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

Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ7479989
Regular
Dec 18, 2015

CARMEN ANDRADE vs. VISITING NURSE & HOSPICE CARE SANTA BARBARA, ILLINOIS MIDWEST INSURANCE COMPANY

The applicant sought reconsideration of a decision that allowed the defendant a credit against her workers' compensation award for her full third-party settlement recovery. The applicant argued the credit should be limited to her net recovery of $2,449.62. The Appeals Board granted reconsideration, finding the applicant failed to prove resolution of the defendant's credit rights. The Board amended the decision to defer the exact credit amount, remanding for further proceedings to determine its value. The September 29, 2015 decision was otherwise affirmed.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and OrderThird Party CreditNet RecoveryLabor Code Section 3861Industrial InjuryCompromise and ReleaseLien ClaimEmployer Negligence
References
Case No. ADJ4471046 (STK 0208353)
Regular
Feb 03, 2017

SHARON PADRON vs. FRITO LAY, SEDGWICK CMS

The Workers' Compensation Appeals Board (WCAB) rescinded the original award due to concerns about exceeding statutory temporary disability limits and an unclear basis for the defendant's credit of $37,700.35. The WCAB found the award for temporary disability indemnity likely surpassed the 104-week statutory maximum under Labor Code section 4656(c)(1). Furthermore, the WCAB determined the credit calculation was not adequately supported by evidence, particularly regarding whether applicant contributed to disability plans and thus whether a proportional credit applied per *Fraide*. The case was returned to the trial level for further proceedings to clarify these issues and recalculate any permissible credit.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardTemporary Disability IndemnityCreditShort-Term DisabilityLong-Term DisabilityLabor Code Section 3751(a)Cumulative Trauma InjuryBilateral Knees
References
Case No. ADJ9942080 ADJ10381122 ADJ10260028
Regular
Apr 07, 2017

MARIO PADILLA vs. RIO FARMS, LLC, NATIONAL UNION FIRE INS. CO.

The Workers' Compensation Appeals Board granted reconsideration to address whether the defendant was entitled to a credit for $11,020 in permanent disability advances. The applicant argued against the credit, citing that the Compromise and Release explicitly stated "0.00" permanent disability indemnity paid and did not include any deductions for such advances. The Board found the defendant's interpretation of the addendum ambiguous and against the explicit language of the settlement agreement. Therefore, the Board amended the award to permit credit only for permanent disability advances made *after* the date of the Compromise and Release.

Permanent disability advancesCompromise and ReleasePetition for ReconsiderationJoint Findings and Awardcreditaddendumsettlement negotiationscontract interpretationmutual intentionWCJ
References
Case No. ADJ7871072
Regular
Sep 27, 2012

SUSAN T. MILLER vs. CHILI'S GRILL AND BAR, BRINKER INTERNATIONAL, LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and affirmed the original decision, with a key amendment. The applicant, Susan T. Miller, is now found to have been temporarily totally disabled from June 28, 2011, to February 7, 2012. Indemnity is payable at $705.53 per week, subject to credits for time worked, EDD benefits, and employer/carrier payments.

Workers' Compensation Appeals BoardChili's Grill and BarBrinker InternationalLiberty Mutual Insurance CompanyADJ7871072Petition for reconsiderationWorkers' compensation administrative law judgeTemporarily totally disabledIndemnityEDD credit
References
Case No. ADJ3904838 (LBO 0377238)
Regular
Jun 20, 2015

EDWARD MORSE vs. CONWAY WESTERN EXPRESS, INDEMNITY INSURANCE, CONSTITUTION STATE SERVICE COMPANY

This case involves cross-petitions for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision regarding an injured truck driver. The WCAB granted the defendant's petition to correct a clerical error, increasing the third-party credit from $179,001.50 to $199,001.50. The Board denied the applicant's petition regarding penalties for failure to provide medical treatment, deferring the issue until the application of the credit is determined. The original decision found the applicant sustained industrial injuries to multiple body parts and systems and awarded penalties against the defendant were not warranted.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryTruck DriverNeck InjuryBack InjuryShoulder InjuryKnee InjuryUpper Extremity Injury
References
Case No. ADJ9001768
Regular
Apr 04, 2019

ERNESTO LANGARICA vs. PENSKE TRUCK LEASING, OLD REPUBLIC GENERAL INSURANCE

This case concerns defendant Penske Truck Leasing's attempt to claim a credit against future workers' compensation benefits owed to applicant Ernesto Langarica. The applicant settled a civil lawsuit arising from an industrial injury, and the defendant had filed a lien in that civil case. The Workers' Compensation Appeals Board (WCAB) rescinded the prior finding and returned the case for further proceedings, holding that the settlement of the defendant's lien in the civil case did not automatically waive their right to claim a credit. The WCAB emphasized that the release language did not expressly waive the credit claim, and applicant's understanding of the settlement did not create a "warranted belief" of such a waiver. Further hearings are required to determine negligence and the final credit amount.

Third-party recoveryLien settlementCredit rightsLabor Code sections 3858 and 3861Joint Findings and OrderPetition for ReconsiderationStipulations and Request for AwardRelease of claimsWCJ Opinion on DecisionEmployer negligence
References
Case No. ADJ12340832
Regular
Sep 14, 2022

JOSE PEREZ vs. VILLA PARK LANDSCAPE, CALIFORNIA INSURANCE COMPANY, APPLIED RISK SERVICES

The applicant sought reconsideration of an award that found industrial injury to his back and entitled him to disability benefits, but also granted the defendant a credit for temporary disability overpayment. The Appeals Board affirmed the award of disability benefits but deferred the issue of the credit for temporary disability overpayment. This deferral is due to the defendant failing to present evidence or provide a clear explanation for the alleged overpayment, and the potential conflict between temporary and permanent disability indemnity purposes. Further proceedings are recommended to determine if the credit should be awarded.

WCABReconsiderationFindings of Fact and AwardIndustrial InjuryTree TrimmerTemporary DisabilityPermanent DisabilityCredit for OverpaymentAgreed Medical Examination (AME)Primary Treating Physician (PTP)
References
Case No. ADJ9464655
Regular
Dec 21, 2020

JOSE GARCIA vs. COUNTY OF ORANGE, PSI, YORK RISK SERVICES GROUP, INC.

This case involves a worker's compensation claim where the employer sought a third-party credit against the applicant's settlement. The Appeals Board amended the findings to attribute 5% of the fault to the applicant and 95% to the employer's employees. Despite the applicant's settlement of $26,000, the employer was denied credit because their 95% fault ($24,700) exceeded the applicant's net recovery ($17,500). The Board affirmed the WCJ's decision that the employer's contribution based on their fault exceeded the credit amount, thus preventing a credit for future benefits.

third-party creditcomparative negligenceemployer negligenceMartinez v. Associated EngineeringLabor Code section 3861settlementindustrial injuryWCJ credibilityproximate causeAssociated Construction & Engineering Co.
References
Case No. ADJ1749318 (OAK 0338628)
Regular
Nov 03, 2015

EDGAR PUENTE vs. MACY'S WEST

This case involves Macy's West seeking removal of an order denying their petition for a $500 credit related to a missed QME appointment. The Workers' Compensation Appeals Board granted removal, finding that summary denial of the credit petition would cause prejudice. The Board amended the original order to defer the issue of the credit petition until the applicant's underlying claims are settled or tried. This allows Macy's to present evidence and arguments for the credit at a later, more appropriate stage.

Workers' Compensation Appeals BoardPetition for RemovalOrder Denying Petition for CreditQME appointmentLabor Code section 5811Petition for Creditmedical-legal costmissed appointment feecompensable consequencehypertension
References
Showing 1-10 of 540 results

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