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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ9473670
Regular
Nov 02, 2020

SANDRA UYAGUARI GARCIA vs. CLAUDIA MENDOZA Dba SWEET MELODY EXPRESS, UEBTF

This case concerns an applicant seeking workers' compensation benefits for an injury sustained while cleaning a defendant's residence. The primary issue was whether the applicant was an employee of the defendant's business, Sweet Melody Express, or an independent residential employee. The Board affirmed the WCJ's finding that the applicant was not an employee of Sweet Melody Express at the time of the injury, deeming her services to the defendant's home to be sporadic and casual housecleaning for the individual, not the business. Therefore, her claim for workers' compensation was denied.

Workers' Compensation Appeals BoardReconsiderationEmployee StatusResidential EmployeeCasual EmploymentLabor Code Section 3351Labor Code Section 3352(a)(8)Burden of ProofCredibility FindingEmployer Capacity
References
Case No. ADJ6995425
Regular
Apr 27, 2012

SERGIO SANCHEZ vs. LIDA KOHANSAMEH, PACIFIC SPECIALTY INSURANCE

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior ruling finding the applicant an employee of Lida Kohansameh. While agreeing the applicant was not an employee of Pacific Great West Construction, the Board remanded the case for further proceedings. The trial judge must now determine if the applicant is excluded from workers' compensation coverage under Labor Code sections 3351(d) and 3352(h), specifically regarding residential or casual employment and hours worked. This decision avoids a final determination on employment status and focuses on potential statutory exclusions.

Workers' Compensation Appeals BoardLida KohansamehPacific Specialty InsuranceTristar Risk ManagementSergio SanchezFindings and OrderEmployee statusPacific Great West ConstructionReport and RecommendationPetition for Reconsideration
References
Case No. ADJ8190306
Regular
Jan 07, 2013

Silvestre Sanchez vs. Robert E. Town, Allied Insurance, A Nationwide Company

This case concerns whether an injured worker, Silvestre Sanchez, was an employee of Robert E. Town for workers' compensation purposes. The Board granted reconsideration to reverse the WCJ's finding of employment. The primary issue was whether Sanchez met the 52-hour work requirement within the 90 days preceding injury under Labor Code section 3352(h), which excludes certain residential employees. The Board found that based on conflicting testimony regarding a second payment, the applicant did not prove he worked over 52 hours, thus excluding him from coverage.

Workers' Compensation Appeals BoardSilvestre SanchezRobert E. TownAllied InsuranceLabor Code section 3352(h)excluded employeeresidential employee90-day perioddate of injuryFindings of Fact
References
Case No. SJO 0210015
Regular
Mar 04, 2008

CARLOS SALAZAR vs. JOSE VIDRIO, LIBERTY MUTUAL INSURANCE COMPANY

This case concerns whether a comprehensive personal liability policy provided by Liberty Mutual to Jose Vidrio covered applicant Carlos Salazar's workers' compensation claim for injuries sustained while working at Vidrio's residence. The Appeals Board affirmed the arbitrator's decision, finding that Insurance Code section 11590 mandates such coverage for residential employees incidental to the dwelling's use, regardless of specific policy wording. The Board also confirmed Salazar met the statutory employee criteria of working over 52 hours and earning over $100 in the 90 days prior to injury.

Workers' Compensation Appeals BoardIndustrial InjuryResidential EmployeeComprehensive Personal Liability InsuranceLabor Code section 3351(d)Insurance Code section 11590Labor Code section 3352(h)Incidental DutiesDwelling MaintenanceUninsured Employers Benefits Trust Fund
References
Case No. LAO 0879648
Regular
Jun 09, 2008

ANTO'NIO GONZALEZ vs. ASH, AMIR LANKARANI dba ANAHEIM CAR WASH

The Workers' Compensation Appeals Board denied reconsideration of a decision finding Antonio Gonzalez was an employee of Anaheim Car Wash when he was injured. The Board adopted the administrative law judge's report, which found the applicant credible and the employer not credible. The judge determined that Gonzalez was hired to provide services for a daily wage, fulfilling the definition of an employee.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ reportLabor Code section 5313credibility findingGarza v. Workmen's Comp. Appeals Bd.employment disputeAnaheim Car WashAntonio GonzalezAmir Lankarani
References
Case No. B167017
Significant
Nov 18, 2004

General Casualty Insurance and Regent Insurance, Joseph A. Lane, American Home Assurance Company vs. Workers' Compensation Appeals Board and California Insurance Guarantee Association

The court has requested responses from the Workers' Compensation Insurance Rating Bureau (WCIRB) and the California Insurance Commissioner regarding the exclusion of special employees from a special employer's workers' compensation policy, specifically questioning the use and requirements of Form No. 11 for this purpose.

WCIRBForm No. 11limiting endorsementsrestricting endorsementsspecial employeesgeneral employerstemporary employeesleased employeesInsurance CommissionerCalifornia Code of Regulations
References
Case No. ADJ4543302 (LBO 0384577) ADJ4573415 (LBO 0384579)
Regular
Oct 31, 2008

SANDRA AREBALO vs. MELISSA & ARTUR SPOKOJNY, SPECIALTY RISK SERVICES c/o ALL STATE INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration, reversing a prior ruling. The Board found that the applicant's specific injury claim was barred by Labor Code section 3352(h) because she did not meet the minimum hours or earnings threshold for an employee. Additionally, the Board determined that the applicant's cumulative trauma claim was barred by Labor Code section 3600(a)(10) as it was filed after notice of termination. Consequently, the applicant will take nothing from her claims.

Labor Code Section 3352(h)Labor Code Section 3600(a)(10)post-termination defensespecific injurycumulative traumahousekeeperbabysitterdate of injurydefinition of employeePetition for Reconsideration
References
Case No. SFO 0499272
Regular
Jul 07, 2008

Helen Miller vs. Green Gulch Farm and Zen Center, EVEREST NATIONAL INSURANCE

The Workers' Compensation Appeals Board affirmed the administrative law judge's finding that Helen Miller was an employee of Green Gulch Farm and Zen Center and sustained an industrial injury to her left ankle. The Board found Miller was not a volunteer due to the extensive benefits received and the employer's control, and her jogging injury during a lunch break was a reasonable expectancy of employment, not barred by Labor Code section 3600(a)(9). Therefore, her injury arose out of and occurred in the course of her employment.

Workers' Compensation Appeals BoardHelen MillerGreen Gulch Farm and Zen CenterEverest National InsuranceGallagher BassettSFO 0499272Opinion and Decision After ReconsiderationLabor Code Section 3351Labor Code Section 3352(i)Employee definition
References
Case No. ADJ7874903
Regular
Feb 22, 2018

Abraham Gonzalez vs. Jose Echeverry, Echeverry Family Trust

The Workers' Compensation Appeals Board (WCAB) rescinded the trial judge's finding that the applicant was not an employee. The applicant claimed an industrial injury while working as a laborer for the defendant, who was uninsured. The core issue was whether the applicant was an employee or an independent contractor, with the defense arguing an exemption under Business and Professions Code section 7048 for jobs under $500. The WCAB found the record insufficient, particularly regarding the total contract price of the project, and returned the case for further development and a new decision.

Workers' Compensation Appeals BoardADJ7874903Abraham GonzalezJose EcheverryEcheverry Family TrustOpinion and Decision After ReconsiderationFindingsregular hourly employeeemployment relationshipuninsured
References
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