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

Case No. B167017
Significant
Nov 18, 2004

General Casualty Insurance and Regent Insurance, Joseph A. Lane, American Home Assurance Company vs. Workers' Compensation Appeals Board and California Insurance Guarantee Association

The court has requested responses from the Workers' Compensation Insurance Rating Bureau (WCIRB) and the California Insurance Commissioner regarding the exclusion of special employees from a special employer's workers' compensation policy, specifically questioning the use and requirements of Form No. 11 for this purpose.

WCIRBForm No. 11limiting endorsementsrestricting endorsementsspecial employeesgeneral employerstemporary employeesleased employeesInsurance CommissionerCalifornia Code of Regulations
References
Case No. ADJ8202286; ADJ8202308
Regular
Jul 23, 2013

BRADLEY WHEELER vs. COUTS HEATING & COOLING, INC., ZURICH AMERICAN INSURANCE CO.

The Appeals Board dismissed Zurich's unverified Petition for Removal due to procedural defects and its misrepresentation of the record. The Board also removed the cases to itself on its own motion and issued a notice of intention to impose sanctions on Zurich for frivolous actions. The Board directed the WCJ to hold a priority hearing to determine if Seabright should be joined as a party and to resolve issues regarding alternative dispute resolution provisions.

Workers' Compensation Appeals BoardPetition for RemovalDismissedSanctionsLabor Code Section 3201.7Alternative Dispute ResolutionWCIRBSocial Security EarningsPetition for DismissalOff Calendar
References
Case No. ADJ7964733
Regular
May 29, 2018

JOSE LUIS MASTACHE vs. STAFFCHEX, INC., JESSIE LORD BAKERY; CALIFORNIA GUARANTEE ASSOCIATION for ULLICO CASUALTY COMPANY in Liquidation through its servicing facility SEDGWICK CMS; TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

This case involves a workers' compensation claim where CIGA seeks reconsideration of a prior decision. The core dispute centers on whether a Travelers insurance policy issued to Jessie Lord Bakery excludes coverage for special employees leased from Staffchex. The Appeals Board granted reconsideration, rescinded the prior decision, and found that the Travelers policy provided coverage, reasoning that the exclusion endorsement was invalid as it lacked the required written affirmation by the policyholder. Furthermore, the Board clarified that general and special employers remain jointly and severally liable for workers' compensation benefits, irrespective of agreements between them.

CIGAStaffchexJessie Lord BakeryTravelers Property Casualty CompanyUllico Casualty CompanySpecial EmployeeGeneral EmployerJoint and Several LiabilityLabor Code Section 3602(d)Limiting Endorsement
References
Case No. STK 0201989
Regular
Oct 03, 2007

JUAN PRADO vs. PRICE SMART, INC.,, COMMERCE & INDUSTRIAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded the previous findings, remanding the case for further proceedings. The defendant argued that insurance coverage disputes must be arbitrated and that the WCJ lacked jurisdiction to determine liability. Additionally, the defendant claimed lack of notice for the hearing and that the applicant's injury occurred outside California. The Board found that the WCJ erred in not issuing a proper notice of intention before issuing the award, necessitating a new trial.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardJurisdictionInsurance Carrier LiabilityArbitrationLabor Code Section 5275WCIRBExpedited HearingNotice of Trial
References
Case No. ADJ1308665
Regular
Jan 27, 2014

GARY STALCUP vs. BRAD JOHNSON TRUCKING, CLARENDON NATIONAL INSURANCE COMPANY

This case involves a dispute over the date of injury for Gary Stalcup's left knee. The defendants seek reconsideration of the WCJ's finding of injury on February 10, 1998, arguing the applicant stipulated to November 10, 1997, and that medical evidence does not support the later date. The Appeals Board denied reconsideration, agreeing with the WCJ that it was equitable to set aside both stipulations (date of injury and insurance coverage) due to apparent mistakes by the parties. The Board affirmed the WCJ's decision to amend the date of injury based on contemporaneous medical evidence rather than enforcing potentially erroneous stipulations.

WCABPetition for ReconsiderationFindings and Awarddate of injurystipulationtotal temporary disabilitymedical evidencedue processcoverageWCIRB
References
Case No. ADJ10334806
Regular
May 19, 2025

MARITZA VILLATORO vs. WALLPAPER CITY LLC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration in the case of Maritza Villatoro against Wallpaper City LLC. and State Compensation Insurance Fund. Lien claimant Citywide Scanning Service, Inc. petitioned for reconsideration after a WCJ ruled it failed to prove a contested claim existed when its medical-legal services were requested. The Board rescinded the WCJ's Findings and Order, determining that a contested claim did indeed exist, evidenced by a delay letter from the State Compensation Insurance Fund and the applicant's filing of an Application for Adjudication before the lien claimant's services were provided. The matter is now returned to the trial level to address the remaining issues.

Workers' Compensation Appeals BoardReconsiderationLien ClaimantFindings and OrderWCJContested ClaimMedical-Legal ExpenseLabor CodeSubpoena Duces TecumDelay Letter
References
Case No. ADJ10773162
Regular
May 21, 2018

JUAN CASTILLO vs. CORNERSTONE PROPERTIES FAMILY, LP, STATE COMPENSATION INSURANCE FUND

This case involves a dispute over workers' compensation insurance coverage for Commercial Machineworx Company, LLC (CMC). The State Compensation Insurance Fund (SCIF) seeks to deny coverage, arguing CMC was not listed on the policy and its payroll was not properly reported. However, the Appeals Board found sufficient evidence that CMC was intended to be covered under the policy due to common ownership with other insured entities. The Board also found that payroll for CMC was indeed submitted, and SCIF failed to present contradictory evidence or adequately explain its position on combinability. Therefore, SCIF's petition for reconsideration was denied.

Workers' Compensation Appeals BoardCornerstone Properties Family LPState Compensation Insurance FundJuan CastilloADJ10773162Petition for ReconsiderationFindings and OrderCommercial Machineworx Company LLCcombinable entityexperience modification
References
Case No. ADJ2183699 (VNO 0558048)
Regular
Oct 23, 2019

ALICIA RAMOS vs. DAVID HAKIM, The Handal Family Trust

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior determination that David Hakim was an illegally uninsured employer. Hakim appealed, arguing the applicant was an independent contractor, not an employee, thus he was not required to carry workers' compensation insurance. The Board found that Hakim's contention regarding the employment status sufficiently rebutted the prima facie case required for an illegally uninsured employer finding. The case is returned to the trial level for further proceedings to determine employment status and other related issues.

Workers' Compensation Appeals BoardPrima Facie DeterminationIllegally Uninsured EmployerPetition for ReconsiderationIndependent ContractorLabor Code Section 3715Uninsured Employers Benefit Trust FundArising Out Of and Occurring In The Course Of EmploymentAOE/COEDirector of Industrial Relations
References
Case No. ADJ9984568
Regular
Dec 13, 2017

GUADALUPE MAGALLON DE ALVAREZ vs. ACCOUNTABILITIES, INC. BY TRI-STATE EMPLOYMENT SERVICES, INC., LUMBERMEN'S MUTUAL CASUALTY COMPANY, In Liquidation, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, Administered By SEDGWICK CLAIMS MANAGEMENT SERVICE, NATIONAL INTERSTATE INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed National Interstate Insurance's petition for reconsideration as it was not a final order. However, the WCAB granted National's petition for removal, rescinding the WCJ's order to transfer claim administration. This was due to National being served incorrectly, lacking proper notice and opportunity to object, which constituted a due process violation. The case is returned to the trial level for a new hearing to determine National's involvement.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalOrder to Change Administration of BenefitsCalifornia Insurance Guarantee AssociationNational Interstate InsuranceWCIRBSpecial Dispatch of CAInc.Joinder
References
Case No. ADJ7989476 ADJ9983597 ADJ9983898
Regular
Jun 18, 2018

MARIA MIRANDA vs. KOOSHAREM dba SELECT STAFFING dba SELECT FOCUS, EVANS MANUFACTURING, ACE AMERICAN INSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE (CIGA) Adjusted by SEDGWICK for ULLICO CASUALTY, in liquidation, TRUCK INSURANCE EXCHANGE

This case involves a dispute over workers' compensation insurance liability for injuries sustained by applicant Maria Miranda in 2011 while employed by Select Staffing (general employer) and Evans Manufacturing (special employer). The Workers' Compensation Appeals Board (WCAB) rescinded the arbitrator's decision because the evidence, particularly insurance policy endorsements, was not adequately identified and admitted. The WCAB found the record insufficient to determine which insurer, ACE American Insurance Company or Truck Insurance Exchange, is primarily liable for benefits. The matter is returned to the arbitrator to establish a complete and proper record for a new decision, addressing the specific requirements for insurance endorsements limiting coverage.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderInsurance LiabilityGeneral EmployerSpecial EmployerACE American Insurance CompanyTruck Insurance ExchangeCalifornia Insurance Guarantee AssociationCIGA
References
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