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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. 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. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. VNO 0461030
Regular
Nov 30, 2007

CHRISTOPHER MENDEZ vs. GRAY LIFT, INCORPORATED, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board rescinded a prior award and returned the case for further proceedings to determine the general employer's (Lyon Lift, Inc.) potential liability for the applicant's injury. This is to address whether Lyon had duties under workplace safety laws (Labor Code sections 6400-6404) and if its negligence, if any, contributed to the injury caused by a defective saw provided by the special employer. The Board will then determine if Lyon is entitled to a third-party credit for the applicant's settlement based on its own negligence and established credit principles.

Workers' Compensation Appeals BoardThird-party creditGeneral employerSpecial employerImputation of negligenceLabor Code sections 6400-6404Workplace safetyPrimary employerSecondary employerDual employment
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. 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. ADJ7675972
Regular
Jan 07, 2013

Miguel Guzman vs. Girardi & Keese, Angelus Block Company, Inc., Integrated Claims

This case concerns an employer's lien for death benefits paid after an employee's death from an industrial injury. The employee's dependents settled a third-party lawsuit for $445,000, with a portion withheld pending determination of the employer's lien. A Superior Court found it lacked jurisdiction over the employer's reimbursement claim, and the WCJ similarly dismissed the matter, finding no pending workers' compensation issue. The Appeals Board, however, determined it has jurisdiction to adjudicate employer negligence and the amount of the lien, drawing parallels to its authority in credit claims. The matter is returned for trial at the WCAB level.

Workers' Compensation Appeals BoardDeath BenefitThird-Party ActionEmployer LienReimbursementDeclaratory ReliefSuperior Court JurisdictionCollateral EstoppelLabor Code Section 3856(b)Labor Code Section 3858
References
Case No. ADJ1973537 (SRO 0141664)
Regular
Jun 24, 2019

KENT WARD vs. TIMEC COMPANY, INC., ZURICH AMERICAN INSURANCE COMPANY

The applicant sought reconsideration of an arbitration decision that found his employer, Timec, 25% comparatively negligent for his injury, reducing Timec's credit from a third-party settlement. The applicant argued for a higher employer negligence percentage to increase his potential workers' compensation benefits. The Board denied reconsideration, adopting the Arbitrator's findings and reasoning. The Board found the applicant failed to present evidence to overcome the Arbitrator's negligence determination.

Third-party creditComparative negligenceArbitrator's findingsPetition for reconsiderationLabor Code section 3861Employer's liabilityThird-party claim valueNet settlement amountCredit against workers' compensationEmployer's breach of duty
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
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