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

Case No. ADJ9180559
Regular
Sep 18, 2015

JACKIE SUEHIRO (Dec'd), ALVIN SUEHIRO (Husband) vs. RALPHS GROCERY COMPANY, permissibly self-insured, adjusted by SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The Appeals Board granted the defendant's petition for removal, rescinding a prior Minute Order. The WCJ had found ex-parte communication by the defendant and ordered a new QME panel without a trial or sworn testimony. The Board found this violated the defendant's due process rights, as no evidence was presented to support the ex-parte communication finding. The case is returned to the trial level for a hearing on all issues, including alleged ex-parte communication, with parties afforded the chance to present evidence and witnesses.

Petition for RemovalMinute OrderQualified Medical EvaluatorEx-parte CommunicationDue ProcessWCJReplacement QME PanelLabor Code Section 5313Admitted EvidenceProof of Service
References
Case No. ADJ11584415
Regular
Sep 30, 2019

GUY SYLVA vs. CITY AND COUNTY OF SAN FRANCISCO

This case involves an applicant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that denied temporary disability benefits and a motion to strike a Qualified Medical Evaluator's (QME) reports. The applicant alleged ex parte communication between the defendant and the QME, violating Labor Code section 4062.3. The WCAB granted reconsideration, finding that the issue of ex parte communication was not adequately addressed due to conflicting dates and unadmitted evidence. The matter is remanded to the trial level for further proceedings to determine if ex parte communication occurred and to address the temporary disability issue.

WCABAOE/COEQMEex parte communicationLabor Code section 4062.3Petition for ReconsiderationFindings and Orderremovaltemporary disabilityprimary treating physician
References
Case No. OAK 0254576, OAK 0254577, OAK 0282653
Regular
Jul 30, 2007

PATRICIA LE MELLE vs. FED EX, OAKLAND UNIFIED SCHOOL DISTRICT, METRO ONE TELECOMMUNICATIONS, LIBERTY MUTUAL INSURANCE COMPANY, COUNTY OF ALAMEDA

The Appeals Board granted reconsideration due to insufficient explanation from the trial judge regarding medical opinions, temporary disability allocation, and permanent disability apportionment. The original decision is rescinded and the case is returned for further proceedings and a new decision. Notably, the Board observed that Fed Ex likely is not liable for back treatment and that a prior finding of cumulative injury against Metro One stands.

Workers' Compensation Appeals BoardReconsiderationFindings Awards OrdersClerical ErrorIndustrial InjuryTemporary DisabilityPermanent DisabilityAgreed Medical Evaluator (AME)ApportionmentCumulative Injury
References
Case No. ADJ6755820, ADJ7231247, ADJ6777953
Regular

NORMA HERNANDEZ vs. KRAGEN AUTO PARTS, ZURICH NORTH AMERICA INSURANCE COMPANY

This case involves a Petition for Removal filed by Norma Hernandez against Kragen Auto Parts and its insurer, Zurich North America. The applicant, Hernandez, subsequently withdrew the petition. Consequently, the Workers' Compensation Appeals Board has dismissed the petition. No further action will be taken on this matter.

Petition for RemovalDismissedWorkers' Compensation Appeals BoardApplicantDefendantKragen Auto PartsZurich North America Insurance CompanyLong Beach District OfficeOrder Dismissing PetitionWithdrawn Petition
References
Case No. ADJ 10470293
Regular
Jul 10, 2017

Herbert Miller vs. O'Reilly Auto Parts, SAFETY NATIONAL CASUALTY, CORVEL

Here's a summary for a lawyer: The Workers' Compensation Appeals Board affirmed the finding of industrial injury for an applicant who was injured in a car accident while commuting home after picking up a company part. This trip was deemed a "special mission" for the employer, thus overcoming the going-and-coming rule defense. However, the issue of reimbursement for family-provided home health care was deferred for further development of the record, as the applicant did not initially meet the prescription requirements.

Going and Coming RuleSpecial Mission ExceptionAOE/COEHome Health CarePrescription RequirementMedical TreatmentLabor Code Section 3600Industrial InjuryWCJPetition for Reconsideration
References
Case No. ADJ6624821
Regular
Oct 10, 2014

ED WACKERMAN vs. NAPA AUTO PARTS, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted a petition for reconsideration filed by defendant Napa Auto Parts. This action was taken due to statutory time constraints and an initial review of the record, necessitating further study of the factual and legal issues. The WCAB requires more time to thoroughly understand the case and issue a just decision. All future communications regarding this case must be filed in writing directly with the WCAB Commissioners' office, not with any district office or via e-filing.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationOPINION AND ORDERADJ6624821Napa Auto PartsEmployers Compensation Insurance CompanyJuly 18 2014statutory time constraintsfactual and legal issuesjust and reasoned decision
References
Case No. ADJ9376633, ADJ9378451
Regular
Oct 29, 2018

MARIA GONZALEZ vs. CRST VAN EX/CEDAR RAPIDS, NEW HAMPSHIRE INSURANCE COMPANY

This case involves applicant Maria Gonzalez and defendants CRST Van Ex/Cedar Rapids and New Hampshire Insurance Company. The Workers' Compensation Appeals Board granted reconsideration of a prior decision from August 13, 2018. The Board rescinded that decision and returned the matter to the workers' compensation administrative law judge for further proceedings and a new decision. This order is procedural and does not address the merits of the case.

Petition for ReconsiderationWorkers' Compensation Appeals BoardWCJ reportgrant reconsiderationrescind decisionfurther proceedingsDecision After Reconsiderationtrial leveladministrative law judgeADJ9376633
References
Case No. ADJ821366 (OAK 0323506) ADJ7173636
Regular
Jun 01, 2010

ANTHONY REYNOLDS vs. COCA-COLA BOTTLING COMPANY, Permissibly Self-Insured

Defendant Coca-Cola Bottling Company sought reconsideration of a Workers' Compensation Appeals Board (WCAB) decision regarding applicant Anthony Reynolds' industrial injuries. The WCAB granted reconsideration and rescinded the original decision, returning the matter for further proceedings. This action was primarily to address the defendant's contention that the WCJ erred in determining apportionment of permanent disability under Labor Code section 4664. The WCAB clarified that the defendant bears the burden of proving the extent of overlap between a prior permanent disability award and the current injury. The WCAB also instructed the WCJ to correct a clerical error regarding the defendant's self-insured status.

Labor Code section 4664ApportionmentWhole Person ImpairmentPermissibly Self-InsuredCumulative TraumaSpecific InjuryPanel Qualified Medical ExaminerOld Rating ScheduleNew Rating ScheduleBurden of Proof
References
Case No. ADJ9927385
Regular
Sep 12, 2016

VAHAK AMIRIAN vs. MERCEDES & BMW AUTO PARTS & DISMANTLING, INCOPRORATED, A CALIFORNIA CORPORATION, UNINSURED

This case involves a defendant, Mercedes & BMW Auto Parts & Dismantling, Inc., seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision. The WCAB denied the petition, upholding the finding that the applicant, Vahak Amirian, was an employee, not a partner, based on a lack of credible evidence of a partnership. The WCAB also affirmed the finding that the defendant willfully failed to maintain workers' compensation insurance, rejecting the defendant's claims of good faith belief they had no employees. The WCAB gave significant weight to the judge's credibility determinations regarding witness testimony.

Workers' Compensation Appeals BoardEmployee vs. PartnerUninsured EmployerLabor Code Section 4554Willful Failure to InsureCredibility DeterminationFindings and AwardPetition for ReconsiderationAdministrative Law JudgeWCJ Report
References
Case No. ADJ2906378
Regular
May 24, 2011

NORMA ALONSO vs. PRECISION CAST PARTS CORPORATION AKA AVIBANK MANUFACTURING, INC.; SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves Norma Alonso's workers' compensation claim against Precision Cast Parts Corporation and Sedgwick Claims Management Services. Alonso filed a Petition for Reconsideration and Removal, seeking to overturn a prior decision. The Workers' Compensation Appeals Board reviewed the petition and the administrative law judge's report. Ultimately, the Board denied both reconsideration and removal, adopting the reasoning of the administrative law judge's report.

ReconsiderationRemovalPetitionWorkers' Compensation Appeals BoardAdministrative Law JudgeDeniedPrecision Cast Parts CorporationSedgwick Claims Management ServicesADJ2906378LAO 0881297
References
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