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Case Law Database

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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ4629950
Regular
Dec 21, 2012

JOHNNY BETTENCOURT vs. DONALD WILLIAMS, SAFECO INSURANCE COMPANY, UNINSURED EMPLOYERS' BENEFIT TRUST FUND DEPARTMENT OF INDUSTRIAL RELATIONS

The Uninsured Employers' Benefit Trust Fund (UEBTF) sought reconsideration, arguing Safeco's policy covered the applicant's injury. The Arbitrator previously ruled Safeco had no liability as its policy with Donald Williams did not include "comprehensive personal liability" insurance as required by Insurance Code section 11590. The Appeals Board affirmed this decision, finding the Safeco policy explicitly limited coverage to premises liability and lacked the necessary language for comprehensive personal liability coverage. Therefore, Safeco was correctly found not liable for the applicant's injury.

Uninsured Employers' Benefit Trust Fundcomprehensive personal liability insuranceLabor Code section 3351(d)Labor Code section 3352(h)Insurance Code section 11590premises liability insuranceSafeco Insurance CompanyDonald WilliamsJohnny Bettencourtworker's compensation coverage
References
Case No. ADJ2497883 (SFO 0450940) ADJ3261393 (SFO 0504693)
Regular
Apr 30, 2010

JANETTE HARDIN vs. COUNTY OF ALAMEDA, SEDGWICK CLAIMS MANAGEMENT SERVICES, CHARTIS INSURANCE, TRISTAR RISK MANAGEMENT

This case involves Chartis Insurance seeking reconsideration of an arbitrator's decision setting the date of cumulative trauma injury for Janette Hardin's breast cancer as May 28, 1997, not the previously stipulated date of May 16, 2001. Chartis argued the stipulated date was res judicata and could not be altered, especially in a contribution proceeding. The Workers' Compensation Appeals Board denied the petition, affirming that contribution proceedings allow for a relitigation of liability and the determination of the true date of injury based on facts, not prior stipulations between the applicant and one defendant. The Board reasoned that findings of liability in the primary case are not binding in supplemental contribution proceedings.

Cumulative traumaDate of injuryContribution proceedingsRes judicataStipulated awardLabor Code section 5500.5Apportionment of liabilityCase-in-chiefSupplemental proceedingsGreenwald v. Carey Distribution Company
References
Case No. ADJ1747488
Regular
Dec 19, 2011

ADRIENNE BOYLAN vs. NEW COVENANT CARE GROUP, STATE COMPENSATION INSURANCE FUND

This case concerns the defendant's petition for reconsideration of a prior Board decision. The Board previously affirmed the dates of temporary disability for the applicant but amended the original award to grant the full value of temporary disability indemnity, rather than an apportioned percentage. The defendant argued against this full award, but the Board found that while liability for indemnity can be apportioned between defendants, an employee's entitlement to temporary disability indemnity cannot be apportioned. The Board denied the petition for reconsideration, reaffirming that the defendant is solely liable for the full value of temporary disability indemnity.

Temporary Disability IndemnityCumulative Trauma InjuryApportionment of LiabilityExclusive LiabilityLabor Code Section 3208.2FibreboardGranadoWCAB OpinionPetition for ReconsiderationSpecific Injury
References
Case No. ADJ3588884 (FRE 0222309) ADJ4330880 (FRE 0223217)
Regular
Feb 22, 2011

ENEDELIA LUNA vs. FRESNO UNIFIED SCHOOL DISTRICT, UNITED ARTISTS THEATRE CIRCUIT; AMERICAN MOTORISTS INSURANCE COMPANY, Administered By BROADSPIRE

This case concerns American Motorists Insurance Company's petition for reconsideration of a Joint Findings and Award. The original award addressed two admitted industrial injuries sustained by the applicant, one against Fresno Unified School District (FUSD) and another against United Artists Theatre Circuit, insured by American Motorists. The petition specifically challenges the WCJ's failure to incorporate a stipulated liability apportionment between the defendants into the award. The Appeals Board denied the petition, ruling that the WCJ correctly deferred the issue of contribution between co-defendants, as they remain jointly and severally liable to the applicant.

Petition for ReconsiderationJoint Findings and AwardSpecial Education Teacher's AideCumulative InjuryBilateral Upper ExtremitiesPermanent DisabilityFurther Medical TreatmentPermissibly Self-InsuredStipulated Percentage of LiabilityContribution Between Co-Defendants
References
Case No. ADJ10717774
Regular
Oct 12, 2020

DEVON PROVENCHER vs. ELECTROLURGY, INSURANCE COMPANY OF THE WEST

This case concerns whether a lien claimant, Med-Legal LLC, is entitled to payment for services rendered. The Appeals Board rescinded a prior finding, determining that a "contested claim" existed at the time Med-Legal provided services, satisfying the initial burden under Labor Code section 4620. This determination was based on the applicant's unresolved issues regarding various benefits, including temporary and permanent disability, despite the employer initially accepting liability for the injury itself. The matter is now returned to the trial level for further proceedings to assess the reasonableness and necessity of the lien claimant's services.

Labor Code Section 4620Contested ClaimLien ClaimantMedical-Legal ExpensesEmployer LiabilityCompromise and ReleaseFindings and OrderReconsiderationSubpoena Duces TecumWorkers' Compensation Appeals Board
References
Case No. ADJ865164 (AHM 0127447)
Regular
Mar 22, 2011

DARRIEN GORDON vs. OAKLAND RAIDERS, PACIFIC EMPLOYERS INSURANCE COMPANY, XCHANGING, INC., ATLANTA FALCONS, ST PAUL TRAVELERS

This case concerns a professional football player's cumulative trauma injury claim. The Workers' Compensation Appeals Board granted reconsideration to correct an arbitrator's apportionment of liability. The Board found that under Labor Code section 5500.5, liability should be based on employment within the one year preceding the date of injury. Consequently, Travelers Indemnity, as insurer for the Atlanta Falcons, was ordered to reimburse the Oakland Raiders for 4% of benefits paid, reflecting the Falcons' minimal employment during the last year of injury. This reversed the original award which had apportioned liability at 39%.

Cumulative TraumaProfessional Football PlayerDate of InjuryLast Year of EmploymentApportionment of LiabilityContinuous TraumaOccupational DiseaseInsurer LiabilityContribution ClaimWorkers' Compensation Appeals Board
References
Case No. MON 0255472
Regular
Mar 17, 2008

MARIA RODRIGUEZ vs. LOS ANGELES COUNTY METROPOLITAN TRANSPORTATION AUTHORITY, TRAVELERS INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a previous award, rescinding the arbitrator's decision that equally divided liability between the County and Travelers Insurance. The Board found the arbitrator improperly determined the date of injury and confused initial liability proceedings with apportionment. The case is remanded to the trial level for specific findings on the date(s) of injury and last injurious exposure, followed by a reconsidered liability apportionment based on proportionate coverage during the relevant one-year period.

Cumulative injuryDate of injuryInjurious exposureApportionment of liabilityContributionTravelers Insurance CompanyLos Angeles County Metropolitan Transportation AuthoritySection 5500.5Section 5412Permissibly self-insured
References
Case No. ADJ3957329 (OAK 0162600) ADJ621097 (OAK 0183630)
Regular
Jan 27, 2017

JUDITH KRAFT vs. CORREY JAMESTOWN, HARTFORD INSURANCE COMPANY, FACILITY SYSTEMS, INC., BROADSPIRE CONCORD

Here's a summary for a lawyer in maximum four sentences: Hartford Insurance sought removal of an order requiring it to administer the applicant's future medical award for all body parts. Hartford argued this would cause irreparable harm by potentially barring reimbursement from CIGA for neck injury treatment, for which Hartford claims no current liability. The Workers' Compensation Appeals Board denied removal, adopting the judge's reasoning that potential prejudice to Hartford was outweighed by applicant's need for a single administrator and the judge's discretion to assign administration pending adjudication of neck injury liability. Commissioner Lowe dissented, arguing Hartford faces substantial prejudice and potential liability for an injury it did not insure.

Workers' Compensation Appeals BoardPetition for RemovalFindings of FactAdministrative Law JudgeIndustrial InjuryLow BackLeft AnkleNeckDistrict ManagerAccount Executive
References
Case No. ADJ1988743 (OAK 0328856)
Regular
Aug 10, 2012

JAMES KENDALL (Deceased) vs. OPENWAVE SYSTEMS, INC., AMERICAN PROTECTION INSURANCE CO., BROADSPIRE, A CRAWFORD CO., TRAVELERS INDEMNITY CO. OF CONNECTICUT, LUMBERMEN'S MUTUAL CASUALTY CO.

This case concerns the determination of liability for a deceased worker's cumulative trauma injury, specifically carpal tunnel syndrome. The Workers' Compensation Appeals Board granted reconsideration to amend the period of injurious exposure. The Board found that the applicant's date of injury, based on the onset of temporary disability, was September 30, 2004. Therefore, the statutory period of liability under Labor Code § 5500.5 was established as September 30, 2003, through September 29, 2004, the employee's last day of work. This amendment impacts the contribution between insurers APIC and Travelers.

Cumulative traumaLabor Code section 5500.5Labor Code section 5412Period of liabilityCarpal tunnel syndromeTemporary disabilityPermanent disabilityDate of injuryInjurious exposureReconsideration
References
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