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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. FRE 0147567
En Banc
Jan 24, 2002

Maria Yolanda Jimenez vs. San Joaquin Valley Labor, Superior National Insurance Company

The Board holds that an industrially injured seasonal employee is entitled to two separate temporary disability indemnity rates based on their in-season and off-season earning capacity, and consequently, their Vocational Rehabilitation Maintenance Allowance (VRMA) should also be a two-tiered award corresponding to those rates.

Workers' Compensation Appeals BoardEn Banc DecisionReconsiderationFindings and AwardSeasonal Farm LaborerTemporary Disability IndemnityVocational Rehabilitation Maintenance Allowance (VRMA)Average Weekly EarningsEarning CapacityIn-Season Rate
References
Case No. FRE 0147567
Significant
Jan 24, 2002

MARIA YOLANDA JIMENEZ vs. SAN JOAQUIN VALLEY LABOR, SUPERIOR NATIONAL INSURANCE COMPANY

The Board holds that an industrially injured seasonal employee's vocational rehabilitation maintenance allowance (VRMA) should be calculated at two-tiered rates, reflecting in-season and off-season earning capacity, similar to temporary disability indemnity. The case is remanded to determine the applicant's off-season earning capacity.

Seasonal farm laborerVocational Rehabilitation Maintenance Allowance (VRMA)Temporary Disability Indemnity (TDI)In-season earnings capacityOff-season earnings capacityAverage weekly earningsLabor Code section 139.5En banc decisionEarning capacity benchmarkTwo-tiered award
References
Case No. ADJ9473670
Regular
Nov 02, 2020

SANDRA UYAGUARI GARCIA vs. CLAUDIA MENDOZA Dba SWEET MELODY EXPRESS, UEBTF

This case concerns an applicant seeking workers' compensation benefits for an injury sustained while cleaning a defendant's residence. The primary issue was whether the applicant was an employee of the defendant's business, Sweet Melody Express, or an independent residential employee. The Board affirmed the WCJ's finding that the applicant was not an employee of Sweet Melody Express at the time of the injury, deeming her services to the defendant's home to be sporadic and casual housecleaning for the individual, not the business. Therefore, her claim for workers' compensation was denied.

Workers' Compensation Appeals BoardReconsiderationEmployee StatusResidential EmployeeCasual EmploymentLabor Code Section 3351Labor Code Section 3352(a)(8)Burden of ProofCredibility FindingEmployer Capacity
References
Case No. ADJ124002
Regular
Apr 21, 2011

RAMON RUIZ vs. DOLE FRESH VEGETABLES, SPECIALTY RISK SERVICES

The Appeals Board granted reconsideration and modified a prior award regarding temporary disability overpayments. Defendant sought credit for temporary disability paid during the applicant's off-season and after the permanent and stationary date. The Board denied credit for off-season payments, finding them inequitable. However, credit was allowed for temporary disability paid after the permanent and stationary date, recognizing these payments as advances against permanent disability.

ADJ124002Findings Order AwardPermanent DisabilityTemporary DisabilityCredit for OverpaymentOff-Season EmploymentPermanent and Stationary DateLabor Code 4909Equitable PrinciplesDouble Recovery
References
Case No. ADJ6995425
Regular
Apr 27, 2012

SERGIO SANCHEZ vs. LIDA KOHANSAMEH, PACIFIC SPECIALTY INSURANCE

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior ruling finding the applicant an employee of Lida Kohansameh. While agreeing the applicant was not an employee of Pacific Great West Construction, the Board remanded the case for further proceedings. The trial judge must now determine if the applicant is excluded from workers' compensation coverage under Labor Code sections 3351(d) and 3352(h), specifically regarding residential or casual employment and hours worked. This decision avoids a final determination on employment status and focuses on potential statutory exclusions.

Workers' Compensation Appeals BoardLida KohansamehPacific Specialty InsuranceTristar Risk ManagementSergio SanchezFindings and OrderEmployee statusPacific Great West ConstructionReport and RecommendationPetition for Reconsideration
References
Case No. ADJ8190306
Regular
Jan 07, 2013

Silvestre Sanchez vs. Robert E. Town, Allied Insurance, A Nationwide Company

This case concerns whether an injured worker, Silvestre Sanchez, was an employee of Robert E. Town for workers' compensation purposes. The Board granted reconsideration to reverse the WCJ's finding of employment. The primary issue was whether Sanchez met the 52-hour work requirement within the 90 days preceding injury under Labor Code section 3352(h), which excludes certain residential employees. The Board found that based on conflicting testimony regarding a second payment, the applicant did not prove he worked over 52 hours, thus excluding him from coverage.

Workers' Compensation Appeals BoardSilvestre SanchezRobert E. TownAllied InsuranceLabor Code section 3352(h)excluded employeeresidential employee90-day perioddate of injuryFindings of Fact
References
Case No. ADJ4216095 (BAK 0149327)
Regular
Oct 25, 2010

ALICIA NUNEZ ARREOLA vs. SUNTREAT PACKING, STATE COMPENSATION INSURANCE FUND

This case concerns a seasonal worker who sustained an industrial injury to her right shoulder and cervical spine. The defendant sought reconsideration of the permanent disability rate awarded by the WCJ, arguing it was miscalculated for a seasonal employee. The Appeals Board granted reconsideration, finding the WCJ erred in calculating the rate by focusing solely on in-season earnings. The Board amended the award, establishing the permanent disability rate based on the applicant's actual annual earnings, which resulted in a lower rate than initially awarded.

WCABPetition for ReconsiderationFindings and AwardSeasonal workerTemporary disabilityPermanent disabilityStipulationLabor Code section 4453(c)(4)Earning capacityMontana
References
Case No. ADJ20699429
Regular
Sep 15, 2025

VICENTE RAMIREZ vs. FAMILY RANCH, ZENITH INSURANCE COMPANY

Applicant Vicente Ramirez sought reconsideration of a Findings of Fact and Award (F&A) issued by a Workers' Compensation Judge, challenging the findings regarding his employment status and the calculation of his average weekly wage and temporary disability rate. The Appeals Board denied the petition for reconsideration, upholding the WCJ's conclusion that the applicant was not a seasonal employee and had a reasonable expectation of continued employment. The Board found that the evidence presented by the defendant did not support the claim of seasonal employment, affirming the WCJ's calculations for average weekly wage and temporary disability rate.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardSeasonal EmployeeReasonable Expectation of Continued EmploymentAverage Weekly WageTemporary Disability IndemnityLabor Code section 5909Electronic Adjudication Management SystemFarm Laborer
References
Case No. B167017
Significant
Nov 18, 2004

General Casualty Insurance and Regent Insurance, Joseph A. Lane, American Home Assurance Company vs. Workers' Compensation Appeals Board and California Insurance Guarantee Association

The court has requested responses from the Workers' Compensation Insurance Rating Bureau (WCIRB) and the California Insurance Commissioner regarding the exclusion of special employees from a special employer's workers' compensation policy, specifically questioning the use and requirements of Form No. 11 for this purpose.

WCIRBForm No. 11limiting endorsementsrestricting endorsementsspecial employeesgeneral employerstemporary employeesleased employeesInsurance CommissionerCalifornia Code of Regulations
References
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