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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ8753985; ADJ8753959
Regular
Dec 02, 2015

BOB BORBECK vs. ACE BUILDING MAINTENANCE, ZURICH NORTH AMERICA

This case concerns a dispute over a workers' compensation lien filed by the Employment Development Department (EDD). The defendant, Ace Building Maintenance, settled a workers' compensation claim via Compromise and Release (C&R) with the applicant, Bob Borbeck, while aware of EDD's lien for unemployment benefits that duplicated temporary disability payments. The defendant argues they provided sufficient notice to EDD regarding benefit payments and should not be liable for the lien. However, the Board denied the defendant's petition for reconsideration, finding them liable for EDD's lien because they settled the case without resolving it, thus agreeing to pay any subsequently determined amount.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Findings and OrderCompromise and ReleaseEDD LienUnemployment Compensation BenefitsTemporary Disability BenefitsLabor Code Section 4904Notice of Lien ClaimDuplicate Benefits
References
Case No. ADJ1298520
Regular
Dec 24, 2010

CLUSEGUN AFOLAYAN (DECEASED), OLUWASEUN AFOLAYAN, et al vs. STATE OF CALIFORNIA CDCR, CALIFORNIA REHABILITATION CENTER, Legally Uninsured, SCIF/STATE CONTRACTS

In this workers' compensation case, the Appeals Board reconsidered a WCJ's award of dependency benefits to three adult children of a deceased worker. The WCJ had awarded $192,000 total, based on the children being total dependents despite the widow electing CalPERS benefits which typically bar other death benefits. The Board agreed that the adult children are entitled to benefits under Labor Code section 4702, as the widow's CalPERS election does not necessarily exclude other dependents with good cause. However, the Board disagreed with the WCJ's calculation method and remanded the case for a new decision, directing the adult children to divide the difference between the maximum benefit for a widow with dependents and the benefit for a widow without dependents.

Workers' Compensation Appeals BoardDependency benefitsLabor Code Section 4702Adult childrenDeath benefitsLabor Code Section 4707CalPERS special death benefitGood causeTotal dependentsWidow's benefits
References
Case No. ADJ9100288
Regular
May 17, 2018

GILBERT CORTEZ (Deceased), NOHEMA CORTEZ (Surviving Spouse & Guardian Ad Litem), et al. vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, Legally Uninsured, CALIFORNIA PUBLIC EMPLOYEES RETIREMENT SYSTEM, STATE COMPENSATION INSURANCE FUND (Claims Administrator)

The Workers' Compensation Appeals Board (WCAB) rescinded a prior decision concerning death benefits for the deceased employee's children, Andres and Marisa Cortez. The WCAB remanded the case to the administrative law judge to properly join the California Public Employees' Retirement System (CalPERS) and determine the entitlement to and coordination of workers' compensation death benefits with CalPERS special death benefits. The WCAB clarified that the "good cause" standard under *Antrim* applies and that CalPERS benefits may offset workers' compensation benefits to avoid duplicate payments. Further proceedings are required to consider the specific claims of dependency and the impact of CalPERS payments.

Workers' Compensation Appeals BoardCDCRSCIFCalPERSdeath benefitsdependent childrenspecial death benefitsoffsetAntrim standardLabor Code section 4707
References
Case No. ADJ6473555, ADJ7393801
Regular
Sep 18, 2014

Frank Jones (Deceased), Araceli Jones, Mya Jaedyn Jones vs. CDCR KERN VALLEY STATE PRISON, State Compensation Insurance Fund

The Workers' Compensation Appeals Board affirmed a previous award for death benefits to the minor daughter of deceased correctional officer Frank Jones. The WCJ found that the daughter, Mya Jones, was entitled to the special minor's death benefit due to "good cause," as her mother is now a sole provider facing significant financial hardship after the decedent's death. The Board agreed, citing compelling evidence of the mother's financial strain and the minor's ongoing needs. This decision overrides the defendant's contentions that the award was improper and denies credit for prior permanent disability advances.

Workers' Compensation Appeals BoardCalPERSspecial death benefitminor dependentGuardian Ad LitemLabor Code section 4704good causeaverage weekly earningstemporary total disabilitypermanent disability indemnity
References
Case No. AHM 98231
Regular
Sep 24, 2007

MYLINH WHITMAN vs. CINGULAR WIRELESS, SEDGWICK CLAIMS MANAGEMENT

The Appeals Board is reconsidering whether the defendant, Cingular Wireless, is entitled to a credit for salary continuation benefits paid to the applicant. The key issue is whether these benefits were of the "same general character" as workers' compensation, which would permit integration and a credit. The case is returned to the trial level for further evidence development on this specific point, rescinding the prior award of a credit.

Workers' Compensation Appeals BoardCreditSalary continuation planWage loss planMetropolitan Life Short Term Disability PolicyHealth and Welfare Benefits PlanSummary plan descriptionEmployer policyTaxable benefitsPermanent disability indemnity
References
Case No. ADJ7699696
Regular
Apr 06, 2020

George Ramirez, Jr vs. Preston Pipelines, Subsequent Injuries Benefits Trust Fund

This case concerns the applicant's claim for Subsequent Injuries Benefits Trust Fund (SIBTF) benefits, which was initially denied by the WCJ who excluded Dr. Chen's medical reports as inadmissible "doctor shopping." The applicant appealed, arguing Dr. Chen's reports were admissible and not duplicative of Dr. Lockwood's initial, incomplete report. The Appeals Board rescinded the prior order, finding the applicant should not be denied benefits solely due to the exclusion of Dr. Chen's reports, and returned the matter to the trial level to allow the applicant to obtain supplemental reporting from Dr. Lockwood to address his SIBTF eligibility.

Subsequent Injuries Benefits Trust FundSIBTFLabor Code section 4751inadmissible evidencedoctor shoppingQME evaluationsLabor Code section 5703examining physiciancumulative traumaCompromise and Release
References
Case No. ADJ9091836
Regular
May 09, 2018

CHRISTOPHER DOUGLAS (Deceased), AMY DOUGLAS (Surviving Spouse Guardian Ad Litem) vs. CALIFORNIA DEPARTMENT OF FORESTRY AND FIRE PROTECTION, CALIFORNIA PUBLIC EMPLOYEES RETIREMENT SYSTEM, STATE COMPENSATION INSURANCE FUND (Claims Administrator)

This case involves a dispute over workers' compensation death benefits for the dependents of a deceased CalFIRE engineer/paramedic. The appeals board is reconsidering a prior decision that awarded benefits but ordered coordination with CalPERS special death benefits. The central issue is whether workers' compensation death benefits should be awarded to the decedent's children, considering they already receive CalPERS benefits, and how to properly coordinate these two types of benefits. The Board rescinded the prior decision and returned the case for further proceedings, emphasizing the need for proper joinder of CalPERS and a careful consideration of coordination rules.

WCABCalFIRESCIFCalPERSDeath BenefitsSpecial Death BenefitAntrimThompsonCoordination of BenefitsGuardian Ad Litem
References
Case No. ADJ2444888 (POM 0268959)
Regular
Apr 30, 2012

PHILLIP ROBINSON vs. LUKE'S TRANSMISSION, INC., LWP CLAIMS; LWP CLAIMS SOLUTIONS

Applicant sought reconsideration of a WCJ's award for a right hand industrial injury, specifically challenging the denial of temporary disability during incarceration, the occupational group rating, the need for future medical care, and the permanent disability rating. The Workers' Compensation Appeals Board (WCAB) denied the petition for reconsideration. The WCAB adopted the WCJ's report and recommendation, which found that the applicant had received duplicate benefits and did not require further medical treatment.

Workers' Compensation Appeals BoardFindings and Awardindustrial injurypermanent disabilitydisability indemnitytemporary disability benefitsEmployment Development Departmentoccupational group ratingfuture medical carePetition for Reconsideration
References
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