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

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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ7039301
Regular
Mar 16, 2011

ROBLY HART vs. LA JOLLA PACIFIC/DRR NEFF & ASSOCIATES, OAKS RIVER INSURANCE/BERKSHIRE HATHAWAY HOMESTATE COMPANIES

This case concerns Robly Hart's workers' compensation claim for an injury sustained in a motorcycle accident. The applicant was a construction consultant who used his motorcycle for work, traveling between home, job sites, and interviews. The primary dispute centers on whether the accident occurred during the course and scope of his employment, with conflicting evidence regarding his activities and timeline leading up to the incident. The Workers' Compensation Appeals Board denied reconsideration, adopting the judge's report that found the applicant's testimony lacked credibility due to inconsistent statements and timeline discrepancies.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJGarza v. Workers' Comp. Appeals Bd.Findings and OrderCourse of EmploymentConstruction ConsultantBuilding InspectorMotorcycle TravelJob Sites
References
Case No. ADJ4153143, ADJ1964837 and ADJ1933860
Regular
Nov 05, 2010

JACK L. MARCUM vs. OUTSOURCE MANAGEMENT, INC. dba THE MANAGEMENT CONNECTION, SUPERIOR NATIONAL INSURANCE CO., now liquidation, administered by CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, KLEEGE INDUSTRIES, INC. dba HANDS-ON EVENT LABOR SERVICES, STATE COMPENSATION INSURANCE FUND

This case involves an applicant who sustained shoulder injuries in 1999 and 2000, with a compensation judge awarding 4% permanent disability. The California Insurance Guarantee Association (CIGA) is appealing a decision holding it liable, arguing the applicant was not employed by a company insured by Legion Insurance (now handled by CIGA) but rather by Kleege Industries, insured by SCIF. CIGA contended there was a general/special employment relationship and that SCIF's policy should cover the applicant. The Appeals Board granted reconsideration, affirmed the previous awards, and corrected a clerical error to accurately reflect Legion Insurance as the insurer for Outsource Management, Inc. during the relevant period.

California Insurance Guarantee AssociationLegion Insurance CompanyOutsource Management Inc.The Management ConnectionKleege Industries Inc.Hands-On Event Labor ServicesState Compensation Insurance Fundcumulative traumaright shoulder injurypermanent disability
References
Case No. STK 0192198, STK 0192199(M)
Regular
Mar 27, 2008

DAVID FONSECA vs. ALAMEDA COUNTY SHERIFF'S DEPARTMENT, TRISTAR RISK MANAGEMENT, SEDGWICK CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board granted reconsideration and removal, rescinding the finding of no cumulative trauma injury and amending the finding regarding the applicable rating schedule for a 1992 knee injury. The case is returned to the trial level for further development of the record on cumulative trauma, permanent disability, and apportionment. Medical evaluators should be provided with the applicant's deposition transcript and a job description.

Workers Compensation Appeals BoardPermissibly Self-InsuredTristar Risk ManagementSedgwick Claims ManagementRemovalReconsiderationFindings Award and OrdersSchedule for Rating Permanent DisabilitiesCumulative Trauma InjuryFuture Medical Treatment
References
Case No. SJO 0264010
Regular
Feb 11, 2008

CIPRIANO LOMOTAN vs. GE INFRASTUCTURE SECURITY, MATRIX ABSENCE MANAGEMENT SERVICES

In *Lomotan v. GE Infrastructure Security*, the Appeals Board vacated a judge's notice of intention to impose sanctions and a related job analysis order. This decision followed a Commissioner's Conference where the parties reached a compromise and release resolving all issues, including vocational rehabilitation benefits. The Board found no basis for sanctions and determined the job analysis issue was moot due to the settlement.

RemovalAppeals BoardSupplemental OrderSanctionsWCJCommissioner's ConferenceCompromise and ReleaseVocational RehabilitationSupplemental Job Displacement BenefitsJob Analysis
References
Case No. SAC 357129
Regular
Sep 24, 2007

MICHAEL HANCOCK vs. TOWNSEND & SCHMIDT MASONRY, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant injured in a car accident while commuting to work, with the employer arguing the "going and coming" rule barred recovery. The Workers' Compensation Appeals Board affirmed a finding that the applicant's injuries were industrial, holding that the rule did not apply. The Board reasoned that the applicant's use of his personal vehicle to transport tools, the potential for inter-job site travel, and the employer's travel pay policy conferred a benefit to the employer, thus justifying an exception to the rule.

going and coming ruleindustrial injuryautomobile accidentcommutebrick tendercourse of employmentWCJpetition for reconsiderationemployer benefitwork materials
References
Case No. ADJ7899311
Regular
Jun 17, 2014

RONNY PINEDA vs. PEPSI BEVERAGE COMPANY, ACE AMERICAN INSURANCE COMPANY

A lien claimant's petition for reconsideration was denied by operation of law because it was improperly labeled in the Electronic Adjudication Management System, preventing the Appeals Board from timely acting on it. The Board determined the lien claimant's error, not any fault of the Board, prevented the petition from being considered within the statutory 60-day period. Furthermore, the petition was sought from a procedural order, not a final determination of substantive rights or liabilities, which is a prerequisite for reconsideration. Therefore, the petition would have been dismissed even if properly filed.

Workers' Compensation Appeals BoardPetition for ReconsiderationElectronic Adjudication Management System (EAMS)Lien ClaimantAdministrative Law Judge (WCJ)Discovery RequestAffidavitOperation of LawToll the PeriodFinal Order
References
Case No. ADJ9160815
Regular
Jun 10, 2014

ALMA CEDILLO vs. CEDARS SINAI MEDICAL CENTER, TRISTAR RISK MANAGEMENT

This case involves an applicant, Alma Cedillo, seeking workers' compensation benefits from Cedars Sinai Medical Center and Tristar Risk Management. The Workers' Compensation Appeals Board (WCAB) issued an order denying a Petition for Removal filed in the case. The WCAB adopted the reasoning of the workers' compensation administrative law judge (WCJ) in reaching its decision to deny removal. Therefore, the applicant's request to remove the case from the current process was rejected.

Petition for RemovalWorkers' Compensation Appeals BoardCedars Sinai Medical CenterTristar Risk ManagementAdministrative Law JudgeADJ9160815Van Nuys District OfficeAlma Cedillodenying removalworkers' compensation
References
Case No. ADJ3413739 (SAL 0120295)
Regular
Nov 26, 2013

YOLANDA OSUNA vs. MARRIOTT HOTEL, ARCHIE MAYS, M.D., RUBY LEYNES, M.D., SCOTT ROSENZWEIG, M.D., EDWARD KOMBERG, D.C.; INNOVATIVE MEDICAL MANAGEMENT and LOUIS HEARD

This case involves a sanction against Innovative Medical Management and Louis Heard for reasons outlined in a prior Notice of Intention. The Appeals Board received a $2,500 payment from them, which they deemed an acknowledgment of the undisputed reasons for the proposed sanction. Consequently, the Board ordered a $2,500 sanction, crediting the payment already made, thus settling the matter.

Workers' Compensation Appeals BoardRemovalSanctionNotice of Intention to Impose SanctionHearing RepresentativesInnovative Medical ManagementLouis HeardMedical ManagementAppeals BoardOpinion and Decision
References
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