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

Case No. ADJ3138312 (WCK 0059967)
Regular
Jul 05, 2011

GREGORY McBEE vs. AMERICAN DESIGN ROOFING, CIGA, LEGION INSURANCE COMPANY

The Appeals Board rescinded a prior award of temporary disability benefits because the applicant's period of temporary disability commenced more than five years after his date of injury. The Board found that Labor Code section 5410, which allows for claims of new and further disability within five years of injury, did not apply here. Jurisdiction to award temporary disability beyond five years is limited to continuous disability that began within that timeframe, which was not established. The case was returned for further proceedings on the issue of permanent disability.

Petition to reopennew and further disabilitytemporary disability indemnityjurisdictionfive-year limitationdate of injurystipulated awardAgreed Medical Evaluatorwrit deniedsubstantial medical evidence
References
Case No. ADJ4092048 (SAC 0315575)
Regular
Feb 03, 2012

CLINTON BAKER vs. TRAYLOR BROTHERS; ST. PAUL FIRE and MARINE UNSURANCE

This case concerns a dispute over temporary disability benefits awarded to applicant Clinton Baker. The Appeals Board granted reconsideration of a prior award finding total temporary disability from May 21, 2007, to the present. The Board determined that while jurisdiction exists to award temporary disability beyond five years post-injury if disability began within that period and a timely petition to reopen was filed, the prior award was rescinded. The matter is returned to the WCJ for further proceedings to clarify the correct commencement date of temporary disability, which applicant argues should be March 19, 2007, a date within the statutory five-year window.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardTemporary Total DisabilityPetition to ReopenFive-Year PeriodJurisdictionIndustrial InjurySpineRight Shoulder
References
Case No. ADJ6659926 ADJ6659223
Regular
Jan 06, 2012

MICHELLE JIMENEZ vs. DENCO SALES COMPANY, ACE PROPERTY AND CASUALTY COMPANY, ARGONAUT INSURANCE COMPANY

This case concerns applicant Michelle Jimenez's claim for additional temporary disability benefits for lumbar spine injuries sustained from a specific injury in July 2007 and a cumulative trauma injury ending in July 2008. The Appeals Board found that while the 2007 injury's temporary disability indemnity limit under Labor Code section 4656(c)(1) expired in August 2009, the applicant is entitled to remaining temporary disability under section 4656(c)(2) for the 2008 cumulative trauma injury. Because the applicant had only received 69 weeks of temporary disability for the cumulative trauma injury and is entitled to 104 weeks within five years of the injury date, she is awarded an additional 35 weeks of temporary disability indemnity prior to July 17, 2013.

Labor Code section 4656temporary disability indemnityaggregate disability paymentscompensable weeksperiod of two yearsperiod of five yearsdate of commencementdate of injurycumulative trauma injuryspecific injury
References
Case No. ADJ2378668 (FRE 0197604)
Regular
Nov 21, 2008

DANIEL LOERA vs. BOB JONES PAINTING, LWP CLAIMS SOLUTIONS, Security Insurance Company of Hartford

The Board granted reconsideration to reverse an award of temporary total disability benefits. The WCJ erred in awarding continuing temporary disability as it began more than five years after the date of injury, a period beyond the Board's jurisdictional authority. The decision emphasizes that temporary disability indemnity may not be awarded for a period commencing more than five years from the date of injury, even if surgery was recommended or delayed.

Cumulative traumaTemporary total disabilityFive-year limitationDate of injuryReconsiderationFindings and AwardPetition to reopenContinuing jurisdictionEstoppelSurgical delay
References
Case No. MON 258668
Regular
Apr 23, 2008

HILDA E. LLERENA-HOJJATI vs. SBC/PACIFIC BELL, HELMSMAN MANAGEMENT SERVICES

The Workers' Compensation Appeals Board (WCAB) reviewed a case where the applicant sought temporary total disability (TTD) indemnity. The WCAB amended a prior award, removing TTD benefits commencing May 23, 2006, because they began more than five years after the date of injury and applicant had returned to work. However, the WCAB affirmed the award of TTD indemnity for the period of October 13, 2003, through July 14, 2004, as it fell within the five-year jurisdictional limit. The WCAB also granted applicant's attorney fees but deferred calculation of both TTD indemnity and fees pending further evidence on earnings.

Workers Compensation Appeals BoardReconsiderationTemporary Total DisabilityPetition to ReopenNew and Further DisabilityFive-Year RuleJurisdictionAgreed Medical EvaluatorTreating PhysicianGastric Bypass Surgery
References
Case No. ADJ394938 (OAK 0328377)
Regular
Dec 16, 2015

LONDON MORROW vs. GOLDEN GATE BRIDGE HIGHWAY AND TRANSPORTATION DISTRICT

This case concerns an applicant who sustained a right shoulder injury in 2003 and was awarded temporary disability indemnity for a new period of disability in 2015. The defendant challenged this award, arguing the Board lacked jurisdiction to grant temporary disability more than five years after the injury date, as the applicant had not been continuously disabled. The majority of the Board denied reconsideration, adopting the WCJ's report. However, a dissenting commissioner argued that Labor Code section 4656 and prior case law preclude jurisdiction for a new temporary disability period initiated more than five years post-injury, especially when disability was not continuous.

Workers' Compensation Appeals BoardPetition for ReconsiderationTemporary Disability IndemnityDate of InjuryJurisdictionLabor Code Section 4656Nickelsberg v. Workers' Comp. Appeals Bd.Continuous DisabilityNew Period of Temporary DisabilityPermanent and Stationary
References
Case No. FRE 0199865
Regular
Feb 04, 2008

CHRYSTI WIMER vs. FRESNO UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board granted reconsideration and rescinded a previous award, holding that the applicant was not entitled to "new and further" temporary disability benefits commencing after the five-year statutory period from her original injury. While the WCAB agreed with the administrative law judge's amended order clarifying the scope of the decision, they found that the claim for temporary disability after the five-year mark lacked jurisdiction. The issue of new and further permanent disability remains deferred.

new and further disabilitypetition to reopentemporary disabilitystipulated awardpermanent disabilitydate of injuryfive-year limitationSarabiAcostaWCAB Rule 10859
References
Case No. ADJ7811907
Regular
Jul 10, 2017

KYLE PIKE vs. COUNTY OF SAN DIEGO

The Workers' Compensation Appeals Board denied the County of San Diego's petition for reconsideration, affirming an award of temporary disability and salary continuation benefits to Kyle Pike. Despite the benefits extending beyond five years from the injury date, the Board found applicant's temporary disability commenced within that period and was limited to 104 weeks. This decision aligns with a judicial interpretation that allows such awards when a timely petition to reopen is filed and benefits begin within the statutory five-year window. The dissenting opinion argued that Labor Code section 4656(c)(2) strictly prohibits temporary disability payments beyond five years from the injury date for injuries after January 1, 2008.

Labor Code section 4850temporary disability benefitsPetition to ReopenLabor Code section 4656(c)(2)five-year limitation104 weeksDeputy Sheriff Detentiondate of injurycontinuing jurisdictionnew and further disability
References
Case No. 57
Regular
Apr 28, 2011

LAURIE TRINIDAD vs. ALBERTSON'S, PSI, Administered by SPECIALTY RISK SERVICES

This case concerns an applicant's claim for temporary disability benefits beyond five years from the date of injury. The Workers' Compensation Appeals Board (WCAB) affirmed the WCJ's decision that it lacked jurisdiction to award these benefits. The WCAB determined that while the applicant experienced new periods of disability after the five-year mark, no petition to reopen or for new and further disability was filed within the statutory period following a prior order awarding temporary disability. The Board distinguished this case from prior decisions where jurisdiction extended beyond five years due to the absence of any prior award or a continuing award that was improperly terminated.

Workers Compensation Appeals BoardLaurie TrinidadAlbertson'sSpecialty Risk ServicesOpinion and Decision After Reconsiderationtemporary disability benefitsjurisdictiongrocery checkerlumbar spinebilateral shoulders
References
Case No. ADJ9519790
Regular
Sep 10, 2019

MARK CARREON vs. CLEVELAND INDIANS, SAN FRANCISCO GIANTS

This case concerns the Cleveland Indians' petition for reconsideration, arguing that California workers' compensation jurisdiction is barred under Labor Code Section 3600.5(d) due to the applicant's last year of employment with the Jackson Diamond Cats. The Board affirmed the original award, finding the Indians failed to meet their burden of proving the exemption. The applicant's employment with the Diamond Cats was not established as "professional athlete" employment under the statute, nor was it proven that the Diamond Cats qualified for exemption under Section 3600.5(c) as the applicant did not work in California for that team. Furthermore, the Indians failed to identify or prove any other law exempting the Diamond Cats from California jurisdiction.

Labor Code 3600.5WCAB jurisdictionprofessional athlete exemptioncumulative trauma injuryMark CarreonCleveland IndiansSan Francisco GiantsCIGAGallagher BassettJackson Diamond Cats
References
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