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

Case No. ADJ10013565
Regular
Nov 05, 2018

ANTONIO GUZMAN vs. KLEAN SWEEP PARKING LOT SERVICE, INC., STATE COMPENSATION INSURANCE FUND, INSURANCE COMPANY OF THE WEST

The Workers' Compensation Appeals Board (WCAB) granted Trucare Pharmacy's Petition for Reconsideration, rescinding the prior order to stay Trucare's lien. The WCAB found that the defendant failed to meet its burden of proof that Trucare was "controlled" by a criminally charged provider as defined by Labor Code section 139.21(a)(3). Specifically, there was no evidence that John Garbino, the criminally charged provider, was an officer, director, or 10% shareholder of Trucare Pharmacy. Therefore, Trucare's lien is not subject to a stay under Labor Code section 4615 and the case is returned for further proceedings.

Labor Code section 4615criminally charged providerjoint venturepartnershiplien claimantprovider statuscontrolled entitystatutory interpretationdue processadministrative director
References
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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ2238226
Regular
Mar 04, 2013

JUDINE JACOBS vs. RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC.

The Workers' Compensation Appeals Board affirmed the dismissal of an applicant's claim, finding it lacked jurisdiction due to Indian tribal sovereign immunity. The applicant, a nurse, claimed a psyche injury while employed by Riverside-San Bernardino County Indian Health, Inc. (RSB). RSB, despite being incorporated under California law, was deemed a governmental entity linked to tribes and serving federal policy, thus entitled to sovereign immunity. The Board found no evidence of an explicit waiver of this immunity.

Tribal sovereign immunityWorkers' Compensation Appeals BoardIndian Healthpsyche injurynursefindings and orderjurisdictionpetition for reconsiderationreport and recommendationadministrative law judge
References
Case No. ADJ8574285
Regular
Jan 24, 2017

CALE HULSE vs. CALGARY FLAMES, FEDERAL INSURANCE COMPANY

The Workers' Compensation Appeals Board reversed a prior award, finding California lacked subject matter jurisdiction over the applicant's cumulative trauma claim. The Board determined that the applicant, a professional hockey player, had insufficient connection to California, playing only 25-42 games out of over 848 total games. This minimal contact, insufficient for a legitimate and substantial interest, meant requiring the defendant to litigate in California would violate due process, as established in *Federal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)*. Therefore, the applicant was awarded nothing.

Workers Compensation Appeals BoardCalgary FlamesFederal Insurance CompanyCale HulseSubject Matter JurisdictionCumulative Trauma InjuryProfessional Hockey PlayerDue ProcessFederal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)Legitimate Interest
References
Case No. ADJ9379743 ADJ9133071
Regular
Dec 10, 2018

SHERRY ARELLANES vs. COUNTY OF RIVERSIDE

The Workers' Compensation Appeals Board granted Firstline Health's Petition for Reconsideration, rescinding the prior order that Firstline's liens were subject to a stay under Labor Code section 4615. The Board found the original decision improperly relied on criminal indictment allegations as evidence and lacked substantial evidence to prove Firstline was "controlled" by a criminally charged individual as defined by statute. Consequently, the cases are returned to the trial level for further proceedings to properly address the evidentiary basis for any potential stay.

Labor Code Section 4615Labor Code Section 139.21Lien ClaimantPetition for ReconsiderationJoint Findings of FactWorkers' Compensation Administrative Law Judge (WCJ)Criminal IndictmentDepartment of Industrial Relations (DIR)Electronic Adjudication Management System (EAMS)Dirt potential stay list
References
Case No. ADJ704709 (RIV 0053815)
Regular
Sep 08, 2009

RAMON CHAVEZ vs. RANCHO MIRAGE COUNTRY CLUB, FEDERAL INSURANCE c/o CHUBB SERVICES, MITSUI SUMITOMO, AMERICAN NATIONAL FIRE, INCORPORATED, INSURANCE COMPANY OF NORTH AMERICA by and through ACE, USA/ESIS

This case concerns a workers' compensation claim settled via Compromise and Release, leaving medical lien claims outstanding. The defendant insurer, Federal, sought to join other insurers (INA and American) based on new evidence regarding the period of injurious exposure. The trial judge dismissed INA and American, finding Federal's claims barred by the statute of limitations for contribution. The Appeals Board granted reconsideration, holding that Federal was not seeking contribution but rather defending against a lien claim, making dismissal improper. The matter was returned to the trial level to determine liability for the medical treatment expenses.

Workers' Compensation Appeals BoardRamon ChavezRancho Mirage Country ClubFederal InsuranceMitsui SumitomoInsurance Company of North AmericaACE USA ESISLabor Code Section 5500.5(e)Statute of LimitationsApportionment
References
Case No. ADJ11167540
Regular
Feb 15, 2019

CHARLES SENIFF vs. FEDERAL EXPRESS CORPORATION

The Workers' Compensation Appeals Board denied Federal Express's petition for reconsideration, upholding the administrative law judge's finding of jurisdiction. Federal Express argued the Board lacked jurisdiction because the applicant did not work in California after 2006. The Board adopted the judge's report, which found California jurisdiction supported by Labor Code section 3600.5(a) and precedent case law, deeming these sufficient grounds despite the defendant's jurisdictional challenge.

Workers' Compensation Appeals BoardFederal Express CorporationSedgwick Claims Management ServicesADJ11167540Santa Ana District OfficeAmended Findings and AwardWorkers' Compensation Administrative Law JudgejurisdictionLabor Code section 3600.5(a)Alaska Packers Asso. v. Industrial Acci. Com.
References
Case No. ADJ3907382 (AHM 0133851)
Regular
Aug 28, 2009

Mayekal andREW WAGNER vs. WALMART, AVIZENT BENTONVILLE

The Workers' Compensation Appeals Board dismissed the lien claimant's petition for reconsideration because it was not verified as required by law. The applicant's own petition, initially filed as a complaint against the judge, was also denied due to its lack of specificity regarding grounds and supporting evidence. The Board noted the applicant may have intended to file a judicial ethics complaint instead. Therefore, both petitions were ultimately rejected, upholding the original June 12, 2009 Findings, Award, and Orders.

Lien claimantPetition for reconsiderationVerified petitionLabor Code section 5902Judicial ethics complaintComplaint About a Workers' Compensation Administrative Law JudgeWCJFindings Award and OrdersUnlawful or unjustMaterial evidence
References
Case No. ADJ7408183
Regular
Feb 09, 2016

GABRIEL LOPEZ vs. EXPRESS REGENCY PARKING, BERKSHIRE HATHAWAY HOMESTATE COMPANIES

This case involves a dispute over conflicting stay orders on lien claims filed by Landmark Medical Management. The Appeals Board granted Landmark's Petition for Removal, rescinding a June 26, 2015 order that stayed proceedings due to criminal and civil indictments against Landmark. This rescinded order was superseded by an earlier, broader stay order from May 14, 2015, in a consolidated matter. The Board is consolidating this case with the prior stayed matters to ensure consistent application of a single stay order.

Petition for RemovalLandmark Medical ManagementPharmaFinance LLCMedRx Funding LLCSupplemental Minute Ordercriminal indictmentscivil complaintconflicting stay orderOscar ArreolaWestern Door & Trim
References
Case No. ADJ8765034
Regular
May 03, 2017

Darren Langdon vs. New Jersey Devils, Montreal Canadiens, Federal Insurance Company

This case involves a professional hockey player's cumulative injury claim against his former teams, the Montreal Canadiens and New Jersey Devils, and their insurer, Federal Insurance Company. The applicant was hired in California by an earlier team, establishing WCAB jurisdiction despite playing for out-of-state teams later. Federal argued the WCAB lacked jurisdiction over the Montreal and New Jersey employments due to insufficient California contacts, but this was rejected as jurisdiction is based on being hired in California, and the cumulative injury occurred over time. The Board affirmed the finding of jurisdiction and liability, clarifying that employer-specific apportionment issues are addressed in separate proceedings.

Cumulative InjuryProfessional Hockey PlayerJurisdictionFederal Insurance CompanyNew Jersey DevilsMontreal CanadiensLabor Code SectionsApportionmentSubject Matter JurisdictionDue Process
References
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