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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ10009703 ADJ10043837
Regular
Feb 19, 2019

ZULAY DAVILA vs. EMPLOYERS RESOURCE GROUP, VENSURE HR, INC., LCF LIBERTY JR, LLC/SECURITY NATIONAL INSURANCE COMPANY, AMTRUST NORTH AMERICA, PROPORTION FOODS, LLC/REDWOOD FIRE AND CASUALTY INSURANCE COMPANY, BERKSHIRE HATHAWAY HOMESTATE COMPANIES

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the WCJ's decision due to a due process violation. The WCJ had determined employment by ERG without providing ERG notice and an opportunity to be heard. The WCAB returned the case to the trial level for further proceedings to determine employment status. Issues of insurance coverage will be subject to mandatory arbitration once employment is established.

Workers' Compensation Appeals BoardVENSURE HRSecurity National Insurance CompanyProportion FoodsLLCREDWOOD FIRE AND CASUALTY INSURANCE COMPANYBERKSHIRE HATHAWAY HOMESTATE COMPANIESAMTRUST NORTH AMERICAEMPLOYMENT RESOURCES GROUPINC.
References
Case No. SBR 309137
Regular
Aug 28, 2007

JOSE CARMONA vs. ARROW EMPLOYMENT SERVICES dba ARROW STAFFING SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for LEGION INSURANCE COMPANY, in liquidation, by CAMBRIDGE INTEGRATED SERVICES, KELLY PRODUCTIONS, INC., FARMDALE CREAMERY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board is reconsidering a prior award due to CIGA's contention that the applicant's claim is not a "covered claim" because other insurance was available. The central issue is whether the special employer's (Farmdale Creamery) workers' compensation policy with SCIF constitutes "other insurance" under Insurance Code section 1063.1(c)(9), which would exclude the claim from CIGA's coverage. The case is remanded for further proceedings to definitively determine the availability of this "other insurance" and its impact on CIGA's liability.

CIGALegion Insurance CompanyArrow Employment ServicesFarmdale CreameryState Compensation Insurance Fundcovered claimother insuranceInsurance Code section 1063.1(c)(9)general employerspecial employer
References
Case No. GOL 86641, GOL 99800
Regular
Aug 07, 2008

MIGUEL TORRES vs. HENDRY TELEPHONE PRODUCTS, CONNECTICUT INDEMNITY/ROYAL & SUNALLIANCE INSURANCE, HR3 STAFFING SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, LEGION INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to correct errors in the original award, specifically the misidentification of employers and their insurers. The WCAB rescinded the prior award and returned the case for further proceedings to determine the existence of a cumulative injury and clarify employer liability. The Board also noted that Connecticut Indemnity's policy likely constitutes "other insurance," thus precluding CIGA's involvement.

Workers' Compensation Appeals BoardJoint Findings and AwardReconsiderationIndustrial InjuryNeckRight Upper ExtremityCarpal Tunnel SyndromeCubital Tunnel SyndromeHeadachesDizziness
References
Case No. ANA 0324555
Regular
Aug 19, 2007

CONNIE CERVANTES vs. TEMPEST SERVICES INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ITT CANON

This case concerns whether a self-insured special employer's coverage constitutes "other insurance" that would relieve the California Insurance Guarantee Association (CIGA) of liability for an injured worker's benefits. The Appeals Board denied reconsideration, affirming the administrative law judge's finding that ITT, a permissibly self-insured special employer, was liable for benefits. The Board relied on precedent establishing that self-insurance by an employer is considered "other insurance" under relevant statutes, thus excluding CIGA's coverage.

Workers Compensation Appeals BoardGeneral employerSpecial employerPermissibly self-insuredCalifornia Insurance Guarantee AssociationCIGALiquidationCovered claimsOther insuranceInsurance Code section 1063.1(c)(9)
References
Case No. GRO 0023124
Regular
Dec 31, 2007

CAROLINA CAMACHO vs. TEAMWORK, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, INTERCARE INSURANCE SERVICES, DEN-MAT, ZENITH INSURANCE COMPANY

Zenith Insurance sought reconsideration of a WCAB decision that found CIGA not liable because other insurance was available, ordering Zenith to reimburse CIGA for benefits paid. Zenith argued the WCAB lacked jurisdiction, claiming the contribution issue was subject to mandatory arbitration under Labor Code § 5275. The WCAB denied reconsideration, ruling that § 5275 did not apply as this was a general/special employment situation, not a cumulative trauma case, and Zenith's insurance constituted "other insurance" relieving CIGA of liability.

Workers' Compensation Appeals BoardCalifornia Insurance Guarantee AssociationCIGAZenith Insurance CompanyContributionMandatory ArbitrationLabor Code Section 5275Labor Code Section 5500.5General EmploymentSpecial Employment
References
Case No. ADJ700106 (SAL 0075388) ADJ4293270 (SAL 0067937) ADJ3847224 (SAL 0067938) ADJ1646200 (SAL 0011386)
Regular
Sep 01, 2015

WILLIE PEARSON vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS, Chamberlain's Children Center, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, SUPERIOR NATIONAL INSURANCE COMPANY

In this workers' compensation case, CIGA sought to be relieved of liability for applicant's medical treatment, arguing that the State of California Department of Corrections ("the State") constituted "other insurance." The Appeals Board affirmed the WCJ's decision that the State does not qualify as "other insurance" under Insurance Code section 1063.1(c)(9)(A). Unlike private self-insured employers, the State is not required to obtain workers' compensation insurance or a certificate of self-insurance, and thus does not fall within the statutory definition of an "insurer." The Board further clarified that the State Compensation Insurance Fund's role in claim adjustment services for the State does not make it "other insurance" when the State is not otherwise insured with SCIF.

CIGASupernational Insurance Companylegally uninsuredother insurancecovered claimsInsurance Code Section 1063.1State of California Department of Correctionsreimbursementstipulated awardjoint and several liability
References
Case No. ADJ265314 (LAO 0790236)
Regular
May 21, 2009

VICTORIA RODRIGUEZ vs. THIBIANT INTERNATIONAL, INC., FIREMAN'S FUND INSURANCE COMPANY, SELECT PERSONNEL SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCATION, LEGION INSURANCE CO.

This case involves a workers' compensation applicant injured while working for a special employer, Thibiant International, insured by Fireman's Fund. The applicant was hired by a general employer, Select Personnel, whose insurer, Legion Insurance, became insolvent. The California Insurance Guarantee Association (CIGA) paid benefits but argued its coverage was excluded by Fireman's Fund being "other insurance." The Appeals Board affirmed Fireman's Fund's liability as the special employer's insurer and reversed CIGA's dismissal, finding Fireman's Fund owed CIGA reimbursement for benefits paid. The Board also deemed Fireman's Fund's challenge to the reimbursement amount waived due to failure to raise it at trial.

Workers' Compensation Appeals BoardVictoria RodriguezThibiant InternationalInc.Fireman's Fund Insurance CompanySelect Personnel ServicesCalifornia Insurance Guarantee AssociationCIGALegion Insurance Companyliquidation
References
Case No. STK 0142666
Regular
Jan 17, 2008

DAVID SOTO vs. ADVANCED PACKING & DISTRIBUTION, STATE COMPENSATION INSURANCE FUND, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION On Behalf Of RELIANCE INSURANCE COMPANY, In Liquidation

This case involves a workers' compensation claim where the applicant sustained an injury while employed by both a general employer (Remedy) and a special employer (Advanced). Remedy's insurer, Reliance, became insolvent, leading CIGA to assume potential liability. The WCJ found that Advanced's insurer, SCIF, provided "other insurance" under Insurance Code § 1063.1(c)(9), thus relieving CIGA of responsibility. The Appeals Board denied SCIF's reconsideration, affirming that SCIF's policy constituted "other insurance" and that CIGA is a last resort insurer.

Workers Compensation Appeals BoardCIGAReliance Insurance Companyliquidationspecial employergeneral employerother insuranceInsurance Code section 1063.1(c)(9)covered claimsjoint and several liability
References
Case No. ADJ347577 (SAC 0220919)
Regular
Jul 09, 2009

STEPHEN FLANNERY vs. G & O SERVICES, RELIANCE INSURANCE, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, PACIFC BELL

In this workers' compensation case, the Appeals Board affirmed an award for applicant Stephen Flannery's back and psyche injury. Pacific Bell, the special employer, was found jointly and severally liable with the general employer's insurer, Reliance (now CIGA), for ongoing benefits, as Pacific Bell's self-insurance constitutes "other insurance." The Board reversed the WCJ's award of temporary total disability beyond the five-year jurisdictional limit unless the disability straddled the anniversary date. The doctrine of laches was found inapplicable against CIGA, and CIGA was not liable for EDD's lien as Pacific Bell was the primary source of benefits.

Workers' Compensation Appeals BoardCIGAReliance Insurance liquidationCalifornia Insurance Guarantee AssociationPacific Bellspecial employerjoint and several liabilitylachesnew and further disabilityfive-year jurisdictional period
References
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