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

Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
Case No. LAO 0869924
Regular
Jun 06, 2008

MIRNA SOSA vs. JESI-CARE, INC., STATE COMPENSATION INSURANCE FUND

The applicant's claim for workers' compensation was denied because the evidence did not support her claim of an industrial injury, and the claim was barred by the statute of limitations and post-termination claim rules. The Board found the applicant's testimony regarding reporting the injury to be not credible, citing contradictory medical evidence and employer testimony. Because the applicant did not report the alleged injury within one year of its occurrence, the statute of limitations was not tolled, and the claim also failed as a post-termination claim due to lack of employer notice or medical records indicating injury prior to termination.

Workers' Compensation Appeals Boardapplicant's claimstatute of limitationspost-termination claimcredible testimonyemployer noticemedical recordsdate of injuryindustrial injuryWCJ credibility determination
References
Case No. ADJ8997647
Regular
Mar 03, 2016

BOB ELIS aka BOB ELIAS vs. TENACORE HOLDINGS, INC., HARTFORD ACCIDENT & INDEMNITY COMPANY

The Workers' Compensation Appeals Board (WCAB) amended a prior finding to include industrial injury to the applicant's bilateral knees, stemming from a fall at work. However, the WCAB affirmed the original finding that the applicant did not sustain industrial injury to any other body parts. Crucially, the claim was barred by the post-termination defense and statute of limitations, as the employer lacked timely notice of the injury, and the psychiatric claim was barred by insufficient employment duration. Ultimately, the applicant was ordered to take nothing on his claim despite the amended finding regarding his knees.

ADJ8997647Petition for ReconsiderationFindings and OrderWCJpro perres judicataLabor Code sections 3600(a)(10)54053208.3(d)post-termination defense
References
Case No. VNO 487026
Regular
Jul 08, 2008

Frank Lujan vs. CG MILLER INC., Republic Indemnity Company of California

The Workers' Compensation Appeals Board denied a lien claimant's petition for reconsideration, affirming the disallowance of a $\$ 12,547.06$ lien for medical treatment expenses. This decision was based on the finding that the applicant did not sustain an injury arising out of and occurring in the course of employment, as the claim was filed after the applicant's termination and no exceptions under Labor Code section 3600(a)(10) were met. The employer lacked prior notice of the injury, and there was insufficient evidence of pre-termination medical records or an injury occurring after notice of termination.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings and OrderAdministrative Law JudgeIndustrial InjuryLow BackMover/PackerSelf-Procured Medical TreatmentLabor Code Section 3600(a)(10)
References
Case No. ADJ9781116
Regular
Mar 22, 2017

RAMIRO RAMIREZ vs. HAAGSMA AND PINHEIRO, ZENITH INSURANCE COMPANY

This case involves a worker's compensation claim filed after termination, where the defendant argued it was barred by the statute of limitations and post-termination defenses. The Workers' Compensation Appeals Board rescinded the prior findings, finding the record insufficient to determine a date of injury or address the statute of limitations. Further proceedings are required to develop the record regarding the applicant's claimed injury, its cause, and the applicant's knowledge of the work-relatedness of any disability. The Board could not determine if the claim was timely or barred without this crucial information.

WCABReconsiderationStatute of LimitationsPost-Termination DefenseCumulative TraumaDate of InjuryPresumption of CompensabilityLabor Code Section 5402Labor Code Section 5412AOE/COE
References
Case No. ADJ6910802
Regular
Jul 30, 2010

JORGE ESCALANTE vs. CINTAS CORPORATION, EXCEL SPECIALTY INSURANCE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to determine if the applicant's claim for industrial injury to his right shoulder and cervical spine is barred by Labor Code section 3600(a)(10). The initial finding of injury AOE/COE by the WCJ is supported by evidence, but the WCAB rescinded this decision to allow the parties to fully litigate the post-termination defense. The matter is returned to the trial level for the WCJ to hear evidence on whether the applicant's claim is barred or if any exceptions under section 3600(a)(10) apply. This ensures due process for both applicant and defendant regarding the application of the post-termination statute.

Workers' Compensation Appeals BoardJorge EscalanteCintas CorporationExcel Specialty InsuranceReconsiderationFindings of Fact and AwardIndustrial InjuryRight ShoulderCervical SpineLabor Code Section 3600(a)(10)
References
Case No. ADJ7751160
Regular
Jun 26, 2012

WALLACE MANNS vs. AMERICAN LABOR POOL, OLD REPUBLIC GENERAL INSURANCE CORPORATION

This case concerns a worker's compensation claim for an inguinal hernia sustained prior to a layoff. The employer argued the claim was barred by Labor Code section 3600(a)(10) as it was filed after notice of termination. The Appeals Board granted reconsideration, finding the Administrative Law Judge erred by requiring proof of retaliatory intent. The Board rescinded the original finding, concluding the post-termination defense applied as no exceptions under the statute were met. The applicant's claim was therefore barred.

Workers' Compensation Appeals BoardWallace MannsAmerican Labor PoolOld Republic General Insurance CorporationADJ7751160Riverside District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWCJ
References
Case No. ADJ6798245 ADJ6864349
Regular
Jan 05, 2010

Jerry Weissberger vs. TRADER JOE'S

Trader Joe's petitioned for removal to litigate post-termination and statute of limitations issues before the completion of the AME/QME process. The Appeals Board denied the petition, adopting the WCJ's reasoning that Trader Joe's failed to demonstrate substantial prejudice or irreparable harm. The Board found that the defendant's petition lacked sufficient allegations regarding termination notice and that further medical evidence was warranted to determine injury dates and potential exceptions. Therefore, the defendant's petition for removal was denied.

Petition for RemovalOrder Taking Off CalendarMandatory Settlement ConferenceAME/QME processthreshold issuespost terminationstatute of limitationsdue processirreparable harmPanel Qualified Medical Evaluator
References
Case No. ADJ6736069 ADJ6736155
Regular
Dec 01, 2020

YVETTE WHITMER vs. HI SHEAR CORPORATION, ZURICH NORTH AMERICA, GOLDEN STATE FOODS, LIBERTY MUTUAL, SANTA BARBARA APPLIED RESEARCH

This case concerns applicant Yvette Whitmer's claim for workers' compensation benefits for back injuries allegedly sustained on May 1 and June 13, 2008. The Workers' Compensation Appeals Board (WCAB) denied reconsideration of its prior decision, which reversed an administrative law judge's finding of compensability. The WCAB found applicant's claims barred by Labor Code section 3600(a)(10) because they were post-termination claims where the employer lacked prior notice of the injury. The applicant contended she provided notice of an injury on June 13, 2008, by reporting a motor vehicle accident, but the WCAB credited employer testimony that she was not late and did not report an injury until after her termination.

Workers' Compensation Appeals BoardReconsideration DeniedLabor Code Section 3600(a)(10)Post-Termination ClaimsCompensable Industrial InjuryNotice of InjuryPre-Termination NoticeMotor Vehicle AccidentAdministrative Law JudgeFindings of Fact
References
Case No. ADJ8142245
Regular
Apr 26, 2013

TRINIDAD POLANCO ESPINOZA vs. RYNSBURGER DAIRY, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of a decision concerning Trinidad Polanco Espinoza's claim against Ryn sburger Dairy and Zenith Insurance Company. The Board adopted the findings of the Workers' Compensation Administrative Law Judge, who determined that Espinoza's claimed industrial injuries were not supported by the evidence. The judge found the claim barred by the post-termination defense and lack of credible medical evidence or timely reporting of the injury. Consequently, the Board denied the applicant's petition for reconsideration.

WCABReconsiderationDeniedIndustrial InjuryAOE/COEPost-TerminationStatute of LimitationsDWC-1Employer NoticeMedical Evidence
References
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