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

Case No. STK 175646 STK 175647
Regular
Jul 08, 2008

Shaw vs. Clovis Unified School District

The Appeals Board affirmed a prior decision finding the employer violated Labor Code section 132a by terminating the applicant due to her industrial injury. The applicant demonstrated a prima facie case of discrimination, and the employer failed to prove a business necessity for her termination, as she was able to perform her job with self-modification and the employer's justification was not supported by evidence available at the time of the termination. Consequently, the employer was ordered to pay increased compensation, lost wages, and benefits, subject to collateral source reductions.

Labor Code section 132adiscriminationreinstatementlost wagesbenefitscollateral sourcesprima facie casequalified injured worker (QIW)customary occupationbusiness necessity
References
Case No. ADJ2984143 (LBO 0340645) MF ADJ3946341 (LBO 0340644) ADJ896223 (LBO 0340643)
Regular
Jun 26, 2012

FERNANDO GUZMAN vs. ACU-AIR CARGO, LLC, PARSONS TRANSPORTATION, LLC, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board granted reconsideration, reversing the WCJ's decision that barred the applicant's claims due to the employer's bankruptcy. The Board clarified that a bankruptcy discharge injunction does not prevent a WCAB proceeding if the goal is to collect from a collateral source like the Uninsured Employers Benefits Trust Fund (UEF), not the discharged bankrupt employer personally. Relying on *In Re Munoz*, the Board held that a WCAB proceeding can continue to establish an award against the bankrupt employer, which is a necessary precursor for the UEF to pay. Therefore, the applicant may proceed with their claims before the WCAB, provided they stipulate they are not seeking personal recovery from the bankrupt employer.

UEFbankruptcy discharge injunctioncollateral sourcesubstantial shareholderLabor Code section 3717.1uninsured employerproof of claimautomatic staynondischargeable debtMunoz
References
Case No. ADJ8531754
Regular
Mar 11, 2019

ARTURO TRUJILLO vs. TIC THE INDUSTRIAL COMPANY, THE HARTFORD INSURANCE

The Workers' Compensation Appeals Board (WCAB) vacated its prior order granting reconsideration and dismissed the defendant's petition for reconsideration. The WCAB granted the defendant's petition for removal, rescinded the WCJ's findings and orders, and returned the case to the trial level for further proceedings. This decision stemmed from a dispute over whether an Agreed Medical Evaluator's (AME) interview with the applicant's wife and the applicant's provision of medical records at the AME's deposition constituted impermissible ex parte communication. The WCAB found that the interview with the wife was permissible as a collateral source to supplement the applicant's potentially impaired memory due to a brain injury, and that the provision of records at the deposition was not ex parte as the defendant was present. However, the WCAB remanded the case for the WCJ to determine if the applicant improperly provided information to the AME, as parties must agree on what information is provided to an AME.

Agreed Medical EvaluatorEx Parte CommunicationPetition for RemovalMedical-Legal ReportingCollateral InterviewApplicant's WifeDepositionsMedical RecordsSubstantial EvidenceLabor Code Section 4062.3
References
Case No. ADJ7774238
Regular
Dec 05, 2013

MIRIAM PANTOJA vs. PAYLESS SHOE SOURCE, GALLAGHER BASSETT SERVICES, INC.

This case involves a Petition for Reconsideration filed by Payless Shoe Source, administered by Gallagher Bassett Services, Inc. The Workers' Compensation Appeals Board dismissed the petition because it was filed **untimely**. Specifically, the petition was filed more than 25 days after the original Findings were issued on September 13, 2013, exceeding the statutory 20-day filing deadline plus mailing extensions. Therefore, the Board found the petition procedurally deficient and dismissed it.

Petition for ReconsiderationuntimelydismissFindingsadministrative law judgeReport and RecommendationLabor Code section 5903Code of Civil Procedure section 1013mailingWorkers' Compensation Appeals Board
References
Case No. ADJ11026657
Regular
Feb 27, 2020

Monnie Wright vs. California Public Employees' Retirement System, State Compensation Insurance Fund

The Workers' Compensation Appeals Board (WCAB) affirmed the finding that collateral estoppel prevents them from determining industrial causation for applicant Monnie Wright's injury under Government Code section 21166. A prior jury found Wright's injury arose out of employment but not in the course of employment. The WCAB has jurisdiction to determine industrial causation for CalPERS disability claims, applying procedural rules and factual findings. However, collateral estoppel, being a hybrid substantive/procedural issue, means the prior jury's determination on "arising out of" but not "in the course of" employment precludes the WCAB from making a new finding of industrial causation (AOE/COE).

WORKERS' COMPENSATION APPEALS BOARDCALIFORNIA PUBLIC EMPLOYEES' RETIREMENT SYSTEMLegally UninsuredSTATE COMPENSATION INSURANCE FUNDClaims AdministratorOPINION AND DECISION AFTER RECONSIDERATIONGovernment Code section 21166collateral estoppelindustrial causationarising out of and in the course of employment
References
Case No. ADJ8835024, ADJ8996815
Regular
Jun 26, 2017

TRACIE KEILLOR vs. COUNTY OF SACRAMENTO

The Workers' Compensation Appeals Board (WCAB) is remanding this case for further proceedings. Initially, the WCAB reversed a judge's finding of industrial injury for a stroke under the heart presumption statute. However, the WCAB acknowledges its prior decision was incomplete as it failed to consider if the applicant could establish industrial injury outside the heart presumption, potentially requiring further medical evaluation. The WCAB also notes that a related civil case finding job stress caused the stroke is now final, raising the issue of collateral estoppel. Therefore, the case is returned to the trial level to determine if collateral estoppel applies or if further development of the record is needed to establish an industrial injury independent of the heart presumption.

Workers' Compensation Appeals BoardRemittiturHeart PresumptionStrokeIndustrial InjuryNewly Discovered EvidenceCollateral EstoppelLabor Code Section 3212.5Sheriff's OfficerNeuroloigical Evaluation
References
Case No. ADJ9323388 ADJ9392268
Regular
Mar 20, 2019

GERALD PHIPPS vs. FRITO-LAY, ACE AMERICAN INS.

The Workers' Compensation Appeals Board (WCAB) rescinded the original Findings and Order due to issues surrounding ex parte communication with a Qualified Medical Evaluator (QME) and the admissibility of his reports. The WCAB found that the record was unclear regarding whether the applicant's wife's communications and notes provided to the QME constituted a violation of Labor Code section 4062.3 and whether the employer objected in a timely manner. Consequently, the case was returned to the trial level for further proceedings to clarify these evidentiary and procedural issues. The WCAB also affirmed the trial judge's discretion to defer other issues for later adjudication.

AOE/COEex parte communicationQMEinadmissiblePetition for Removalreconsiderationsubstantial evidencecollateral sourceLabor Code section 4062.3medical-legal evaluator
References
Case No. ADJ383777
Regular
Apr 04, 2011

Roxanna Ortiz vs. ONE SOURCE, ESIS

The Workers' Compensation Appeals Board denied Roxanna Ortiz's petition for reconsideration of a prior findings and order. The initial ruling determined she sustained industrial injury only to her cervical spine as a janitor, not to other body parts or any resulting temporary/permanent disability or need for further medical treatment. Ortiz argued the judge erred by favoring defense medical reports and discrediting her testimony due to minor inconsistencies in her injury description. The Board adopted the WCJ's report, emphasizing deference to credibility determinations and that admissibility of medical reports should have been challenged at trial, not on reconsideration. A dissenting opinion argued the judge overemphasized minor variations in Ortiz's account and that medical evidence did not sufficiently support denial of other injuries or further treatment.

OrtizOne SourceESISWCABFindings and OrderPetition for ReconsiderationWorkers' Compensation Administrative Law Judgeindustrial injurycervical spineright arm
References
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. ADJ10021120 ADJ8949346
Regular
Apr 14, 2017

ANTHONY BERNARD EDWARDS (Dec'd), CANDACE EDWARDS (Widow), ASHLEY EDWARDS (Daughter), ANTHONY EDWARDS, JR. (Son) vs. CITY OF LOS ANGELES; LOS ANGELES WORLD AIRPORTS, Permissibly Self-Insured

This case involves a workers' compensation death benefit claim for Anthony Bernard Edwards, who died in the course of his employment. The dependents seek death benefits and burial expenses, which were initially awarded by the WCJ. The employer, City of Los Angeles, sought reconsideration, arguing it should receive credit for a third-party settlement the dependents obtained from Kaiser Permanente. The Board agreed to reconsider the issue of credit, specifically whether Civil Code section 3333.1 bars such credit. The Board ultimately deferred the credit issue, affirming the death benefit award and returning the matter for further proceedings to determine the applicability of Civil Code section 3333.1 and potential employer negligence.

Workers' Compensation Appeals BoardADJ10021120ADJ8949346death benefitsLabor Code section 4702burial expensesCivil Code section 3333.1Medical Injury Compensation Reform ActMICRAthird-party settlement
References
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