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

Case No. ADJ7271617
Regular
Aug 27, 2012

LEONARD KEY vs. LOS ANGELES COUNTY OFFICE OF EDUCATION, CORVEL CORPORATION

This case involves applicant Leonard Key seeking workers' compensation benefits for an injury sustained while teaching a music production course. The defendant, Los Angeles County Office of Education (LACOE), contended that Key was an independent contractor and not an employee. The Workers' Compensation Appeals Board (WCAB) affirmed the trial judge's finding that Key was an employee, emphasizing LACOE's control over the means and manner of his work, despite an independent contractor agreement. Key lacked control over class schedules, room assignments, and was paid hourly, weighing against independent contractor status. Therefore, the WCAB found that LACOE failed to meet its burden to prove Key was an independent contractor.

Workers' Compensation Appeals BoardLeonard KeyLos Angeles County Office of EducationCorvel CorporationADJ7271617Opinion and Decision After ReconsiderationWCJemployee statusindependent contractordirection and control
References
Case No. ADJ302560 (LAO 0733786)
Regular
Aug 11, 2009

DAVID COE vs. PROFESSIONAL ASSOCIATION OF DIVING INSTRUCTORS, MISSION INSURANCE COMPANY

The applicant, injured in 1984, filed a workers' compensation claim in 1996, outside the typical statute of limitations. The Administrative Law Judge found the claim barred due to the applicant's failure to prove incompetence during the intervening period. The Appeals Board, while granting reconsideration to address a separate fee issue, affirmed the statute of limitations bar, finding insufficient evidence that the applicant was legally incompetent to file his claim between 1984 and 1996. The Board concluded that the medical expert, while diagnosing dementia, could not definitively state the applicant was incompetent for the entire relevant period, thus applicant failed to meet his burden of proof.

Statute of LimitationsIncompetencyTollingDementiaExecutive FunctioningAgreed Medical EvaluatorEquitable EstoppelLabor Code Section 5710Petition for ReconsiderationWCJ
References
Case No. LAO 733786
Regular
Jul 25, 2007

David Coe vs. PROFESSIONAL ASSOCIATION OF DIVING INSTRUCTORS, MISSION INSURANCE COMPANY, CIGA

The Appeals Board granted reconsideration of the trial judge's decision that barred the applicant's claim due to the statute of limitations. The Board found that the applicant's severe head injury and resulting dementia raised serious questions about his competency to file a timely claim. Therefore, the case was returned to the trial level for further proceedings to determine if the statute of limitations should be tolled due to the applicant's mental incapacity.

Statute of LimitationsIncompetencyGuardian Ad LitemTollingWorkers' Compensation Appeals BoardMission InsuranceCIGAScuba Diving InstructorCatastrophic InjuryHypoxic Encephalopathy
References
Case No. ADJ1075679
Regular
Oct 14, 2008

AMALIA CARDENAS, CARDENAZ, AMALIA-CARDENAS DE ACOSTA vs. KANSTUL MUSICAL INSTRUMENTS, TRUCK INSURANCE EXCANGE, CLARENDON INSURANCE COMPANY

This case concerns a defendant's petition for reconsideration of a workers' compensation award. The Appeals Board denied the petition, affirming the finding that the applicant sustained industrial injuries and is entitled to temporary total disability (TTD) indemnity from August 1, 2006, to January 27, 2008. The Board found sufficient evidence, including the treating physician's reports and applicant's testimony, to support the need for surgery and the resulting TTD period, despite the Agreed Medical Evaluator's later confirmation of the surgical necessity.

Workers Compensation Appeals BoardKanstul Musical InstrumentsTruck Insurance ExchangeClarendon Insurance CompanyAmalia CardenasReconsiderationFindings and AwardIndustrial InjuryNeck InjuryUpper Extremities Injury
References
Case No. ADJ302560
Regular
Jan 10, 2012

DAVID COE vs. PROFESSIONAL ASSOCIATION OF DIVING INSTRUCTORS, MISSION INSURANCE COMPANY, IN LIQUIDATION, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The Appeals Board granted reconsideration on its own motion to correct a clerical error in a prior decision regarding a Labor Code section 5710 attorney's fee. The original award of $1,903.75 was twice the applicant's attorney's requested fee of $1,093.75, which the WCJ and the Board's prior decision acknowledged. The Board corrected its decision to reflect the accurate attorney fee of $1,093.75, while reaffirming that CIGA has no liability for this fee due to a credit against the applicant's third-party recovery, which is reduced by the corrected fee amount.

Workers' Compensation Appeals BoardProfessional Association of Diving InstructorsMission Insurance CompanyCalifornia Insurance Guarantee Association (CIGA)Labor Code section 5710attorney's feeclerical errorpetition for reconsiderationthird-party recoverynet third party recovery
References
Case No. ADJ162531 (SFO 0487527)
Regular
May 10, 2010

ELIZABETH REIERSTAD vs. VSC SPORTS, CASUALTY RECIPROCAL EXCHANGE, In Liquidation, Administered By CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The Workers' Compensation Appeals Board denied defendant's petition for reconsideration, upholding the initial award of 100% permanent disability and medical treatment for the applicant's industrial injury. The Board also granted the applicant's petition for reconsideration regarding an attorney fee dispute. The prior order concerning the commutation of attorney fees to a lien claimant was vacated and remanded for further proceedings to clarify the settlement agreement between the applicant's former and current attorneys. The Board cautioned the defendant regarding procedural rule violations in their lengthy petition.

California Insurance Guarantee AssociationVSC Sportsindustrial injuryskating instructorleft ankleright foottoepermanent disabilitypermanent total disabilityearning capacity
References
Case No. ADJ8657704
Regular
Oct 22, 2013

CLARA GARCIA vs. CITY OF LONG BEACH

The Workers' Compensation Appeals Board denied Clara Garcia's petition for reconsideration. The Board adopted the Workers' Compensation Judge's report, which found Garcia to be an independent contractor, not an employee, of the City of Long Beach. This determination was based on several factors, including Garcia's control over her curriculum, her ability to hire substitutes, and her sale of props. The Board's order upholds the original finding that Garcia is not entitled to workers' compensation benefits under an employment relationship.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeIndependent ContractorEmployee StatusBorello FactorsControl TestDance InstructorCumulative TraumaSpecific Injury
References
Case No. ADJ8376821
Regular
Jul 21, 2014

BRIGHT ONYENWE vs. LOS ANGELES UNIFIED SCHOOL DISTRICT, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, upholding the finding that Bright Onyenwe sustained his injuries arising out of and in the course of employment. The Board deferred to the WCJ's credibility determination regarding the applicant's testimony about a student's assault. The defendant failed to impeach the applicant's testimony or demonstrate that the WCJ's findings were unsupported by substantial evidence. Therefore, the Petition for Reconsideration was denied.

Petition for ReconsiderationWCABAOE/COECredibilityImpeachmentPanel QMESelf-defenseJROTC InstructorLos Angeles Unified School DistrictAdverse Inference
References
Case No. ADJ8608413
Regular
Feb 11, 2014

ANTONIO MORALES CASILLAS vs. 7-ELEVEN, MITSUI MARINE & FIRE INSURANCE COMPANY OF AMERICA, administered by MITSUI SUMITOMO MARINE MANAGEMENT, INC.

The Workers' Compensation Appeals Board denied reconsideration of a decision that found the applicant did not sustain an injury arising out of and in the course of his employment. The Board adopted the judge's report, which emphasized the applicant's inconsistent statements regarding the injury mechanism and the lack of corroborating evidence. The judge found the applicant's testimony not persuasive, particularly in light of subsequent work performed after the alleged incident. Therefore, reconsideration was denied.

AOE/COEPetition for ReconsiderationWCJ7-Elevencashier clerklow back injurymedical evidenceinconsistent testimonycorroborating evidencecredibility
References
Case No. ADJ3702833 (OXN 0149751) ADJ3963548 (OXN 0149750)
Regular
Dec 13, 2010

TANYA HIRZEL vs. 24 HOUR FITNESS, ACE, AMERICAN INSURANCE COMPANY C/O GALLAGHER BASSETT SERVICES, INC.

This case concerns an applicant who sustained two industrial injuries: to her left shoulder in 2007 and her right ankle in 2008. The defendant seeks reconsideration of awards for temporary disability indemnity for both injuries, arguing the 104-week limit was misapplied due to concurrent payments. The Board granted reconsideration to clarify the timeline of the defendant's denial and acceptance of the shoulder injury claim, and to further develop the record regarding the defendant's alleged offer of modified work. The Board rescinded the original awards and returned the matter for further proceedings to address these factual disputes.

Workers' Compensation Appeals BoardTanya Hirzel24 Hour FitnessAce American Insurance CompanyADJ3702833ADJ3963548Findings and AwardsIndustrial InjuryLeft Shoulder InjuryRight Ankle Injury
References
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