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

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. ADJ7379899
Regular
Nov 12, 2012

DARRIN LANNING vs. BAYWOOD INTERIORS, INC., STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration to address the defendant's contention that the WCJ erred by deeming the post-termination defense moot. The Board clarified that Labor Code section 3600(a)(10) provides a defense against claims filed after termination or layoff, and this issue is not moot if an industrial injury is found. Consequently, the Board rescinded the prior findings and returned the case for further proceedings to determine if the post-termination defense applies and, if so, whether applicant meets any exceptions. The merits of the original finding of industrial injury were not decided and are subject to a new ruling after the post-termination defense is resolved.

AOE/COEpost-termination defenseLabor Code section 3600(a)(10)industrial injurycabinetmakerlower backleft groinright kneemootfindings of fact
References
Case No. ADJ10288379
Regular
Sep 13, 2017

XOCHITL CARRERA-MORALES vs. PRIORITY WORKFORCE, INC., ZURICH INSURANCE

This case involves a workers' compensation claim where the administrative law judge (WCJ) initially denied benefits based on the post-termination defense. The applicant argued that her date of injury, defined by significant disability and awareness of its industrial causation, occurred after her termination, thus triggering an exception to the defense. The Appeals Board found that the WCJ's decision lacked clarity regarding the basis for the injury determination and that the analysis of the post-termination defense was insufficient. Therefore, the Board rescinded the original decision and returned the case to the trial level for further proceedings to clarify the findings and address the post-termination defense.

Post-termination defenseSection 3600(a)(10)Date of injurySection 5412Continuous trauma injuryTemporary partial disabilityMedical evidenceSubstantial evidenceReconsiderationFindings and Orders
References
Case No. ADJ10924076
Regular
Aug 28, 2018

PATRICIA VERA vs. BUMBLE BEE FOODS, ACE AMERICAN INSURANCE COMPANY, ESIS

The Workers' Compensation Appeals Board (WCAB) rescinded the Administrative Law Judge's (ALJ) decision denying applicant Patricia Vera's claim. The ALJ had found that Vera did not sustain an injury arising out of and in the course of employment and that her claim was barred by the post-termination defense. The WCAB found that the ALJ failed to fully address the exceptions to the post-termination defense under Labor Code Section 3600(a)(10), specifically subsection (D) concerning the date of injury. Therefore, the case was returned to the trial level for further proceedings to determine if the post-termination defense applies and, if not, to address the issue of industrial causation.

Workers Compensation Appeals BoardBumble Bee FoodsACE American Insurance CompanyESISPatricia VeraOpinion and Decision After ReconsiderationFindings and OrderWCJpost-termination defenseindustrial causation
References
Case No. ADJ10312473
Regular
Sep 01, 2017

CLARA LUNA vs. FISCHER MOLD, INC., PACIFIC COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) rescinded the prior decision and returned the case to the trial level for further proceedings. The WCAB found that the administrative law judge's (WCJ) decision, which barred the applicant's claim based on the post-termination defense under Labor Code section 3600(a)(10), was procedurally flawed and lacked sufficient analysis. Specifically, the WCAB determined that the applicant may qualify for an exception to the post-termination defense if her date of injury, defined by disability and knowledge of its work-related cause, occurred after her termination. This determination hinges on whether the applicant suffered disability and had the requisite knowledge post-termination, which requires further exploration.

Workers Compensation Appeals BoardClara LunaFischer Mold Inc.Pacific Compensation Insurance CompanyOpinion and Decision After ReconsiderationFindings and Orderspost-termination defenseLabor Code Section 3600(a)(10)Labor Code Section 5412continuous trauma injury
References
Case No. ADJ8312614, ADJ9055869
Regular
Sep 02, 2017

IMELDA TAPIA DE RODRIGUEZ vs. BIRRIERIA JALISCO, FARMERS INSURANCE, CYPRESS INSURANCE COMPANY

This case consolidates two workers' compensation claims filed by applicant Imelda Tapia De Rodriguez against Birrieria Jalisco. In one claim (ADJ9055869), the WCJ found a specific injury occurred but was barred by the post-termination defense; the Appeals Board affirmed this finding. In the other claim (ADJ8312614), the WCJ found no injury arose out of employment, which the Appeals Board also affirmed, relying on medical evidence and applicant's failure to properly cite record support in her petition. Applicant appealed, arguing the post-termination defense was inapplicable due to employer notice issues and that her credibility was wrongly assessed without proper interpreter use. A dissenting opinion argues that exceptions to the post-termination defense, specifically notice to the employer prior to termination and the date of injury occurring after termination, should have been applied, warranting reversal and further proceedings.

Workers' Compensation Appeals BoardReconsiderationJoint Findings and OrdersPost-Termination DefenseLabor Code Section 3600(a)(10)Statute of LimitationsLabor Code Section 3550Notice of RightsQualified Medical EvaluatorSubstantial Evidence
References
Case No. ADJ665971
Regular
Apr 29, 2011

ANTONIE TUR vs. EL POLLO LOCO

The Appeals Board granted reconsideration to clarify a prior award of benefits. Although the defendant timely paid the principal award, they failed to pay post-award interest as required by Labor Code Section 5800. The Board found this failure was not unreasonable, thus denying penalties. However, they amended the original award to explicitly order the defendant to pay post-award interest on both the applicant's and attorney's fees.

Workers' Compensation Appeals BoardSupplemental Findings and OrderStipulated AwardLabor Code Section 5800Labor Code Section 5814Labor Code Section 5814.5Petition for ReconsiderationReport and RecommendationPost Award InterestKoszdin v. Workers' Comp. Appeals Bd.
References
Case No. ADJ7472167
Regular
May 04, 2012

MARIA ROSAS vs. S & S RESORT MANAGEMENT, TOWER SELECT INSURANCE

This case involves an applicant who sought reconsideration of a Workers' Compensation Appeals Board decision denying her claim. The Board denied reconsideration, affirming the judge's finding that the claim was barred as a post-termination filing. The applicant failed to present evidence demonstrating any of the statutory exceptions to the post-termination rule. Furthermore, the applicant's arguments regarding the section 5402 presumption of compensability were rejected due to her failure to raise the issue timely at trial.

Petition for ReconsiderationFindings and OrderIndustrial InjuryHousekeeperLeft ArmBackHipsLeft LegLoss of SleepCompensable Consequence
References
Case No. ADJ8443100
Regular
May 28, 2013

KANZLER FRAZIER vs. WARNER BROTHERS STUDIO FACILITIES, INC.

This case involves an applicant claiming a low back injury while working as a lighting technician. The defendant sought reconsideration of the WCJ's finding of injury AOE/COE, arguing insufficient evidence and a post-termination defense. The Appeals Board granted reconsideration, rescinded the original decision, and returned the matter for further development of the record. This was due to inadequate medical reporting which did not constitute substantial evidence. The post-termination defense was deemed waived as it wasn't raised at trial.

Workers' Compensation Appeals BoardIndustrial InjuryLighting TechnicianLow Back InjuryArising Out of and In the Course of EmploymentAOE/COEPost-Termination DefenseLabor Code Section 3600(a)(10)Substantial EvidenceMedical Opinion
References
Case No. ADJ9436553
Regular
Nov 03, 2014

ANA MARIA PENA, vs. SHREE AGASHIMATA INC.; dba BUDGET INN MOTEL; ILLINOIS MIDWEST INSURANCE AGENCY,

Defendant petitioned for removal after the WCJ took the case off calendar, citing the need for a Qualified Medical Evaluator. Defendant argued that a post-termination defense did not require medical evidence and the case should proceed to trial. The Appeals Board granted removal, rescinded the WCJ's order, and returned the case to the trial level. This was done because the WCJ had not yet judicially determined good cause to bifurcate the post-termination defense issue, which is a prerequisite to deciding if a QME is necessary.

Petition for Removalpost-termination defenseLab. Code § 3600(a)(10)discoveryexpert medical evidencetrialWCJoff calendarQMEbifurcate
References
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