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Case Law Database

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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ302560
Regular
Jan 10, 2012

DAVID COE vs. PROFESSIONAL ASSOCIATION OF DIVING INSTRUCTORS, MISSION INSURANCE COMPANY, IN LIQUIDATION, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The Appeals Board granted reconsideration on its own motion to correct a clerical error in a prior decision regarding a Labor Code section 5710 attorney's fee. The original award of $1,903.75 was twice the applicant's attorney's requested fee of $1,093.75, which the WCJ and the Board's prior decision acknowledged. The Board corrected its decision to reflect the accurate attorney fee of $1,093.75, while reaffirming that CIGA has no liability for this fee due to a credit against the applicant's third-party recovery, which is reduced by the corrected fee amount.

Workers' Compensation Appeals BoardProfessional Association of Diving InstructorsMission Insurance CompanyCalifornia Insurance Guarantee Association (CIGA)Labor Code section 5710attorney's feeclerical errorpetition for reconsiderationthird-party recoverynet third party recovery
References
Case No. ADJ1973537 (SRO 0141664)
Regular
Jun 24, 2019

KENT WARD vs. TIMEC COMPANY, INC., ZURICH AMERICAN INSURANCE COMPANY

The applicant sought reconsideration of an arbitration decision that found his employer, Timec, 25% comparatively negligent for his injury, reducing Timec's credit from a third-party settlement. The applicant argued for a higher employer negligence percentage to increase his potential workers' compensation benefits. The Board denied reconsideration, adopting the Arbitrator's findings and reasoning. The Board found the applicant failed to present evidence to overcome the Arbitrator's negligence determination.

Third-party creditComparative negligenceArbitrator's findingsPetition for reconsiderationLabor Code section 3861Employer's liabilityThird-party claim valueNet settlement amountCredit against workers' compensationEmployer's breach of duty
References
Case No. ADJ4238124 (LBO 0384459)
Regular
Sep 14, 2012

LUIS ROMERO vs. CEDARS SINAI HEALTH SYSTEM

The Workers' Compensation Appeals Board affirmed a prior decision granting the defendant employer a $2,000,000 credit against future workers' compensation liability, representing the applicant's net recovery from a third-party lawsuit. The applicant's petition for reconsideration, arguing employer negligence, was denied. The Board found the applicant failed to prove employer negligence, particularly by not presenting expert evidence on the standard of care or causation. Testimony indicated the applicant was aware of and instructed to use safety equipment (outriggers) but proceeded without it, suggesting applicant's own negligence.

Third-party creditEmployer negligenceCivil lawsuit recoveryManlift operationOutriggersProximate causeStandard of careComparative negligenceWCAB reconsiderationFindings of Fact
References
Case No. ADJ9796635
Regular
Dec 14, 2020

ERNEST OZUNA vs. TRIPLE S STEEL HOLDINGS, INC.; SENTRY SELECT STEVENS POINT

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The applicant sought to challenge a prior Finding and Order regarding the defendant's third-party credit rights against future workers' compensation liability. The Board affirmed the WCJ's determination that the applicant's settlement with a third party did not account for workers' compensation benefits or the purchase of the defendant's lien. Consequently, the defendant's credit rights remain valid for the full amount of benefits paid.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and OrderThird-Party CreditSettlementLien PurchaseWCJAdjudicationSubstantive LiabilityThreshold Issue
References
Case No. ADJ1160066 (MON 0261712)
Regular
Apr 29, 2014

ROBERT VILARINO vs. CHROMATICS, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, For FREMONT INSURANCE COMPANY, In Liquidation, Administered by SEDGWICK CMS

This case concerns a worker who sustained a permanent total disability after receiving a voluntary flu vaccination at his employer's premises. The employer sought a credit for the worker's third-party settlement against its workers' compensation liability. The Appeals Board rescinded a prior finding of employer negligence, concluding that the employer was not liable for the independent contractor's actions in administering the vaccine. The Board found no evidence of employer negligence and granted the full third-party settlement amount as a credit to the employer.

Transverse myelitisInfluenza vaccineThird party creditEmployer negligenceNon-delegable dutyIndependent contractorMedical malpracticeStandard of careVicarious liabilityReconsideration
References
Case No. SAC 293290
Regular
Feb 21, 2008

WILLIAM MENDOZA vs. LEE CUNEO dba THE BODY SHOP, UNINSURED EMPLOYERS FUND

The Workers' Compensation Appeals Board granted reconsideration to address the Uninsured Employers Benefits Trust Fund's (UEBTF) contentions. While affirming the award of retroactive vocational rehabilitation maintenance allowance (VRMA) at the delay rate, the Board amended the original order to allow the UEBTF credit for wages earned by the applicant as a property manager and for his net recovery in a third-party civil action against the uninsured employer. This credit will reduce the UEBTF's liability for the VRMA.

UEBTFVRMAdelay ratecredit for wagescivil action recoveryLabor Code section 139.5Labor Code section 4909property manager earningsthird party actionnet recovery
References
Case No. ADJ2552389 (OAK 0301853), ADJ2702419 (OAK 0301854), ADJ350772 (OAK 0301856), ADJ3854894 (OAK 0321466)
Regular
Mar 26, 2012

BARBARA LIGE-DIXON vs. A.C. TRANSIT, SEDGWICK CMS, INC.

The defendant, AC Transit, sought reconsideration of an award finding four industrial injuries and three awards of permanent disability for Barbara Lige-Dixon. The primary dispute concerned whether the defendant could credit permanent disability advances made in one case (resulting in zero disability) against its liability in other cases. The Appeals Board granted reconsideration, finding equitable considerations supported allowing the credit across all cases due to overlapping injuries and evolving medical apportionment. The Board amended the award to permit the $12,930 advance credit, while deferring the issue of attorney fees against third-party recovery for further trial-level proceedings.

Workers' Compensation Appeals BoardPermissibly Self-InsuredJoint Findings Award and OrdersPermanent DisabilityPermanent Disability AdvancesCreditThird Party RecoveryEquitable ConsiderationsApportionmentAgreed Medical Examiner
References
Case No. ADJ2506855 (RDG 0044877) ADJ1687185 (RDG 0032808)
Regular
Aug 24, 2009

Kenny Smith vs. MODERN BUILDING COMPANY, STATE COMPENSATION INSURANCE FUND, ANDERSON & ASSOCIATES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for CALIFORNIA COMPENSATION, BROADSPIRE

This case involves successive spinal injuries to Kenny Smith. CIGA seeks relief as administrator for the 1990 injury, arguing it's not a covered claim as SCIF provides "other insurance." The Appeals Board granted CIGA's petition, finding SCIF is indeed other available insurance for the same injury. SCIF is appointed administrator and is entitled to a $14,667.67 credit against its liability, stemming from the applicant's prior third-party recovery for the 1986 injury.

CIGASCIFReconsiderationAdministratorCovered ClaimsOther InsuranceLabor Code Section 3861Spine InjuryJoint and Several LiabilityInsolvent Insurer
References
Case No. ADJ1416396 (OXN 0147357) ADJ7453200
Regular
Jul 08, 2011

, Applicant, RICHARD DAVIS, vs. , BOTTLING GROUP LLC dba PEPSI BEVERAGES COMPANY; SEDGWICK CLAIMS MANAGEMENT for OLD REPUBLIC,

This case involved an employee who sustained two industrial injuries, one from a third-party's negligence and another cumulative trauma injury. The employer sought to apply a credit for the employee's net third-party recovery against the total workers' compensation award. The Appeals Board denied the employee's petition for reconsideration, upholding the employer's right to this credit. This decision affirmed that a third-party credit can be applied even when industrial injuries are intertwined and awarded jointly, to prevent the employee from obtaining a double recovery.

Petition for ReconsiderationThird-Party CreditJoint and Several AwardDouble RecoveryCumulative InjurySpecific InjuryAgreed Medical EvaluatorUnapportioned Permanent DisabilityBenson v. Permanente Medical GroupBenson v. Workers' Comp Appeal Bd.
References
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