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

Case No. MISSING
Regular Panel Decision

Atlantic Casualty Insurance v. Value Waterproofing, Inc.

Atlantic Casualty Insurance Company sought a declaratory judgment that it had no duty to defend or indemnify Value Waterproofing, Inc. in an underlying breach of contract and negligence lawsuit. Value counterclaimed, requesting a declaration that Atlantic Casualty was required to defend and indemnify. The court granted Atlantic Casualty's request, finding that Value failed to provide timely notice of the claim, thereby prejudicing Atlantic Casualty's investigation capabilities. Additionally, the court ruled that Value's work on a commercial property was not covered by its residential-only roofing insurance policy, further justifying the denial of coverage.

Insurance disputeBreach of contractNegligenceDeclaratory judgmentTimely noticeCoverage exclusionCommercial General LiabilityResidential roofingPolicy interpretationPrejudice
References
46
Case No. MISSING
Regular Panel Decision

Claim of Korthals v. Valu Home Centers, Inc.

Claimant sustained back injuries in 2003 and 2009 while employed by Valu Home Centers, Inc. and Spectrum Human Services, respectively. A 2009 independent medical examination apportioned liability for her condition across both injuries and prior motor vehicle accidents. After claimant's 2011 back surgery, Spectrum's carrier requested further action, prompting Valu's carrier to seek a liability transfer for the 2003 claim to the Special Fund for Reopened Cases. The Workers’ Compensation Board approved this transfer, ruling no prior request to reopen the 2003 claim existed. The Special Fund appealed, contending the 2009 medical report served as an application to reopen. The court reversed the Board's decision, determining that the medical report submitted in 2009 indeed constituted a timely application to reopen the 2003 claim, thereby preventing liability transfer to the Special Fund.

Workers' Compensation LawSpecial Fund for Reopened CasesLiability ApportionmentClaim ReopeningIndependent Medical ExaminationWorkers' Compensation Board DecisionAppellate ReviewBack InjuryPrior InjurySeven-Year Rule
References
5
Case No. MISSING
Regular Panel Decision
Mar 02, 2006

People v. Niver

The defendant was convicted of grand larceny in the fourth degree, welfare fraud in the fourth degree, and two counts of offering a false instrument for filing in the first degree, all stemming from her failure to report income while receiving public assistance benefits. On appeal, the defendant challenged the denial of her speedy trial motion, the legal sufficiency of the evidence for her convictions, particularly regarding the value of property wrongfully taken and intent to defraud, and several evidentiary rulings by the County Court. The court found no speedy trial violation, concluding that only 173 days were chargeable to the People. The court also determined that the evidence was legally sufficient to support the convictions, noting witness testimony on overpayment exceeding $1,000 and the defendant's failure to disclose workers' compensation income. The various evidentiary rulings, including those related to the Molineux application and business records, were upheld. Therefore, the judgment was affirmed.

Grand LarcenyWelfare FraudFalse Instrument for FilingSpeedy Trial ViolationLegal Sufficiency of EvidenceIntent to DefraudEvidentiary RulingsMolineux ApplicationBusiness Records ExceptionCriminal Procedure Law
References
14
Case No. ADJ3123745 (VNO 0551286) ADJ3791599 (VNO 0548958)
Regular
Apr 29, 2015

Steven Kroesen (Deceased), Jennifer Kroesen (Widow) vs. CITY OF TORRANCE, CITY OF LONG BEACH

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a denial of death benefits for Steven Kroesen due to a dispute over the timeliness of the applicant's petition. The applicant claims their petition was timely delivered on November 12, 2014, via FedEx, but the WCAB's records show a filing date of November 13, 2014. The WCAB has returned the case to the administrative law judge for an evidentiary hearing to determine the exact filing date and address jurisdiction to consider the merits of the claim. This hearing will resolve whether the petition was filed within the statutorily allowed timeframe, considering Veterans Day and potential delays.

Petition for ReconsiderationTimelinessJurisdictionEvidentiary HearingJoint Findings and OrderReport of Workers' Compensation JudgeSupplemental PetitionFedEx deliveryR. SolisVeteran's Day
References
6
Case No. ADJ9944770
Regular
Oct 19, 2018

Sam Zavalata vs. Conifer Value Based Care, LLC

This case involves applicant Sam Zavaleta's workers' compensation claim for psychiatric and orthopedic injuries against Conifer Value Based Care, LLC. The Workers' Compensation Appeals Board (WCAB) rescinded the trial judge's decision, finding that the medical opinions from both the orthopedic and psychiatric evaluators required further development. Specifically, issues exist regarding the orthopedic causation of cumulative trauma injury to the applicant's psyche, back, neck, and wrist, as well as the substantial causation of the psychiatric injury in relation to the defendant's good faith personnel action defense. The matter is returned to the trial level for further proceedings and a new decision.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderPsychiatric InjuryCumulative TraumaPersonnel Action DefenseGood FaithCausationMedical OpinionApportionment
References
12
Case No. ADJ4052884 (AHM 0136124), ADJ6520242, ADJ7028149
Regular
Jul 20, 2016

EMILIO EDDIE ROMERO, SARA ROMERO vs. CLOROX PRODUCTS MANUFACTURING, GALLAGHER BASSETT SERVICES

Defendant Clorox sought removal to the Appeals Board to review an order allowing a second deposition of the decedent's QME, arguing prejudice from delay. Defendant contended the applicant waived discovery rights and the issue should be the QME's report's evidentiary value. However, the QME's deposition subsequently occurred. Therefore, the Appeals Board dismissed the Petition for Removal as moot and ordered the matter returned to the trial calendar.

Workers' Compensation Appeals BoardRemovalPetition for RemovalQualified Medical EvaluatorQMEDepositionDiscoveryVacated OrderSubstantial PrejudiceIrreparable Harm
References
1
Case No. ADJ6626132
Regular
Jan 21, 2011

IMELDA DELACRUZ LOPEZ vs. PACIFIC BELL; SEDGWICK 51460 ONTARIO

The defendant sought reconsideration and removal of a WCJ's order denying their petition to strike a Qualified Medical Evaluator's report. The Appeals Board dismissed the Petition for Reconsideration because the order was not a final one. The Board also denied the Petition for Removal, finding the defendant failed to demonstrate significant prejudice or irreparable harm. The defendant's arguments regarding the QME report's evidentiary value and due process were not considered due to procedural deficiencies.

WCABADJ6626132Pacific BellSedgwickPetition for ReconsiderationPetition for RemovalMinute OrderPetition to Strike QME PanelDr. Sanatharasubstantial evidence
References
5
Case No. ADJ11880536
Regular
Aug 01, 2025

SERGIO AVILA vs. ADVANCED CONSTRUCTION, BITCO/OLD REPUBLIC GENERAL INSURANCE CORP.

The initial Findings and Order (F&O) from May 8, 2025, granted a credit to defendant Advanced Construction (ACS) from a third-party settlement. Applicant Sergio Avila sought reconsideration, arguing the WCJ erred in calculating ACS's comparative negligence and the total value of his case. The Appeals Board found the F&O lacked definite findings and identified evidentiary gaps concerning the net recovery, the WCJ's reliance on experts, and proof of benefits paid by ACS. Consequently, the Appeals Board rescinded the F&O and remanded the case for further proceedings consistent with its opinion.

Labor Code section 3861Third-party settlement creditComparative negligenceEmployer negligenceApplicant negligenceTotal damagesNet recoveryAllocation of faultPetition for ReconsiderationFindings and Order
References
11
Case No. ADJ6521264
Regular
Oct 11, 2013

ANGELA STUART-KNIGHTS vs. EMPLOYMENT DEVELOPMENT DEPARTMENT, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of an award finding the applicant sustained 66% permanent disability due to a cumulative trauma injury. The applicant argued that the Agreed Medical Examiner's (AME) report rebutted the permanent disability rating, particularly regarding her chronic pain syndrome. However, the WCAB affirmed the original award, deferring to the judge's credibility determination regarding the applicant's demeanor and testimony, which contradicted the AME's assessment of severe pain. Furthermore, the AME himself deferred to another physician on the issue of chronic pain, undermining his report's evidentiary value on that point.

WCABReconsiderationFindings of FactAwardAdministrative Law JudgeWCJCumulative TraumaPermanent DisabilityAMA GuidesAlmaraz/Guzman
References
4
Case No. MISSING
Regular Panel Decision
Apr 03, 1995

Adams v. Alexander's Deptment Stores of Brooklyn, Inc.

Plaintiff Janie Adams alleged that she slipped and fell on melted ice cream at Kings Plaza Mall, sustaining injuries that required lumbar spine fusion. Defendant Ogden Services Corporation, responsible for common area maintenance, moved for summary judgment. The Supreme Court denied the motion, finding a triable issue of fact regarding notice. However, on appeal, the order was reversed, and the complaint dismissed. The Appellate Division found that Adams failed to make a prima facie case against Ogden, lacking evidence that Ogden created or had actual or constructive notice of the hazardous condition. Furthermore, an unsworn statement by a witness was deemed to be without evidentiary value, insufficient to defeat summary judgment.

Slip and FallPremises LiabilitySummary JudgmentActual NoticeConstructive NoticeEvidentiary ValueUnsworn StatementAppellate ReviewMaintenance ContractIce Cream
References
9
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