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

Case No. ADJ7186596
Regular
Feb 28, 2011

ANDREW MARTINEZ vs. CITY OF SANTA ROSA, REDWOOD EMPIRE MUNICIPAL INSURANCE FUND

This case involves a defendant seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) award. The defendant argued for a 15% reduction in permanent disability payments based on an offer of regular work, contending it should apply retroactively to all unpaid benefits. The WCAB denied reconsideration, finding the reduction only applies to payments becoming due *after* the work offer was made. The Board affirmed the judge's finding that the defendant had a duty to advance permanent disability payments earlier, due to indications of potential permanent disability from medical reports prior to the offer. Therefore, the 15% reduction under Labor Code § 4658(d) was correctly limited to post-offer payments.

Labor Code § 4658(d)Findings and AwardPermanent DisabilityTemporary DisabilityOffer of Regular WorkPermanent and Stationary DateLabor Code § 4650(b)Labor Code § 4061(a)Advance PaymentsMedical Treatment
References
2
Case No. ADJ6884562
Regular
Oct 04, 2010

ERIC KRUSE vs. CITY OF SAN RAFAEL, Permissibly Self-Insured

This case concerns whether a 15% reduction in permanent disability indemnity applies when an employer offers an injured employee regular work after their condition is permanent and stationary. The applicant, a parking enforcement officer, sustained a neck and elbow injury and was temporarily disabled before returning to his regular job. The employer offered regular work after the applicant's condition became permanent and stationary, but the applicant had already returned to his normal duties. The majority found that since there was no indication of permanent disability prior to the employer's offer, all permanent indemnity was payable after the offer, entitling the employer to the reduction. However, a dissenting commissioner argued that the offer lacked practical meaning as the applicant had already returned to work and that no weekly payments remained after the offer to be reduced.

Workers' Compensation Appeals BoardEric KruseCity of San Rafaelparking enforcement officerindustrial injuryneck injuryright elbow injurytemporary total disabilitypermanent and stationaryoffer of regular work
References
0
Case No. ADJ4011315 (ANA 0396860)
Regular
Oct 25, 2010

Jong H. Choi vs. BEST BUY COMPANY, Administered By GALLAGHER BASSETT

The Appeals Board granted reconsideration, affirming the 6% permanent disability award but rescinding a 15% reduction in indemnity. The reduction was improperly applied because the employer failed to offer modified/alternative work within the statutory 60-day window after the applicant reached permanent and stationary status. The Board upheld the WCJ's reliance on the treating physician's report over the QME's for determining the disability level. The employer's offer of work was untimely, thus disqualifying them from the statutory reduction.

Workers' Compensation Appeals BoardPermanent DisabilityQualified Medical ExaminerPrimary Treating PhysicianLabor Code Section 4658(d)(3)(A)Modified WorkAlternative WorkSubstantial Medical EvidenceFindings and AwardReconsideration
References
12
Case No. MISSING
Regular Panel Decision
Jan 07, 1971

In re the Claim of Bus

This case involves an appeal by an employer, Bethlehem Steel Company, from a decision of the Unemployment Insurance Appeal Board, which affirmed a Referee's decision granting unemployment benefits to claimants. Claimants were laid off after refusing offers for lower-paying jobs in different departments, arguing a substantial wage reduction (at least 15%) constituted good cause for refusal. Both the Referee and the Appeal Board agreed with the claimants, citing the significant reduction in earnings as good cause, consistent with their prior decisions. The Appellate Court, however, reversed the decision, holding that a percentage reduction in wages alone does not constitute good cause for refusing suitable employment for which one is fitted by experience and training, emphasizing the purpose of the Unemployment Insurance Law is to ease involuntary unemployment, not subsidize workers who refuse suitable work. The matter was remitted for further proceedings to determine if the offered jobs were indeed suitable for the claimants based on their training and experience.

Unemployment BenefitsWage ReductionGood Cause for RefusalSuitable EmploymentLabor Law InterpretationAppellate ReviewUnemployment Insurance Appeal BoardBethlehem Steel CompanySeniority RightsIndustrial Commissioner
References
9
Case No. 2025 NY Slip Op 02401 [237 AD3d 595]
Regular Panel Decision
Apr 24, 2025

American Empire Surplus Lines Ins. Co. v. Hudson Ins. Group

The Appellate Division affirmed an order denying American Empire Surplus Lines Insurance Company's motion for leave to renew its motion for summary judgment. The original summary judgment motion in this insurance coverage dispute was denied due to uncertified and unauthenticated documents. American Empire subsequently obtained deposition testimony from witnesses, which it claimed was new evidence. However, it admitted to strategically withholding this testimony from the initial motion due to concerns about its potential negative impact. The Supreme Court's decision to deny the renewal motion based on this 'new' evidence was deemed a provident exercise of discretion by the Appellate Division.

Summary JudgmentMotion to RenewNew EvidenceStrategic DecisionInsurance Coverage DisputeDeposition TestimonyUncertified DocumentsAuthenticated EvidenceAppellate ReviewDiscretionary Denial
References
1
Case No. MISSING
Regular Panel Decision
Feb 04, 2004

HRH Construction Interiors, Inc. v. Royal Surplus Lines Insurance

This case involves HRH Construction Interiors, Inc. (HRH) and National Union Fire Insurance Company (National) seeking to establish Royal Surplus Lines Insurance Company's (Royal) obligation to defend HRH in an underlying action and reimburse legal fees. The Supreme Court, New York County, initially ruled that Royal was obligated to defend HRH and reimburse legal fees from December 30, 1999. Upon appeal, this order was modified to change the reimbursement start date to November 22, 2000, and otherwise affirmed. The court rejected Royal's argument that a specific endorsement overrode a general blanket additional insured endorsement, which Royal claimed would make them coprimary insurers with National. The duty to defend was clarified to be triggered upon the commencement of the underlying action against HRH.

Insurance disputeGeneral contractor liabilityAdditional insured endorsementDuty to defendInsurance reimbursementSummary judgmentPolicy interpretationConstruction site accidentPrimary insuranceOther insurance clause
References
0
Case No. MISSING
Regular Panel Decision
Nov 16, 2004

Bovis Lend Lease LMB, Inc. v. Royal Surplus Lines Insurance

This case involves an insurance coverage dispute between National Union Fire Insurance Company of Pittsburgh, PA (National Union), The Trustees of Columbia University in the City of New York (Columbia), and Bovis Lend Lease LMB, Inc. (Bovis) against Royal Surplus Lines Insurance Company (Royal). The core issue is whether Royal's disclaimer of liability under Insurance Law § 3420 (d) was timely. The court found that Royal's disclaimer to Bovis and Columbia was untimely as a matter of law because its internal staffing issues were not a reasonable excuse for the delay. However, the court also ruled that § 3420 (d) does not apply to disclaimers between co-insurers, thus Royal's disclaimer was timely as to National Union. Furthermore, the court determined that Royal's "New Residential Work or Products Exclusion" did not apply to Millennium's work on a mixed-use building, thus obligating Royal to defend and indemnify Bovis and Columbia, and Royal was ordered to reimburse National Union for defense costs incurred from March 3, 2003.

Insurance CoverageDisclaimer of LiabilityDenial of CoverageInsurance Law § 3420 (d)Timeliness of DisclaimerInternal Staffing IssuesCo-Insurer LiabilityAdditional InsuredPolicy ExclusionNew Residential Work Exclusion
References
22
Case No. ADJ9008079
Regular
Aug 31, 2015

CHAD CURRY vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS & REHABILITATION, legally uninsured; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES, adjusting agency

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding a prior award of 25% permanent disability to the applicant. The defendant argued for a 15% reduction in weekly payments based on an alleged offer of regular work, but failed to present evidence of this offer or properly raise the issue during trial. The Board found no evidence in the record of the required notice being sent or admitted, and the defendant did not list this issue in the pre-trial conference statement. Therefore, the Board concluded the defendant failed to support its claim for a reduction in benefits.

Petition for ReconsiderationFindings and AwardPermanent Disability IndemnityNotice of Offer of Regular WorkLabor Code Section 4658(d)(3)(A)Weekly Permanent Disability IndemnityPre-Trial Conference StatementBontempoCity of Sebastopol v. Workers' Comp. Appeals Bd.Braga
References
2
Case No. ADJ6957361
Regular
Jan 12, 2012

ROBERTO BARAJAS vs. FRESNO UNIFIED SCHOOL DISTRICT

This case concerns a petition for reconsideration by Fresno Unified School District regarding a workers' compensation award for Roberto Barajas. The District challenged the permanent disability rating, arguing the Agreed Medical Examiner improperly included grip strength loss alongside range of motion limitations, contrary to AMA Guides guidelines. Additionally, the District contested a 10% penalty for delayed permanent disability advances and sought a reduction in benefits based on an offer of regular work. The Workers' Compensation Appeals Board denied reconsideration, affirming the WCJ's findings on the permanent disability rating by finding the AME appropriately applied *Almaraz/Guzman II* principles for calculating impairment. The Board also upheld the penalty for delayed advances and rejected the District's claim regarding work offer reductions.

Workers' Compensation Appeals BoardFresno Unified School DistrictRoberto BarajasFindings of Fact and Awardpermanent disabilityright wrist injuryright hand injuryright finger injurygroundskeeper/gardenerLabor Code section 4650
References
3
Case No. VNO 523244
Regular
Aug 04, 2008

ANGIE JAUREGUI vs. MERCY SOUTHWEST HOSPITAL

This case involves an employer seeking reconsideration of a workers' compensation award for an injured nurse. The employer argued their modified work offer should have reduced the permanent disability award, but the Board denied reconsideration. The Board determined the employer's work offer was not a bona fide modified work offer, and thus did not qualify for the statutory reduction.

Permanent and stationaryMedical-legal reportWork restrictionsModified workAlternative workLabor Code Section 4658(d)Permanent disability awardPetition for reconsiderationFindings and AwardWCJ
References
1
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