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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. SAU9997873
Regular
Nov 20, 2019

MELVIN GARCIA GALDAMES vs. VINYL TECHNOLOGY, INC., SEDGWICK, CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board dismissed a petition for reconsideration of an order consolidating liens under Labor Code § 139.21, as it was not a final order. However, the Board granted the petition for removal, finding that consolidating Mesa Pharmacy's liens without a determination of whether it was controlled by suspended provider John Garbino violated due process. The Board amended the consolidation order to only include liens filed by or on behalf of John Garbino or entities controlled by him, and scheduled a new status conference.

Labor Code § 139.21Petition for RemovalPetition for ReconsiderationOrder of ConsolidationSuspended ProviderControlled EntityDue ProcessIrreparable HarmThreshold IssueInterlocutory Order
References
Case No. ADJ9917235 MF ADJ9917234
Regular
Sep 28, 2018

JOSE ARANA vs. 9 TO 5 SEATING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the administrative law judge's finding. The defendant failed to prove that liens filed by Reshealth Medical Group and Trucare Pharmacy should be stayed under Labor Code section 4615. Specifically, the Board found insufficient evidence that Reshealth Medical was controlled by a criminally charged individual, and while Trucare participated in a fraud scheme, there was no proof the individual controlled the entity as statutorily defined. Therefore, neither lien was stayed.

Labor Code section 4615Labor Code section 139.21criminally charged providerlien staycontrolled entityDIR listEAMS notationburden of proofReshealth MedicalTrucare Pharmacy
References
Case No. ADJ8804520
Regular
Feb 15, 2019

WENJU LIU vs. CALIFORNIA COMMERCE CASINO, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The Workers' Compensation Appeals Board granted Firstline Health, Inc.'s petition for reconsideration regarding a stay on its lien claim under Labor Code section 4615. The Board found the original judge's decision lacked sufficient evidence to prove Firstline was "controlled" by a criminally charged provider as defined by statute. Due process concerns regarding judicial notice and the opportunity to be heard also factored into the decision. The case is remanded for further proceedings to develop the record on the control issue and ensure proper due process.

Labor Code section 4615Lien claimantPetition for ReconsiderationJudicial noticeDue processDIR listCriminal chargesControlled entitySection 139.21Findings and Order
References
Case No. ADJ6875081
Regular
Oct 18, 2012

LOURDES MORENO vs. MELTON FRANCHISE SYSTEMS, INC.; dba COVERALL; EVEREST NATIONAL INSURANCE COMPANY, GALLAGHER BASSETT SERVICES

This case concerns Lourdes Moreno's claim for workers' compensation benefits following a back injury sustained while performing janitorial services. The Workers' Compensation Appeals Board (WCAB) reversed a prior finding that Moreno was an independent contractor, ruling instead that she was an employee of Melton Franchise Systems, Inc. (dba Coverall). The WCAB determined that Coverall exerted pervasive control over Moreno's work, dictating numerous aspects of her business operations beyond mere quality control, which indicated an employer-employee relationship. This decision shifts the responsibility for her injury from Moreno to Coverall for workers' compensation purposes.

Workers' Compensation Appeals BoardIndependent ContractorEmployee StatusFranchise AgreementRight to ControlJanitorial ServicesBorello TestSecondary IndiciaAdhesion ContractPervasive Control
References
Case No. ADJ10229956
Regular
Aug 13, 2018

VIRGIL GRAY vs. ARENA FOOTBALL LEAGUE, SAN JOSE SABERCATS, ZURICH AMERICAN INSURANCE, UNINSURED EMPLOYER BENEFITS TRUST FUND

This case denies the defendants' petition for reconsideration of a finding of joint employment for an industrial knee injury. The applicant, Virgil Gray, was found to be a joint employee of both the Arena Football League and the San Jose SaberCats, despite receiving paychecks from the League. Evidence such as the San Jose SaberCats' direct control over the applicant's work, provision of equipment, and housing, supported the finding that both entities exercised the right to direct and control his activities. The Appeals Board affirmed the administrative law judge's decision, finding the totality of the record supported joint employment.

joint employmentspecial employergeneral employerArena Football LeagueSan Jose SaberCatsZurich American InsuranceUninsured Employer Benefits Trust Fundprofessional athleteindustrial injuryleft knee
References
Case No. GOL 100978
Regular
Feb 14, 2008

JANETTE HOPE vs. TRI-COUNTIES REGIONAL CENTER, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and reversed the judge's finding, concluding applicant was an employee of Tri-Counties Regional Center, not an independent contractor. The Board found the Center exercised sufficient control over the applicant's work, providing office space, supplies, and scheduling, which outweighed the contractual designation. The case is remanded for further proceedings to determine the applicant's entitlement to benefits.

Independent contractor vs. employeeIndustrial injuryMulti-system immunological problemsControl of workRight to controlSecondary factors of employmentDistinct occupationTools and suppliesMethod of paymentContractual designation
References
Case No. ADJ9235285
Regular
Feb 15, 2019

MARIO RAMIREZ vs. TAWA SUPERMARKET, INC., SAFETY NATIONAL CASUALTY COMPANY, MATRIX ABSENCE MANAGEMENT, INC.

The Workers' Compensation Appeals Board granted Firstline Health's petition for reconsideration, rescinding the prior decision that its lien was subject to a stay under Labor Code section 4615. The Board found insufficient evidence that Firstline was controlled by criminally charged individuals during the relevant period of service in 2014. Therefore, the case was returned to the trial level for further proceedings, as the defense failed to meet its burden of proof for imposing the stay.

Workers' Compensation Appeals BoardLien claimantLabor Code section 4615Labor Code section 139.21Labor Code section 4903.05DIR listcriminally charged providersWUC OrderEAMS notationcontrolled entity
References
Case No. ADJ6520136
Regular
Jan 24, 2011

GARY HECK vs. L.A. DEPOSITIONS dba FIRST LEGAL COURIER, TOWER SELECT INSURANCE COMPANY, administered by ILLINOIS MIDWEST INSURANCE AGENCY, LLC

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior decision that found the applicant was an independent contractor. The WCAB found the applicant was, in fact, an employee, reversing the administrative law judge's determination. Factors including the defendant's control over the applicant's work, the integral nature of the applicant's tasks to the defendant's business, and the applicant's lack of a true independent business weighed heavily in this decision. The WCAB emphasized that labels and self-serving documents do not override the reality of the employment relationship.

Workers Compensation Appeals BoardReconsiderationEmployee vs. Independent ContractorBorello factorsControl testLabor Code Section 3351Labor Code Section 3353Labor Code Section 3357Independent Contractor ProfileEagle 1 Delivery
References
Case No. ADJ9686953 MF ADJ9686845
Regular
Sep 28, 2018

JOSE POOL vs. VOLT, NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PENNSYLVANIA, 99 CENTS ONLY STORE

The Workers' Compensation Appeals Board granted Firstline Health, Inc.'s petition for reconsideration, rescinding a prior order that stayed Firstline's liens. The Board found insufficient evidence that Dr. Munir Uwaydah, a criminally charged provider, controlled Firstline as defined by Labor Code section 139.21. Evidence presented by Firstline indicated Dr. David Johnson was the sole owner, and no proof established Uwaydah as an officer, director, or 10% shareholder in Firstline. The case was returned to the trial level for further proceedings.

Labor Code section 4615Labor Code section 139.21Munir UwaydahFirstline HealthInc.controlled entityDIR listcriminally charged providerslien stayDepartment of Industrial Relations
References
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