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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. ADJ8128282
Regular
Jan 23, 2014

ANGELA EGBIKUADJE vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATIONS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award, returning the case for further proceedings. The defendant, California Department of Corrections and Rehabilitation, argued that the applicant's psychiatric injury claim was preempted by the ADA and not proven under Labor Code section 3208.3. The Board found the original decision lacked proper analysis regarding predominant industrial causation and the good faith personnel action defense. Therefore, the case was remanded for further development of the record, including expert medical opinion on these issues.

Workers' Compensation Appeals BoardAngela EgbikuadjeCalifornia Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8128282Van Nuys District OfficeReconsiderationFindings and AwardIndustrial cumulative trauma injury
References
Case No. ADJ9942537
Regular
Dec 09, 2018

ANGELO RIOS vs. RUSHER AIR CONDITIONING, INSURANCE CO OF THE WEST SAN DIEGO

This case involves an applicant seeking workers' compensation benefits for an injury sustained during his unpaid lunch break. The Workers' Compensation Appeals Board granted reconsideration, reversing the prior decision that denied the claim. The Board found that the applicant's injury did not fall under the "going and coming" rule due to evidence that he was performing work-related tasks during his break, including taking work calls and researching for a bid. Furthermore, the Board determined the injury likely occurred after the unpaid lunch period concluded, extending into a paid break.

Going and coming ruledual purpose exceptioncourse of employmentscope of employmentAOE/COEpersonal comfort doctrinepaid breaksunpaid lunch breakassaultthird-party assault
References
Case No. ADJ11076937
Regular
Apr 07, 2018

MELISSA MAZZIE vs. TORRANCE UNIFIED SCHOOL DISTRICT

The Appeals Board granted reconsideration, reversing the finding that the applicant was not entitled to temporary disability (TD) benefits at the stipulated rate of $1,172.57 per week. The Board found that the applicant, a salaried teacher, continued to receive her regular wages during winter and spring breaks. Therefore, her TD rate should not have been reduced, as the purpose of TD is to substitute for lost wages.

Temporary DisabilityWage LossAverage Weekly EarningsLabor Code Section 4453(c)(3)Winter BreakSpring BreakSalary DistributionSeasonal WorkerPaid Work DaysPetition for Reconsideration
References
Case No. ADJ10864843
Regular
Nov 15, 2018

YOLANDA PLASCENCIA vs. HYUNDAI CAPITAL AMERICA, SOMPO AMERICA INSURANCE COMPANY

This case involves an applicant who sustained injuries after falling into a pothole on her employer's premises during a break. The applicant was in the process of switching vehicles with her daughter when the incident occurred. The defendant argued the injury was not AOE/COE, as the personal vehicle exchange served no employer benefit and the personal comfort doctrine did not apply. The Board denied reconsideration, adopting the WCJ's report which found the injury compensable under the personal comfort doctrine. The Board reasoned that it's reasonably contemplated for employees to access the employer's parking lot during breaks, and moving a personal car is a personal convenience incidental to employment.

AOE/COEPersonal Comfort DoctrineIndustrial InjuryCourse of EmploymentWorkers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactWCJEmployer's PremisesPaid Break
References
Case No. ADJ7332384
Regular
Jul 19, 2011

DEBORAH CULP vs. UNITED HEALTH GROUP, U.S. FIDELITY & GUARANTY INSURANCE, Administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board denied reconsideration of the applicant's claim. The applicant argued her injury during an extended break en route to a PTA meeting was compensable. The Board adopted the judge's report, which found the injury did not arise out of and occur in the course of employment. This conclusion was based on stipulated facts indicating the accident occurred during more than a lunch break, for a personal errand unrelated to employment.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedStipulated FactsAOE/COEGoing and Coming RulePersonal Comfort DoctrineCompensable InjuryNon-compensable InjuryPaid Lunch Break
References
Case No. ADJ3785318 (LBO 0365737)
Regular
Apr 01, 2020

ANDRES MARIN vs. SANTEE DAIRIES, INC., SENTRY INSURANCE GROUP

The Workers' Compensation Appeals Board (WCAB) granted applicant Andres Marin's Petition for Removal. The WCAB rescinded an order by the WCJ which stated future medical treatment would be handled by Liberty Mutual with a right to contribution. This order was inconsistent with the Stipulations with Request for Award, which only named Santee Dairies/Sentry Insurance Group as a party and did not involve Liberty Mutual. The WCAB found that the erroneous order created prejudice by assigning future medical treatment responsibility to a non-party carrier.

Petition for RemovalWalk Through Appearance SheetStipulations with Request for Awardfuture medical treatmentLiberty MutualSentry Insurance GroupOrder on Walk Through Appearance Sheetinconsistency with stipulationscarrier not party to agreementRESCINDED
References
Case No. LAO 0778727
Regular
Sep 18, 2007

MICHAEL CHAPMAN vs. CURRAN'S CUSTOM PLASTERING, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration, rescinding the original decision that denied the applicant's psychiatric injury claim. The Board found the applicant's fall due to a broken scaffold plank constituted a "sudden and extraordinary employment condition," thus overcoming the six-month employment rule exception. The case is returned for further proceedings to determine compensability for the psychiatric injury.

Workers' Compensation Appeals BoardLabor Code § 3208.3(d)six-month rulepsychiatric injurysudden and extraordinary employment conditionMatea v. Workers' Comp. Appeals Bd.broken plankscaffold fallindustrial injurypermanent disability
References
Case No. ADJ870019 (SFO 0455266) ADJ3218516 (SFO 0428166) ADJ322513 (SFO 0423213)
Regular
Oct 05, 2015

LINDA LECHNER vs. MARIN GENERAL HOSPITAL, ARROWOOD INDEMNITY COMPANY

The Board granted reconsideration of the award for self-procured medical expenses for a walk-in bathtub. The applicant failed to provide a proper request for authorization (DWC Form RFA) from her treating physician. Therefore, the defendant was not obligated to conduct utilization review for the bathtub. The case is returned to the trial level for the applicant's physician to submit a correct request for retrospective authorization.

Utilization ReviewDWC Form RFAPrimary Treating PhysicianWalk-in BathtubSelf-Procured Medical ExpensesPetition for ReconsiderationSupplemental Findings and AwardRetrospective ReviewMedical NecessityIndustrial Injury
References
Case No. ADJ8241877
Regular
May 02, 2014

CONNA NICHOLS, DONNA NICHOLS, DONNA M. NICHOLS vs. EARLY LEARNING INSTITUTE, REPUBLIC INDEMNITY COMPANY OF AMERICA, REPUBLIC INDEMNITY CO.

This case concerns a Petition for Removal denied by the Workers' Compensation Appeals Board (WCAB). The applicant, Donna Nichols, sought removal of an order compelling her deposition, alleging defects and medical inability to attend. The WCAB adopted the Workers' Compensation Judge's (WCJ) report, which found the petition lacked merit. The WCJ reasoned that the deposition order was not a "walk-through" petition and that the applicant's medical evidence was insufficient to justify further delay.

Petition for RemovalWorkers' Compensation Appeals BoardWCJLabor Code section 5313Smales v. Workers' Comp. Appeals Bd.ADJ8241877depositionPetition to Compel Attendance at DepositionDeclaration of Readiness to Proceedwalk-through petition
References
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