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

Case No. ADJ2759696 (VNO 0492027)
Regular
Oct 11, 2010

WOON YOUNG PARK vs. FILM PAYMENT SERVICES, INC., CHARTIS INSURANCE

The Board granted reconsideration, rescinding the WCJ's decision on the defendant's credit for overpaid temporary disability. The defendant is allowed credit for temporary disability payments made from March 26, 2009, to June 3, 2009, at the temporary disability rate. Further credit is granted for payments made from June 4, 2009, to December 7, 2009, at the permanent disability rate of $185.00 per week. The Board denied further credit due to insufficient evidence regarding post-AME report overpayments.

Petition for ReconsiderationPermanent DisabilityTemporary DisabilityCreditStipulated AwardAgreed Medical ExaminationPermanent and StationarySection 4909Abuse of DiscretionDue Process
References
Case No. ADJ7454224
Regular
May 13, 2016

JEFF REECE vs. SAN BERNARDINO COUNTY PROBATION DEPARTMENT; COUNTY OF SAN BERNARDINO

The Appeals Board denied the defendant's petition for reconsideration regarding the lien of the California Law Enforcement Association (CLEA). The defendant voluntarily paid CLEA before the WCJ's decision became final, despite knowing reconsideration could negate their liability. As this voluntary payment constitutes a new issue, any claim for credit must first be addressed at the trial level. The Board affirmed its prior decision to remove CLEA's lien from the award.

Workers' Compensation Appeals BoardPetition for ReconsiderationOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings Award and OrdersLien WithdrawalVoluntary PaymentLabor Code Section 4909Credit for PaymentTrial Level Jurisdiction
References
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. ADJ6899721
Regular
Jun 01, 2016

SALLY MARTINEZ vs. COUNTY OF LOS ANGELES, Permissibly Self-Insured, SEDGWICK CMS

The Workers' Compensation Appeals Board granted reconsideration to clarify whether the defendant could take credit for permanent disability advances made prior to the formal award. The Board amended the prior decision, allowing the defendant to claim credit for all permanent disability advances made, including those before the March 20, 2012 award. However, the Board affirmed the finding that the defendant underpaid a Labor Code section 5710 fee and is liable for a penalty due to improper service and failure to timely object. The defendant's contention that improper service excused payment of the 5710 fee was rejected.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and Orderspermanent disability advancesLabor Code section 5710section 5813 penaltyStipulations with Request for Awardmaximum medical improvementcredit for paymentsdiscretionary authority
References
Case No. ADJ212916 (VNO 0334702)
Regular
Feb 09, 2011

PETER L. WASCHER vs. AIDS HEALTHCARE FOUNDATION INC., CIGA FOR CAL. COMP. (IN LIQUIDATION), STATE COMPENSATION INSURANCE FUND

This case involves a dispute over reimbursement for workers' compensation payments made by CIGA (California Insurance Guarantee Association) on behalf of an insolvent insurer. The arbitrator initially ordered State Compensation Insurance Fund (SCIF) to reimburse CIGA only $105,511.94, pending further proof of payment. CIGA petitioned for reconsideration, arguing it had provided sufficient evidence of payment for the full $719,238.12. The Workers' Compensation Appeals Board granted the petition, finding CIGA's payment records were reliable and unrebutted. Consequently, SCIF was ordered to reimburse CIGA the entire $719,238.12.

CIGASCIFreimbursementarbitrationreconsiderationindustrial injuryAids Healthcare FoundationCal Compmedical paymentsproof of payment
References
Case No. ADJ3872960
Regular
May 06, 2013

ALONZO WATKINS vs. LONG BEACH UNIFIED SCHOOL DISTRICT

This case concerns applicant Alonzo Watkins' petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision denying his claim for unpaid benefits totaling $14,269.10. The WCAB denied reconsideration, finding that Watkins failed to provide substantial evidence of non-payment, as the employer presented proof of payment via checks issued over 16 years prior. The WCAB also ruled that Watkins raised the issue of the employer's failure to produce payment records for the first time on appeal, which is impermissible. Furthermore, the WCAB clarified that the record retention requirements for adjusting agencies do not mandate indefinite maintenance of claim files.

Petition for ReconsiderationFindings and OrderIndustrial InjuryBack InjuryLower ExtremitiesTeacherCompromise and ReleasePayment RecordsProof of PaymentNon-Payment
References
Case No. SAL 0107814
En Banc
Jun 13, 2007

VALERI HAWKINS vs. AMBERWOOD PRODUCTS, STATE COMPENSATION INSURANCE FUND

The Appeals Board held that the two-year limitation on temporary disability payments under Labor Code section 4656(c)(1) begins from the date the first payment is actually made, not the date for which the benefit is first owed.

Workers' Compensation Appeals BoardEn Banc DecisionTemporary Disability PaymentLabor Code Section 4656(c)(1)Commencement of PaymentDate of InjuryCompensable WeeksAggregate Disability PaymentsSB 899Legislative Intent
References
Case No. ADJ2109115; ADJ3790194; ADJ4103411
Regular
Aug 01, 2013

LETICIA BENAVIDES vs. BON APPETIT DANISH; MACY'S; CHUBB GROUP OF INSURANCE CO.

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The applicant sought penalties and attorney fees for the late payment of a Compromise and Release (C&R) settlement, alleging Chubb Group failed to make timely and correct payment. The Board found that the delay was due to a single instance of human error involving an incorrect address on the C&R, which was promptly corrected upon discovery. The applicant also contributed to the delay by not notifying Chubb of the non-receipt of payment for over three months. Therefore, the Board concluded there was no unreasonable delay justifying penalties.

Workers Compensation Appeals BoardPetition for ReconsiderationDeniedWCJ ReportDefective VerificationCured VerificationSupplemental PetitionCompromise and ReleaseLate PaymentChubb Group
References
Case No. ADJ1775959 (ANA 0387306) ADJ2257120 (ANA 0386617)
Regular
May 17, 2010

SILVIA MORA vs. STEELCASE, INC., LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a prior decision that ordered a lien claimant to reimburse the defendant for chiropractic treatment exceeding the statutory limit. The WCAB held that Labor Code section 4604.5(d)(1) limits chiropractic visits but does not authorize restitution for voluntary payment of excessive treatment. Citing the equitable principles established in *American Psychometric Consultants, Inc. v. Workers' Compensation Appeals Board (Hurtado)*, the Board found that both parties were equally aware of the legal limits, and the defendant voluntarily paid the excess charges. The WCAB emphasized transactional stability, stating that undoing such payments would negatively impact the workers' compensation system.

Workers' Compensation Appeals BoardLien claimantReconsiderationFindings and OrderLabor Code section 4604.5(d)(1)Chiropractic visitsReimbursementPetition for ReimbursementMedical treatment lienEquitable restitution
References
Case No. ADJ387954 (OXN 0145858) ADJ2973719 (OXN 0145147)
Regular
Oct 27, 2017

FRANCISCO PRIETO vs. O.C. CONTRACTING, INC., AMERICAN INTERNATIONAL GROUP, INC., UNINSURED EMPLOYERS BENEFITS TRUST FUND

This case concerns a Petition for Reimbursement filed by Granite State Insurance Company against the Uninsured Employers Benefits Trust Fund (UEBTF). Granite State mistakenly paid workers' compensation benefits to an employee injured while working for an uninsured employer. The Workers' Compensation Appeals Board (WCAB) rescinded a prior order granting reimbursement, holding that UEBTF is not statutorily liable to reimburse insurance carriers for erroneous payments. The WCAB emphasized that UEBTF's purpose is to provide benefits to injured workers of uninsured employers, not to indemnify insurers. A dissenting opinion argued for amending the order to allow reimbursement to Granite State through applicant from funds UEBTF owes the applicant.

Uninsured Employers Benefits Trust FundGranite State Insurance CompanyPetition for ReimbursementLabor Code sections 37153716mistaken paymentillegally uninsured employerLabor Code section 4909creditdirect reimbursement
References
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