July, 2017 - CompFox

Monica Ramirez, vs. Department Of Social Services-in Home Supportive Services, Permissibly Uninsured, Adjusted By York Risk Services,

Leave a Comment / California, Los Angeles / By Ashish

In this case, Monica Ramirez, an employee of the Department of Social Services-In Home Support Services, sought reconsideration of a Findings and Order issued by the workers’ compensation administrative law judge (WCJ) on June 14, 2017. The WCJ found that Ramirez did not sustain an injury arising out of and occurring in the course of her employment to her psyche. Ramirez argued that unrebutted evidence cannot be arbitrarily rejected and the finding of no industrial injury is contrary to the evidence. The WCJ filed a Report and Recommendation on Petition for Reconsideration (Report) recommending that reconsideration be denied. The Workers’ Compensation Appeals Board granted reconsideration solely to correct the clerical error that Ramirez did not sustain industrial injury to her

Henry Hansen, vs. Transport Drivers, Inc.; State Compensation Insurance Fund,

Leave a Comment / California, Pomona / By Ashish

In this case, Henry Hansen, an employee of Transport Drivers, Inc., claimed injury to his psyche, back, and circulatory system occurring on July 24, 2003. Hansen also claimed injury to his psyche from September 1, 2006 to July 15, 2016 while employed as a truck driver for Forest Plywood Sales and Household Industries. Athens Administrators petitioned to consolidate both cases on March 15, 2017, and the Workers’ Compensation Appeals Board granted the petition. However, the State Compensation Insurance Fund (SCIF) objected to the consolidation, arguing that the case had been settled more than five years ago and could not be altered. The WCAB granted SCIF’s petition for reconsideration and rescinded the order, returning the matter to the trial level

Peter Sylves, vs. County Of Riverside,

Leave a Comment / California, Riverside / By Ashish

In this case, the Workers’ Compensation Appeals Board awarded costs in the amount of $327.02 to the applicant, Peter Sylves, after the Fourth District Court of Appeal issued a Remittitur. The Board also returned the matter to the trial level for further proceedings by the WCJ, consistent with the Court of Appeal’s opinion and decision. The Board found that Sylves, while employed as a Deputy Sheriff by the County of Riverside during the period December 27, 1998 through October 28, 2010, sustained industrial injury to his low back, both knees, left shoulder, and in the form of hypertension, GERD, and sleep disorder. The Board also found that the defendant failed to meet its burden of proof on the Statute

Lonnie Roberts, vs. Capital Plumbing; California Insurance Guarantee Association; Reliance National Indemnity Company, In Liquidation, Sedgwick Claims Management Services; Ace Usa, Adjusted By Gallagher Bassett Services,

Leave a Comment / California, Sacramento / By Ashish

This case is about a worker, Lonnie Roberts, who was injured while employed by Capital Plumbing on November 9, 2000 and January 26, 2001. The employer was insured by Reliance Insurance Company in ADJ 870873, and by ACE USA in ADJ 248306. On October 3, 2001, an Order of Liquidation issued with regard to Reliance, and California Insurance Guarantee Association for Reliance National Indemnity Company in liquidation undertook liability for the workers’ compensation obligation of Reliance. On January 8, 2007, Judge Thomas Anthony issued an order effective February 1, 2007, that Gallagher Bassett, claims administrator for ACE USA, undertake administration of all benefits in these two cases. CIGA filed a Petition for

Jorge Lopez, vs. Delta Hi-Tech Inc And Nova Casualty/Hanover Insurance Group, Administered By York Risk Services Group,

Leave a Comment / California, Van Nuys / By Ashish

This case involves a dispute between Delta Hi-Tech Inc and Nova Casualty/Hanover Insurance Group, administered by York Risk Services Group, and Jorge Lopez, an employee of Delta Hi-Tech Inc. Lopez claimed injury to his neck, back, and shoulders while employed by Delta Hi-Tech Inc. The injury claim was denied, but Lopez underwent bilateral shoulder surgeries recommended by his primary treating physician. The orthopedic panel Qualified Medical Evaluator and the Agreed Medical Examiner both concluded that the medical treatment was appropriate and necessary for Lopez’s condition. The injury claim was settled by a Compromise and Release, and the lien claimant, Comprehensive Outpatient Surgery Center, sought reconsideration of the Findings and Order issued by the workers

Martha Ibrahim, vs. The State Of California, Department Of Corrections And Rehabilitation, Legally Uninsured; State Compensation Insurance Fund,

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

This case is about the State of California, Department of Corrections and Rehabilitation, legally uninsured; State Compensation Insurance Fund, Martha Ibrahim, and her workers’ compensation appeals board. Martha Ibrahim claimed to have sustained injuries to her heart, colon, psyche, and other body parts on various dates between 2000 and 2013. The case was heard by a workers’ compensation administrative law judge, who found that Ibrahim had sustained injuries to her neck, thoracic spine, shoulders, elbows, wrists, hands, and lumbar spine on June 27, 2007 and January 24, 2010, and that she had sustained injury to her knees, ankles, and feet on May 10, 2013. The judge also found that Ibrahim’s industrial injuries caused a combined total of 84

Jaime Rueda, vs. Ag Force; California Farm Management, Inc., Administered By Intercare Holdings Insurance Services, Inc.,

Leave a Comment / California, Fresno / By Ashish

In this case, Ag Force and California Farm Management, Inc., administered by Intercare Holdings Insurance Services, Inc., were defendants in a workers’ compensation case brought by Jaime Rueda. Rueda sought reconsideration of the Stipulations with Request for Award issued by the workers’ compensation administrative law judge on December 20, 2016. The Workers’ Compensation Appeals Board dismissed the Petition for Reconsideration, finding that it was timely filed, but that there was insufficient evidence to find good cause to relieve Rueda from the Award. The Board recommended that the WCJ treat Rueda’s Petition as a petition to set aside and set a hearing so Rueda could provide evidence in support of his arguments and create a record upon which

Cynthia Mcdaniel, vs. Timec/Broadspectrum; Esis/Ina,

Leave a Comment / California, San Francisco / By Ashish

In this case, Cynthia Mcdaniel filed a petition for reconsideration and removal with the Workers’ Compensation Appeals Board. The Board dismissed the petition to the extent it sought reconsideration and granted it to the extent it sought removal. The Board rescinded the decision of the workers’ compensation administrative law judge and returned the matter to the trial level for further proceedings and decision.

Mike Andriso, vs. County Of San Diego, Permissibly Self- Insured,

Leave a Comment / California, San Diego / By Ashish

In this case, Mike Andriso, who was injured in a cumulative trauma injury, was awarded 100% permanent disability. The Workers’ Compensation Appeals Board granted reconsideration to amend the Findings and Award to defer the attorney fee award. The Board noted that the WCJ should calculate a fee based upon the articulated factors, including whether this matter was of average or above-average complexity, and the skill required of applicant’s attorney to achieve the result obtained. The Board also noted that the fee should not be set in a manner that would discourage attorneys from accepting representation of injured workers whose life expectancy is significantly reduced.

Jose Aldana, vs. Fairmount Tire And Rubber; Crum & Forster; State Compensation Insurance Fund,

Leave a Comment / California, Long Beach / By Ashish

(LBO 0383773)In this case, Jose Aldana was found to have sustained 100% permanent disability as a result of an October 26, 2006 industrial injury to multiple body parts while employed as a laborer/tire changer by Fairmount Tire & Rubber. The Workers’ Compensation Appeals Board denied the petition for reconsideration filed by Crum & Forster, the insurer for employer Fairmount Tire & Rubber, and granted the petition for reconsideration filed by State Compensation Insurance Fund (SCIF), correcting the clerical error and naming Crum & Forster as the insurer liable for the award of permanent disability and further medical treatment. The Board also affirmed the WCJ’s award of 100% permanent disability, finding that defendant failed

July 2017