February, 2013 - CompFox

Vilma Ruiz vs. Margaret O’Leary; California Insurance Guarantee Association For Fremont Indemnity Company, In Liquidation; Republic Indemnity Company

Leave a Comment / California, Oakland / By Ashish

Margaret O’Leary; California Insurance Guarantee Association for Fremont Indemnity Company, In Liquidation; Republic Indemnity Company Vilma Ruiz WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIACase Nos.ADJ329334 (OAK 0311178)ADJ2064025 (OAK 0318666) OPINION AND DECISIONAFTER RECONSIDERATIONVILMA RUIZ,Applicant,vs.MARGARET O’LEARY; CALIFORNIAINSURANCE GUARANTEE ASSOCIATIONfor FREMONT INDEMNITY COMPANY, InLiquidation; REPUBLIC INDEMNITYCOMPANY,Defendants. We earlier granted the petition of defendant Republic Indemnity Company (Republic) for reconsideration …

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Colee Pitchford vs. Trimac Transportation; Chartis

Leave a Comment / California, Marina del Rey / By Ashish

(MON 0359075) is a case in which the Workers’ Compensation Appeals Board dismissed the Petition for Reconsideration filed by Colee Pitchford against Trimac Transportation and Chartis. The petition was dismissed because it was not served on all adverse parties, as required by Labor Code section 5905. Had the petition been properly served, it would have been denied on the merits for the reasons stated by the Workers’ Compensation Administrative Law Judge in the Report.

Karen Murray vs. Kern Village Assisted Living; State Compensation Insurance Fund

Leave a Comment / Bakersfield, California / By Ashish

is a case in which Karen Murray, an applicant, sought reconsideration of the November 30, 2012 Findings of Fact & Orders issued by the workers’ compensation administrative law judge (WCJ). The WCJ found that Murray did not sustain an industrial injury arising out of and occurring in the course of employment (AOE/COE) to her neck and bilateral shoulders while employed as a caregiver on February 10, 2011. The WCJ further found that Murray’s claim was excluded from compensation as a post-termination claim pursuant to Labor Code section 3600(a)(10). The WCJ ordered Murray to take nothing. The WCJ issued a Report and Recommendation on Petition for Reconsideration (Report) recommending that the Workers’

Reyna Marquez vs. Sensient Technologies; Zurich American Insurance Co., Administered By Sedgwick Cms; Ace American Insurance Co., Administered By Specialty Risk Services

Leave a Comment / California, Sacramento / By Ashish

This case involves a worker’s compensation claim by Reyna Marquez against her employer, Sensient Technologies. The worker’s compensation administrative law judge (WCJ) found that Marquez sustained industrial injury to her left shoulder on August 13, 2009, and to her low back on September 12, 2010. Zurich American Insurance Company (Zurich) and ACE American Insurance (ACE) both petitioned for reconsideration of the WCJ’s findings, but the Workers’ Compensation Appeals Board denied the petitions. Zurich and ACE argued that the WCJ’s findings were not supported by substantial medical evidence and that they were denied due process when the WCJ relied on a supplemental report from the agreed medical evaluator without allowing further discovery. The Appeals Board found that

Marina Bilaver vs. Marriott Renaissance Hotel, Permissibly Self-insured

Leave a Comment / California, Van Nuys / By Ashish

is a case in which Marina Bilaver, an employee of the Marriott Renaissance Hotel, filed a petition for reconsideration after the Workers’ Compensation Appeals Board found that she did not sustain an injury to her right leg, foot, and ankle while working as a front desk clerk. The Board denied the petition, finding that Bilaver failed to introduce a claim form into evidence and that her primary treating physician’s reports were not substantial medical evidence.

Gary Armstrong vs. Rio Tinto Minerals, Permissibly Self-insured, Adjusted By Sedgwick Cms

Leave a Comment / Bakersfield, California / By Ashish

This case involves Gary Armstrong, who sustained an industrial injury on October 26, 2009 to his low back that caused 22% permanent partial disability. The Workers’ Compensation Appeals Board granted reconsideration of the October 22, 2012 Findings, Award and Orders and admitted the Notice of Lien Claim dated December 1, 2009 into evidence. The Board amended the Findings, Award and Orders to defer the issue of reimbursement of the Employment Development Department (EDD) and the award of temporary disability indemnity. The Board affirmed the WCJ’s finding regarding permanent partial disability and deferred the issue of EDD’s lien, returning the matter to the trial level for the WCJ to issue a new decision.

Roger Knight vs. New Orleans Saints; Louisiana Workers’ Compensation Corporation

Leave a Comment / Anaheim, California / By Ashish

In this case, Roger Knight, a professional athlete, sought workers’ compensation benefits for injuries sustained while employed by the New Orleans Saints from December 4, 2001 through August 25, 2005. The parties stipulated that Knight sustained industrial injury to his cervical spine, shoulders, elbows, wrists, thumbs, fingers, lumbar spine, left knee, left ankle, left big toe, gastrointestinal system, headaches, sleep disorder, and post-concussive syndrome, causing 78% permanent disability and requiring further medical treatment. The Workers’ Compensation Appeals Board (WCAB) declined to exercise jurisdiction over the claim due to a reasonable mandatory forum selection clause in Knight’s contract with the Saints, which specified that any workers’ compensation claims arising out of

Gaylon Hyder vs. St. Louis Rams; The Travelers Indemnity Co., Successor In Interest To Gulf Insurance Co.

Leave a Comment / California, Van Nuys / By Ashish

St. Louis Rams; The Travelers Indemnity Co., successor in interest to Gulf Insurance Co. Gaylon Hyder WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIACase No. ADJ6985613(Van Nuys District Office)OPINION AND DECISION AFTERRECONSIDERATIONGAYLON HYDER,Applicant,vs.ST. LOUIS RAMS; THE TRAVELERSINDEMNITY CO., successor in interest toGULF INSURANCE CO.,Defendants. We previously granted reconsideration to further study the factual and legal issues in this …

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Irma Gonzalez vs. J & L Farms; Broadspire Ciga

Leave a Comment / California, Salinas / By Ashish

(SAL 0097970) is a case involving Irma Gonzalez and J & L Farms and Broadspire Ciga. The Workers’ Compensation Appeals Board considered the allegations of the Petition for Reconsideration and the contents of the Report and Recommendation on Petition for Reconsideration of the workers’ compensation administrative law judge and dismissed the petition because it was not taken from a final order and was not timely-filed.

Eleanor Gomez vs. Jostens, Inc.; Travelers Insurance Company

Leave a Comment / California, Fresno / By Ashish

In this case, Eleanor Gomez sought reconsideration of a decision by a workers’ compensation administrative law judge that found that Jostens, Inc.’s Medical Provider Network (MPN) complied with applicable access standards and that the company did not unreasonably delay the provision of medical treatment. After reconsideration, the Workers’ Compensation Appeals Board granted Gomez’s request and allowed her to continue to treat with her long-time treating physician, Dr. Wlasichuk, as the MPN physicians were not close enough to her residence to reasonably require her to obtain treatment from one of them.

February 2013