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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ7264969
Regular
Feb 22, 2011

Richard Warner vs. COUNTY OF LOS ANGELES, INTERCARE INSURANCE SERVICES

Applicant Richard Warner, a firefighter on Catalina Island, sustained injuries while trimming wisteria at his home, which he was required to maintain as a condition of employment and from which he sometimes worked. The Board denied reconsideration, affirming the WCJ's finding that the injury was not arising out of and occurring in the course of employment (AOE/COE). The applicant's home was not considered employer premises under the bunkhouse rule as he owned and maintained it personally, receiving a stipend instead of provided housing. Although working from home was sometimes necessary, trimming wisteria was deemed a purely personal act unrelated to employment duties.

AOE/COEbunkhouse ruleemployer premisessecondary jobsitecourse of employmentperforming serviceproximate causepersonal taskincidental to employmentstipend
References
Case No. ADJ8365866
Regular
May 02, 2014

CESAR MARTIN vs. STUDIO CHAMELEON LLC, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration, affirming the finding that the applicant's injury arose out of and occurred in the course of employment. The Board found the applicant's stop at a friend's house to retrieve a phone charger benefited the employer by enabling continued communication. Additionally, the auto accident occurred after the applicant left his friend's house and was en route back to the employer's premises on a normal route, thus concluding any deviation. The Board also clarified the legal distinction between "scope of employment" (a tort concept) and "course of employment" (a workers' compensation term of art).

Workers' Compensation Appeals BoardPetition for Reconsiderationdeniedcourse of employmentscope of employmentmotor vehicle accidentmaterial deviationemployer's instructionsapplicant's benefitpersonal comfort
References
Case No. ADJ9725488
Regular
Nov 13, 2015

Norris Hollie vs. Management Training Corporation, Zurich American Insurance Company, ESIS

The Workers' Compensation Appeals Board denied reconsideration for applicant Norris Hollie, upholding a finding that his right knee injury on April 27, 2014, did not arise out of or occur in the course of his employment. The Board agreed that Hollie's participation in a continuing medical education program, while necessary to maintain his license, was not a reasonable expectation of his employment as a physician. There was no evidence of employer mandate, knowledge, or encouragement of this specific off-duty educational activity. Therefore, the injury sustained during this program was not deemed industrial.

Continuing educationMedical license renewalOff-duty activityReasonable expectancy of employmentCourse of employmentArising out of employmentIndustrial injuryPetition for reconsiderationFindings and AwardWCJ Report
References
Case No. VNO 0470470
Regular
May 12, 2008

GERARDO RAMIREZ vs. WILLIAM ALONSO, UNINSURED EMPLOYERS FUND

The Workers' Compensation Appeals Board granted reconsideration to further develop the record concerning applicant Gerardo Ramirez's employment status at the time of his injury. The Board rescinded the previous findings, finding the evidence insufficient to support dual employment and needing clarification on whether applicant was a casual employee, which might affect his eligibility for benefits. The case was returned to the trial level for additional evidence gathering, including a review of the defendant's insurance policy for the property where the injury occurred.

Workers' Compensation Appeals BoardUninsured Employers Fundindustrial injuryright major extremitydefendant's contentiondual employmentthreshold issueemployment relationshippresumption of employmentjoint venture
References
Case No. ADJ10009703 ADJ10043837
Regular
Feb 19, 2019

ZULAY DAVILA vs. EMPLOYERS RESOURCE GROUP, VENSURE HR, INC., LCF LIBERTY JR, LLC/SECURITY NATIONAL INSURANCE COMPANY, AMTRUST NORTH AMERICA, PROPORTION FOODS, LLC/REDWOOD FIRE AND CASUALTY INSURANCE COMPANY, BERKSHIRE HATHAWAY HOMESTATE COMPANIES

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the WCJ's decision due to a due process violation. The WCJ had determined employment by ERG without providing ERG notice and an opportunity to be heard. The WCAB returned the case to the trial level for further proceedings to determine employment status. Issues of insurance coverage will be subject to mandatory arbitration once employment is established.

Workers' Compensation Appeals BoardVENSURE HRSecurity National Insurance CompanyProportion FoodsLLCREDWOOD FIRE AND CASUALTY INSURANCE COMPANYBERKSHIRE HATHAWAY HOMESTATE COMPANIESAMTRUST NORTH AMERICAEMPLOYMENT RESOURCES GROUPINC.
References
Case No. ADJ7041104
Regular
Jun 18, 2013

James Stanfield vs. Solid Rock Ranch School, Uninsured Employers Benefits Trust Fund

The Workers' Compensation Appeals Board dismissed the applicant's Petition for Reconsideration as untimely. The applicant failed to file the petition within the statutory 25-day deadline after the March 25, 2013 Findings and Order. The Board adopted the administrative law judge's report, which found the applicant's injury did not arise out of and occur in the course of employment. Specifically, the applicant was engaged in a personal business venture, not employer-contemplated duties, at the time of the tractor accident.

WCABPetition for ReconsiderationuntimelyLabor Code section 5903Code of Civil Procedure section 1013Findings and OrderReport and Recommendationadministrative law judgeinjury arising out of and occurring in the course of employmentAOE/COE
References
Case No. ADJ11968759
Regular
Apr 13, 2023

JESUS ORTEGA GONZALEZ vs. MAJOR TRANSPORTATION SERVICES, INC., BALJINDER S. GILL, PEOPLEASE LLC, NATIONAL INTERSTATE RICHFIELD.

This case involves an applicant injured while employed by both Major Transportation Services and Peoplease, a Professional Employer Organization (PEO). Peoplease sought reconsideration of a finding that they jointly employed the applicant on the date of injury, arguing payroll was not processed through them. The Board denied reconsideration, adopting the WCJ's reasoning that a co-employment relationship existed. The WCJ found that despite Peoplease's argument about payroll timing, evidence showed Peoplease benefitted from the applicant's work and their actions were inconsistent with strict contract adherence, akin to precedent in Gulam v. Patel. Ultimately, Peoplease's arguments regarding payroll timing were deemed coverage issues subject to arbitration and not grounds to deny the finding of co-employment.

Professional Employer OrganizationPEOdual employmentgeneral employerspecial employerco-employmentclient policyLabor Code section 3602(d)presumption of employmentsubstantial evidence
References
Case No. ADJ271398 (SFO 0505138)
Regular
Jun 09, 2009

Fernando Martinez vs. D.H. SMITH COMPANY, INC., ICW GROUP

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration and rescinded the original denial of benefits. The Board found that the applicant's injuries sustained in a vehicle collision arose out of and occurred in the course of his employment, despite his unlicensed driving contrary to employer instructions. The Court held that performing an authorized activity in an unauthorized manner does not remove the injury from the course of employment when the employer provides transportation to a job site. The Board denied the defendant's petition, affirming that the "going and coming rule" did not bar compensation in this instance.

going and coming rulescope of employmentcourse of employmentarising out of employmentemployer provided transportationunauthorized mannermaterial deviationpublic highwayincreased riskLabor Code section 3600
References
Case No. ADJ2136789 (MON 0357209)
Regular
Feb 27, 2012

ROBERT FLORES vs. GARNET PROTECTIVE SERVICES AND SECURITY, INC., JOSEPH'S CAFE, INC., PENNSYLVANIA MANUFACTURERS' ASSOCIATION INSURANCE COMPANY, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded the original decision, and found the applicant was solely employed by Garnet Protective Services, not Joseph's Cafe. The Board further determined the applicant did not sustain an industrial injury on July 12, 2007. The majority concluded the applicant's commute to an extra shift did not constitute a special mission and fell under the "going and coming" rule. A dissenting commissioner argued the extra shift constituted a special mission, making the injury compensable.

Workers' Compensation Appeals BoardGarnet Protective ServicesJoseph's CafePennsylvania Manufacturers' Insurance CompanyUninsured Employers Benefits Trust FundPetition for ReconsiderationArbitrator's DecisionEmployee StatusDual EmploymentSpecial Employer
References
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