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Case No. ADJ7541142

Regular

Jul 02, 2012

MIGUEL OSIO vs. EMBASSY SUITES, FIREMAN'S FUND INSURANCE COMPANY

This case involves a worker's compensation claim where the applicant, Miguel Osio, suffered an industrial injury to his right knee. The defendant insurer, Fireman's Fund, sought reconsideration of a finding that it was estopped from raising the statute of limitations. The Appeals Board denied reconsideration, agreeing that the insurer's February 3, 2004 notice was misleading. Specifically, the notice incorrectly stated the applicant had no permanent limitations and failed to inform him of any time limits to pursue further benefits, thus estopping the insurer from asserting the statute of limitations.

Workers' Compensation Appeals BoardFireman's Fund Insurance CompanyPetition for ReconsiderationFindings and AwardStatute of LimitationsEstoppelPermanent DisabilityRight Knee InjuryWaiterNotice Requirements

References

Case No. ADJ448774

Regular

Nov 14, 2008

LUIS CERVANTES vs. IRVINE MARRIOTT, MARRIOTT CLAIMS SERVICES

The Workers' Compensation Appeals Board granted reconsideration of a decision that awarded 16% permanent disability based on the 2005 rating schedule and applied a 20% apportionment to the applicant's shoulder injury. The applicant argued for the applicability of the 1997 rating schedule and challenged the substantiality of the defense Qualified Medical Evaluator's opinions on permanent disability and apportionment. The Board rescinded the original award and returned the case for further proceedings and a new decision by the WCJ, who will determine the applicable rating schedule and issue a simplified award.

Petition for ReconsiderationFindings and AwardPermanent DisabilityApportionmentRating ScheduleQualified Medical EvaluatorSubstantial EvidenceIndustrial InjuryWaiterBack Injury

References

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MIGUEL OSIO vs. EMBASSY SUITES, FIREMAN'S FUND INSURANCE COMPANY

LUIS CERVANTES vs. IRVINE MARRIOTT, MARRIOTT CLAIMS SERVICES

Petition for ReconsiderationFindings and AwardPermanent DisabilityApportionmentRating ScheduleQualified Medical EvaluatorSubstantial EvidenceIndustrial InjuryWaiterBack Injury