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

Case No. ADJ6601989
Regular
Feb 25, 2011

AMALIA VILLEGAS (Widow) vs. TROJAN BATTERY COMPANY, UNITED STATES FIRE INSURANCE C/O CRUM & FORSTER

In this workers' compensation case, the defendant sought reconsideration of a finding that the widow's claim for death benefits was presumed compensable under Labor Code section 5402. The defendant argued they never received the original Findings and Order and that their timely denial of the decedent's inter vivos claim also covered the death benefits claim. The Appeals Board granted reconsideration, finding the defendant's petition timely due to evidence of improper service. Ultimately, the Board reversed the prior finding, holding that the defendant had timely denied liability for the death benefit claim by denying the underlying injury claim.

Workers' Compensation Appeals BoardReconsiderationLabor Code section 5402Presumption of CompensabilityDeath BenefitsInter Vivos ClaimCumulative TraumaToxins ExposureAdrenal CarcinomaProof of Service
References
4
Case No. MISSING
Regular Panel Decision

Claim of Giaquinto v. Major Sanitation, Inc.

This case addresses whether a widow's "mother's insurance benefits" under the Social Security Act are subject to offset provisions of the Workers' Compensation Law. The employer and its carrier argued that the $331.30 per month received by the widow, statutorily designated as "mother's insurance benefits," should be considered a "survivors insurance benefit" and thus subject to a weekly offset of $38.23. The Workers' Compensation Board interpreted the statute to limit the offset to "widow's insurance benefits" and not "mother's insurance benefits," arguing that the latter primarily benefits the children. The court affirmed the board's decision, distinguishing mother's benefits from survivor's benefits due to their purpose of supporting children and their cessation when children reach maturity or leave care.

Workers' CompensationSocial Security ActMother's Insurance BenefitsSurvivors Insurance BenefitsOffset ProvisionsDeath BenefitsStatutory InterpretationWidow's BenefitsDependent ChildrenAdministrative Agency Interpretation
References
2
Case No. ADJ7787995 ADJ7915018
Regular
Jan 22, 2018

JOSEPH JOHNWELL (Deceased), SA’EEDA JOHNWELL (Widow) vs. DUARTE UNIFIED SCHOOL DISTRICT, YORK RISK SERVICE GROUP

This case involved a widow's petition for reconsideration of a dismissal order for her deceased husband's workers' compensation claims. The original dismissal was due to the widow's failure to attend a mandatory settlement conference and a lack of good cause for her absence. The widow argued the dismissal was procured by fraud, alleging the defendant misrepresented the status of benefits and medical opinions. The Appeals Board denied reconsideration, finding the petition untimely and lacking sufficient proof of fraud, and affirming the dismissal was based on the failure to appear.

Petition for ReconsiderationDismissalMandatory Settlement ConferenceFailure to AppearNotice of Intention to DismissWidowDependentFraudOffer of ProofLabor Code Section 5803
References
0
Case No. ADJ1168599
Regular
May 29, 2009

STANLEY ANGEL (Deceased) WANDA ANGEL (Widow) vs. DOW CHEMICAL COMPANY, CRAWFORD & COMPANY, TRAVELERS

This case concerns a widow's petition for reconsideration of a denial of death benefits for her husband, Stanley Angel, who died of multiple myeloma. The Appeals Board previously ruled that there was insufficient substantial medical evidence to establish that Mr. Angel's exposure to toxic chemicals during his employment with Dow Chemical Company caused his illness. The widow argued the Board erred in disregarding the opinion of her Qualified Medical Evaluator, Dr. Harrison, and misapplied the burden of proof. However, the Board affirmed its prior decision, finding Dr. Harrison's revised opinion lacked a solid basis and was inconsistent with other evidence regarding the extent and duration of exposure.

Multiple MyelomaIndustrial InjuryToxic Chemical ExposureQualified Medical Evaluator (QME)Medical CausationLatency PeriodSubstantial Medical EvidenceBurden of ProofReconsiderationOccupational Medicine
References
7
Case No. ADJ799117 (LBO 0393727)
Regular
Jan 14, 2010

FRANK CRUZ (Deceased), DIANA CRUZ (Widow) vs. KRETSCHMAR & SMITH, INC., STATE COMPENSATION INSURANCE FUND

This case involves a widow's claim for death benefits following her husband's fatal industrial injury. The employer argued the claim was barred by a "carve-out" agreement under Labor Code §3201.5, which allows alternative dispute resolution for unionized employees. The Workers' Compensation Appeals Board rescinded the dismissal, finding that carve-out agreements under §3201.5 apply only to employees, not to dependents' death benefit claims. The Board determined that dependents' death benefits are independent rights, not derived from the employee's claim. The case is returned for further proceedings on the merits of the widow's claim.

Carve-out agreementLabor Code § 3201.5Death benefitsDependentsCollective bargaining agreementWorkers' Compensation Appeals BoardReconsiderationRescinded orderLabor Code § 3202Independent claim
References
3
Case No. ADJ3276532 (OAK 0336096)
Regular
Mar 29, 2011

JERRY DUARTE (Deceased) SHIRLEY DUARTE (Widow) vs. STOESSER INDUSTRIES, SCIF INSURED PLEASANTON, FIREMAN'S FUND SACRAMENTO

This case concerns a widow's claim for workers' compensation death benefits following her husband's cancer death, alleging exposure to carcinogenic chemicals at work. The original finding barred the claim due to the statute of limitations, as the application was filed over a year after the employee's death. The Appeals Board, on reconsideration, reversed this, finding the defendant failed to prove the widow knew or should have known of the industrial causation within the one-year period. Therefore, the claim is not time-barred, and all other issues are returned to the trial level for further proceedings.

Cumulative TraumaCarcinogenic ChemicalsDeath BenefitsStatute of LimitationsIndustrial CausationOccupational ExposureDependent ClaimMedical ConfirmationReasonable DiligenceAffirmative Defense
References
5
Case No. ADJ10649068
Regular
Dec 08, 2017

PATRICK TERRY (Dec'd), WENDY TERRY (Widow) vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

This case involves a widow's claim for death benefits after her husband died from an injury that contributed to his death. The Workers' Compensation Appeals Board denied reconsideration, upholding the administrative law judge's finding that the claim was barred by Labor Code section 5406(b). This statute prohibits death benefit claims filed more than 240 weeks from the "date of injury." The Board clarified that for a specific injury, the date of injury is fixed and cannot be extended to the date of death, even if death is a consequence of that injury. Therefore, the widow's claim was dismissed because it was filed beyond the 240-week statutory limit.

Labor Code § 5406(b)death benefits240-week limitationdate of injuryspecific injurycompensable consequencestatute of limitationsPetition for ReconsiderationWorkers' Compensation Appeals BoardFindings and Award
References
15
Case No. MISSING
Regular Panel Decision
Feb 21, 1986

Claim of Seidel v. Crown Industries

This case involves an appeal from a Workers’ Compensation Board decision denying death benefits to a claimant, who the Board ruled was not the legal widow of the decedent, Harold Seidel. The employer and carrier challenged the claimant's right to compensation, asserting that decedent's prior marriage to Marion Strope was never legally terminated. Both claimant and Strope presented marriage certificates. The court noted the strong legal presumption favoring the validity of the second marriage, especially when the challenger is a stranger to the marital relation. The respondents bore the burden of disproving the second marriage by clear and convincing evidence. The court found that the Board's decision failed to set forth the proper legal standard and appeared to give undue weight to the claimant's knowledge of the prior marriage, which is irrelevant to her legal widow status. Due to the serious question regarding the application of the correct legal standard and the close factual question, the decision was annulled and remitted for clarification and further proceedings consistent with the proper legal standard.

Death BenefitsWorkers' CompensationMarital StatusLegal WidowPresumption of ValiditySecond MarriageBurden of ProofAdministrative LawRemittalJudicial Review
References
8
Case No. CV-23-0874
Regular Panel Decision
Nov 21, 2024

In the Matter of the Claim of Thomas LaMont (dec'd)

This case involves an appeal from a Workers' Compensation Board decision that awarded death benefits to Dalena Lamont, the widow of Thomas Lamont. Thomas Lamont, a participant in World Trade Center rescue operations, developed rectal cancer in 2017, establishing a lifetime claim for an occupational disease. After his death in 2022, his widow sought death benefits. The Board ruled that the death was a consequence of the original occupational disease, setting the date of disablement as September 28, 2017, and holding Safety National Casualty Corp. liable for benefits calculated based on the average weekly wage at that disablement date. The Appellate Division affirmed the Board's decision, emphasizing that in occupational disease cases, disablement is treated as the date of the accident for determining injury date and average weekly wage for death benefits.

Workers' Compensation LawDeath Benefits ClaimOccupational DiseaseWorld Trade Center OperationsRectal Cancer DiagnosisDate of DisablementAverage Weekly Wage CalculationGround Zero ExposureAppellate ReviewThird Judicial Department
References
12
Case No. 2024 NY Slip Op 05854 [232 AD3d 1077]
Regular Panel Decision
Nov 21, 2024

Matter of Lamont v. Superior Ambulance Serv. Inc.

This case involves an appeal from a decision of the Workers' Compensation Board concerning death benefits for Dalena Lamont, widow of Thomas Lamont. Thomas Lamont, a participant in World Trade Center rescue operations, was diagnosed with rectal cancer in 2017, established as an occupational disease. He died in 2022 from metastatic rectal cancer, leading his widow to file for death benefits. The Workers' Compensation Law Judge (WCLJ) and subsequently the Board determined that his death was consequential to the established lifetime claim and that death benefits should be calculated based on his average weekly wage at the time of disablement (September 28, 2017), with Safety National Casualty Corp. as the liable carrier. The Appellate Division affirmed the Board's decision, agreeing that the date of disablement, rather than the date of death, is the proper date for calculating the average weekly wage for death benefits in occupational disease cases.

World Trade CenterWTC Rescue OperationsOccupational DiseaseRectal CancerDeath BenefitsAverage Weekly WageDate of DisablementWorkers' Compensation BoardAppellate DivisionThird Department
References
12
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