Jun 19, 2012

IVORY PHILLIPS vs. IRWIN INDUSTRIES, INC., ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board sanctioned claims adjuster Richard Bailey $250 for failing to appear at an arbitration hearing. Despite Bailey's contentions about lack of written notice and fear of the arbitrator, the Board found he had actual notice of the verbal order. While the underlying issue was resolved, Bailey should have sought permission for his non-appearance, and his disregard for the arbitrator's order undermined the system's integrity.

Workers' Compensation Appeals BoardSanctionsClaims AdjusterArbitrationWritten ObjectionGood CauseArbitratorVerbal OrderLabor Code Section 5701Independent Medical Examination
References
Case No. ADJ1525428
Regular
Aug 20, 2013

Raymond Barrios vs. Irwin Industries, Inc., California Insurance Guarantee Association, For California Compensation Insurance Company, In Liquidation, Mobil Corporation, Petroleum Casualty Company

The Workers' Compensation Appeals Board (WCAB) vacated an arbitrator's findings due to an incomplete arbitration file, lacking essential evidence and documentation. The WCAB found the arbitrator failed to comply with regulations requiring minutes of hearing, stipulations, and a summary of evidence. Consequently, the WCAB rescinded the arbitrator's decision and returned the case to the trial level for further proceedings. The prior order compelling arbitration was also vacated, allowing parties to resubmit to arbitration if desired.

WCABCIGAarbitrationreconsiderationarbitration fileminutes of hearingsummary of evidencedocumentary evidencetestimonial evidencestipulated facts
References
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