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Case Law Database

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

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
Case No. ADJ302560
Regular
Jan 10, 2012

DAVID COE vs. PROFESSIONAL ASSOCIATION OF DIVING INSTRUCTORS, MISSION INSURANCE COMPANY, IN LIQUIDATION, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The Appeals Board granted reconsideration on its own motion to correct a clerical error in a prior decision regarding a Labor Code section 5710 attorney's fee. The original award of $1,903.75 was twice the applicant's attorney's requested fee of $1,093.75, which the WCJ and the Board's prior decision acknowledged. The Board corrected its decision to reflect the accurate attorney fee of $1,093.75, while reaffirming that CIGA has no liability for this fee due to a credit against the applicant's third-party recovery, which is reduced by the corrected fee amount.

Workers' Compensation Appeals BoardProfessional Association of Diving InstructorsMission Insurance CompanyCalifornia Insurance Guarantee Association (CIGA)Labor Code section 5710attorney's feeclerical errorpetition for reconsiderationthird-party recoverynet third party recovery
References
Case No. LAO 801322
Regular
May 23, 2008

O.C. MARSHALL (Deceased) JENNIFER MARSHALL (Widow) vs. ARCO/BRITISH PETROLEUM; ESIS

This case concerns a widow's appeal of a denial of workers' compensation benefits for her husband's death. The Administrative Law Judge (ALJ) denied benefits, finding the death was due to natural causes and not his employment as a pipe fitter for Arco/British Petroleum. The Workers' Compensation Appeals Board affirmed the denial, finding the applicant's medical expert's opinion lacked substantial evidence due to an inaccurate history and incomplete analysis of the decedent's medical records and family history.

Workers Compensation Appeals BoardApplicantDefendantPetition for ReconsiderationFindings of Fact and OrdersAdministrative Law JudgeQualified Medical EvaluatorQMEatherosclerotic diseasehypertension
References
Case No. ADJ3616338 (SBR 0196226), ADJ4315842 (SBR 0308717), ADJ3060486 (RIV 0055969), ADJ2417375 (RIV 0055970)
Regular
Apr 30, 2012

DONALD JOHNSTON (Deceased), RUTH JOHNSTON-MARTIN (Dependent) vs. CITY OF EL MONTE, Permissibly Self-Insured, STATE COMPENSATION INSURANCE FUND

This case involves a dispute over an attorney's fee awarded for home healthcare services. The applicant's attorney sought reconsideration of a 15% fee, arguing for a previously agreed-upon 20% fee based on the widow's settlement. The Workers' Compensation Appeals Board granted the petition, finding the 20% fee reasonable given the complexity, time expended, and uncertainty of the claim. The Board amended the original order to reflect the 20% fee but admonished the attorney for not strictly adhering to notice requirements.

Workers' Compensation Appeals BoardPetition for ReconsiderationAttorney's FeeWidow's RecoveryHome Health Care ServicesFindings and OrderWCJCompromise and ReleaseStipulationDependency Claim
References
Case No. SAC 293290
Regular
Feb 21, 2008

WILLIAM MENDOZA vs. LEE CUNEO dba THE BODY SHOP, UNINSURED EMPLOYERS FUND

The Workers' Compensation Appeals Board granted reconsideration to address the Uninsured Employers Benefits Trust Fund's (UEBTF) contentions. While affirming the award of retroactive vocational rehabilitation maintenance allowance (VRMA) at the delay rate, the Board amended the original order to allow the UEBTF credit for wages earned by the applicant as a property manager and for his net recovery in a third-party civil action against the uninsured employer. This credit will reduce the UEBTF's liability for the VRMA.

UEBTFVRMAdelay ratecredit for wagescivil action recoveryLabor Code section 139.5Labor Code section 4909property manager earningsthird party actionnet recovery
References
Case No. ADJ3694053 (SJO 0239468) MF ADJ2554333 (SJO 0247822)
Regular
Jan 27, 2017

JAMES HARRIS vs. TRENDWEST RESORTS, INC./CENDANT CORPORATION, AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA

This case concerns whether a civil settlement for discrimination and harassment also resolved the applicant's workers' compensation claims and whether the defendant should receive credit for the civil recovery. The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for reconsideration. The WCAB affirmed the finding that the civil release did not settle workers' compensation rights, emphasizing that the release was not submitted for WCAB approval and the applicant credibly testified it did not cover industrial injuries. Citing precedent, the WCAB found that the defendant's wrongful conduct should not benefit from a credit.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderCivil Case SettlementGeneral ReleaseWorkers' Compensation BenefitsDouble RecoveryCredit for Civil RecoveryIndustrial InjuryCardiovascular System
References
Case No. ADJ2552389 (OAK 0301853), ADJ2702419 (OAK 0301854), ADJ350772 (OAK 0301856), ADJ3854894 (OAK 0321466)
Regular
Mar 26, 2012

BARBARA LIGE-DIXON vs. A.C. TRANSIT, SEDGWICK CMS, INC.

The defendant, AC Transit, sought reconsideration of an award finding four industrial injuries and three awards of permanent disability for Barbara Lige-Dixon. The primary dispute concerned whether the defendant could credit permanent disability advances made in one case (resulting in zero disability) against its liability in other cases. The Appeals Board granted reconsideration, finding equitable considerations supported allowing the credit across all cases due to overlapping injuries and evolving medical apportionment. The Board amended the award to permit the $12,930 advance credit, while deferring the issue of attorney fees against third-party recovery for further trial-level proceedings.

Workers' Compensation Appeals BoardPermissibly Self-InsuredJoint Findings Award and OrdersPermanent DisabilityPermanent Disability AdvancesCreditThird Party RecoveryEquitable ConsiderationsApportionmentAgreed Medical Examiner
References
Case No. ADJ1892285 (SAC 0364476)
Regular
Apr 24, 2009

BEVERLY LINDSAY (Widow) vs. EPPS CHEVROLET-PONTIAC-OLDSMOBILE, CAMBRIDGE SAN DIEGO

This case involves a widow's petition for reconsideration of a denial of death benefits for her husband, William Lindsay, who died of heart disease. The applicant argued the deceased's death was industrially caused due to cumulative trauma and stress, supported by her testimony and one medical evaluator's opinion. However, the defense medical evaluator opined that Mr. Lindsay's fatal heart condition was due to non-industrial causes like obesity and a possible viral infection, and was not exacerbated by work stress. The Board denied reconsideration, adopting the findings of the administrative law judge and finding the defense medical opinion more persuasive and substantial.

WCABPetition for Reconsiderationindustrial cumulative traumaheart diseasecardiovascular systemwidow's claimdate of knowledgequalified medical evaluatorsubstantial evidencenon-industrial conditions
References
Case No. ADJ3252798 (ANA 0407298)
Regular
Nov 02, 2011

CATALINO DIAZ (Deceased), RUBERTA DIAZ (Widow), MARGARET NATASHA DIAZ vs. PEOPLE'S CARE INC., STATE COMPENSATION INSURANCE FUND

This case concerns Ruberta Diaz's claim for death benefits as the widow of Catalino Diaz, who sustained a fatal industrial injury. The initial decision awarded benefits to their minor child but denied Ruberta’s claim, finding she failed to prove dependency. Ruberta contends she is a total dependent and that the judge erred in not addressing this, or alternatively, in finding no partial dependency. The Appeals Board granted reconsideration, deferred the issue of Ruberta's dependency, and returned the case to the trial level for further evidence and decision, while affirming the award to the minor child.

DependencyDeath BenefitWidow's ClaimMinor ChildPartial DependencyTotal DependencyPetition for ReconsiderationFindings and AwardWCJEvidence
References
Case No. ADJ8741424
Regular
May 19, 2016

CHARLES LAUDERDALE (Dec'd), KATHLEEN LAUDERDALE (Widow) vs. CRISP ENTERPRISES, INC. dba C2 REPROGRAPHICS, GOLDEN EAGLE INSURANCE COMPANY

This case concerns a widow's claim for workers' compensation benefits after her husband's death. The initial ruling denied the claim, finding no injury arising out of employment. However, the Appeals Board granted reconsideration, finding the employer failed to deny the claim within the 90-day period required by Labor Code § 5402(b), thus creating a presumption of compensability. The Board determined the employer's evidence to rebut this presumption was insufficient because the witness testimony used was available and discoverable within the 90-day timeframe. Therefore, the Board found the decedent sustained an injury to his left foot arising out of and in the course of employment.

WCABPetition for ReconsiderationFindings and OrderLabor Code Section 5402(b)Presumed CompensableRebuttal of PresumptionReasonable DiligencePercipient WitnessSpecific InjuryLeft Foot
References
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