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

Case No. ADJ2192154 (LBO 0345063)
Regular
Nov 12, 2010

IRMA ZAMORA vs. STATE OF CALIFORNIA, DEPT. OF AGRICULTURE, Adjusted By SCIF CONTRACT SERVICES

The Board granted reconsideration to address ambiguities in the original award. Defendant sought credit for prior permanent disability payments and argued a penalty for delayed compensation should only apply from the date the disability increased, not the entire delayed amount. The Board agreed defendant is entitled to credit for prior payments. However, due to unclear findings on attorney fees and a confusing reference to a "self-assessed penalty," the Board rescinded the original decision and returned the case for further proceedings and a clarified new decision.

WCABpetition to reopenpermanent disabilitypenaltyattorney feescredit for paymentsagreed medical evaluatorLabor Code section 4650Labor Code section 5814unreasonable delay
References
Case No. ADJ2304783 (OAK 0312156)
Regular
Jul 07, 2009

ROGELIO MARTINEZ vs. URBAN BROTHERS PAINTING, STATE COMPENSATION INSURANCE FUND

This case involves a defendant's petition for reconsideration of a workers' compensation award. The defendant challenged penalties imposed for unreasonable delays in temporary and permanent disability indemnity payments. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to correct clerical errors identified by the WCJ. The WCAB amended the award to reflect a corrected period for the temporary disability delay and to grant the defendant credit for a self-imposed penalty on the permanent disability delay, otherwise affirming the original decision.

Workers' Compensation Appeals BoardReconsiderationTemporary Disability IndemnityPermanent Disability IndemnityPenaltySelf-Imposed PenaltyUnreasonable DelayClerical ErrorCreditFindings Award and Orders
References
Case No. ADJ1493279 (LAO 440248)
Regular
Oct 22, 2008

CALDWELL JOHNSON vs. LOS ANGELES DEPARTMENT OF WATER AND POWER, Permissibly Self-Insured

The Workers' Compensation Appeals Board granted reconsideration and rescinded prior orders awarding penalties and attorney fees. The Board found the record unclear regarding whether the defendant had fully paid awarded penalties and returned the matter to the trial level for further clarification on this issue. The ultimate goal is to ensure a fair balance and substantial justice between the parties concerning the amounts paid versus owed.

Labor Code section 5814Labor Code section 5814.5penalty awardattorney feesreconsiderationaccounting summaryunreasonable delaypayment of compensationestate of applicantself-insured
References
Case No. ADJ9614737 ADJ9613068
Regular
Oct 30, 2018

NORA MAY RAMIREZ-CORTES vs. MARQUEZ BROTHERS ENTERPRISE, INC., TRAVELERS INSURANCE COMPANY

This case involves a defendant's petition for reconsideration of an administrative law judge's (WCJ) order assessing penalties for late payment of a workers' compensation award. The defendant argued that confusion over the applicant's name justified the delay, but the Board found the four-month delay after the initial inquiry unreasonable. The Board adopted the WCJ's report, denying reconsideration and upholding the penalty, interest, and attorney's fees. The Board found no evidence the defendant took reasonable steps to resolve the payment issue after May 9, 2017.

Workers' Compensation Appeals BoardFindings and OrdersCompromise and ReleaseLabor Code section 5814Penalty assessmentInterestAttorney's feesPetition for ReconsiderationWCJ Report and RecommendationGood faith
References
Case No. ADJ1775698 (LAO 0800658)
Regular
Aug 21, 2012

ANTONIO CERVANTES-LOPEZ vs. UNIVERSAL FURNITURE, AMERICAN HOME ASSURANCE COMPANY

Applicant sought reconsideration of a WCJ's decision denying substantial attorney fees and sanctions related to a $14,800 compromise and release for a low back injury. The WCJ awarded $2,222 in attorney fees but rejected the applicant's claim for over $29,000 in penalties, interest, and sanctions for alleged bad faith. The Board denied reconsideration, agreeing with the WCJ that the requested fees were unreasonable. Both parties' counsel were admonished for unprofessional conduct that wasted the Board's time.

Labor Code section 5814.5attorney feesreconsiderationFindings and Ordersbad faithsanctionsCompromise and Releasepenaltiesself-assessed penaltyunreasonable delay
References
Case No. ADJ3910048 (VNO 0417016)
Regular
Jul 30, 2010

NAHID JAVADI vs. SIMI VALLEY HOSPITAL, ADVENTIST HEALTH SYSTEMS WEST

This case involves an employer, Simi Valley Hospital/Adventist Health Systems West, seeking to prevent the joinder of AIG as a defendant in a workers' compensation claim. The employer argues it is permissibly self-insured and self-administered, and joining AIG, an excess carrier, would cause irreparable harm. The Appeals Board found that since there is no third-party administrator involved, the precedent relied upon for joinder is inapplicable. Consequently, the Board rescinded all orders joining AIG and returned the case to the trial level.

Workers' Compensation Appeals BoardPetition for RemovalJoinder of DefendantReinsurance CarrierExcess CarrierPermissibly Self-InsuredSelf-AdministeredIndustrial InjuryFindings and AwardPetition to Reopen
References
Case No. POM 240908, LAO 712097
Significant

Juan A. Rivera, Applicant vs. Tower Staffing Solutions, State Compensation Insurance Fund

The Workers' Compensation Appeals Board, in an en banc decision, holds that the 10 percent penalty for late indemnity payments under Labor Code section 4650(d) applies only to periodic payments and not to lump-sum proceeds from commutations or Compromise and Release agreements.

En BancReconsiderationLabor Code Section 5814Labor Code Section 4650(d)Commuted AwardCompromise and ReleaseDeath BenefitsVocational Rehabilitation Maintenance AllowancePeriodic Indemnity PaymentsLump Sum Proceeds
References
Case No. ADJ7275781
Regular
Jun 17, 2013

DAINA ROBERTSON vs. VETERINARY CENTERS OF AMERICA, ZURICH AMERICAN INSURANCE CO.

This case concerns a WCJ's imposition of a 25% penalty for defendant's failure to include a 10% self-imposed penalty under Labor Code section 4650(d) when paying a previous award. The defendant argued no penalty was due as they disputed indemnity periods and paid within fourteen days of the award. The Appeals Board granted reconsideration, rescinded the supplemental award, and returned the matter for further proceedings. This action was taken because the record was unclear regarding whether the defendant's dispute over indemnity payments constituted a genuine dispute that would excuse the 10% increase under section 4650(d).

Labor Code section 4650(d)Supplemental Findings and Awardtemporary total disability indemnitypermanent disability indemnityindustrial injuryleft ankleregistered veterinary technicianAgreed Medical Evaluator (AME)permanent and stationarysurgery
References
Case No. ADJ1047594 (VNO 0549852)
Regular
Dec 22, 2016

Diane De Los Reyes vs. Mediscan, Zurich American Insurance Company

In this case, the applicant, Diane De Los Reyes, sought reimbursement for self-procured medical treatment related to her work-induced Reactive Airway Disease and Anxiety Disorder. The Appeals Board found that some of the applicant's self-procured treatment was likely industrial and reversed the WCJ's finding that all such treatment was non-industrial. The Board therefore rescinded the original order and returned the matter to the WCJ for further proceedings to determine the extent of reimbursable self-procured medical treatment and associated penalties. The applicant's entitlement to reimbursement for medical mileage and penalties thereon was affirmed.

Workers' Compensation Appeals BoardReconsiderationAgreed Medical EvaluatorReactive Airway DiseaseAnxiety DisorderSelf-procured Medical TreatmentReimbursementPenaltiesMedical MileageLabor Code § 4600(a)
References
Case No. ADJ4579659
Significant
Sep 09, 2008

Dee Anne Ramirez, Applicant vs. Drive Financial Services, One Beacon Insurance Co.

The Appeals Board, in an en banc decision, holds that penalties under Labor Code section 5814(a) are discretionary, successive penalties are permissible under specific circumstances, and attorney's fees under section 5814.5 apply to private employers for unreasonable delays occurring after January 1, 2003, regardless of the injury date.

WCABLabor Code section 5814Labor Code section 5814.5penaltyattorney feesen bancreconsiderationdiscretionary penaltysuccessive penaltyunreasonable delay
References
Showing 1-10 of 2,434 results

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