Case Name:	People v. Diop		03/08/2021
Summary:	IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA FOURTH APPELLATE DISTRICT DIVISION TWO THE PEOPLE, Plaintiff and Respondent, E073789 v. (Super. Ct. No. RIF1705383) NDIAWAR DIOP, OPINION Defendant and Appellant. The doctor testified that a feature of PTSD is “an amnesic response,” which is the inability to recall important aspects of the trauma. On August 28, 2017, after reviewing defendant’s file, agent Oden spoke to Correctional Deputy Marc Escarcega and recorded their conversation. The deputy added: “If staff had been assaulted, the inmate would have had a rules violation report or a 115 written up on him. You just gonna have Hep C. It’s not like malaria in—you’re not gonna have malaria like in Africa.
Note:
Citation:	E073789
WCC Citation:	E073789

Case Name:	People v. Galante		02/04/2008
Summary:	No. B190373 February 4, 2008 THE PEOPLE, PLAINTIFF AND RESPONDENT, v. ROBERT GALANTE, DEFENDANT AND APPELLANT. This opinion has not been certified for publication or ordered published for purposes of rule 8. 1115. Robert Galante appeals from a judgment following his conviction after a jury trial of two counts of insurance fraud. BACKGROUND Appellant worked as a power line truck operator for the Glendale Department of Public Works for 17 years. In July 2002, his right ankle "gave way" and felt painful while he was walking at work. He did not present the testimony of Dr. Nagelberg to establish the diagnosis supporting his referrals to Abe and Pinkston.
Note:	[Unpublished] Appellant failed to establish the relevance of testimony from his proffered medical experts. The court's exclusion of irrelevant evidence did not violate appellant's right to present a defense.
Citation:	B190373
WCC Citation:	WCC 33132008 CA

Case Name:	People v. Grigsby		02/27/2008
Summary:	At the sentencing hearing, the court allowed Grigsby to cross-examine Gutierrez on the factual basis for the restitution request. At the conclusion of the hearing, the court ordered Grigsby to pay $4,403. 05 in restitution without specifying who should receive the restitution. The court sentenced Grigsby to a three-year middle term to run consecutively to the sentences he was already serving. Certificate of Probable Cause The People urge us to dismiss this appeal because Grigsby did not obtain a certificate of probable cause. The court's decision to order Grigsby to pay $4,403. 05 in restitution to the prison arose after entry of the plea.
Note:	[Unpublished] Because the prison was not a direct victim of the defendant and so not entitled to restitution, the restitution order should be modified to change the payee to the injured prison guard.
Citation:	A116118
WCC Citation:	WCC 33232008 CA

Case Name:	People v. Groce		08/31/2010
Summary:	Groce's employer (Theodore Claudat) testified that Groce was his sole employee and that Groce had a key to the business premises. Claudat told Groce that he did not have workers' compensation insurance, but he agreed to provide Groce with assistance for his medical expenses. Regarding the August 20 that letter Groce wrote to Claudat, the jury convicted Groce of attempting to dissuade a witness from making a report of a crime. However, the court stated its ruling did not preclude Groce from cross-examining Claudat about whether the checks were written to compensate Groce for his injuries. Groce also notes that Claudat testified that he interpreted the August 20 letter as a threat that he should not testify against Groce.
Note:	Excluded evidence that an employer failed to provide workers' compensation insurance would not likely change the outcome in the trial of a man accused of forging company checks which he claimed were advances for medical treatment, a California appeals court held.
Citation:	D055456
WCC Citation:	WCC 36622010 CA

Case Name:	People v. Hammond		10/11/2012
Summary:	Dr. Hensle believes that Robert Hammond, defendant's husband, would drive defendant to the visits with Dr. Hensle, and Hammond would be waiting for defendant when she finished treatment. Hammond, defendant's husband of 33 years, testified at trial that from 2003 through 2005 defendant was in poor condition. Hammond testified that he "generally" drove defendant to her medical appointments, including during the period of 2003 through 2005. Hammond does not believe that he told defendant's attorney that defendant had driven, despite Hammond having seen her drive. Hammond testified that defendant's counsel told defendant to answer non-medical questions generally "unless they ask for a specific point .
Note:	A California appellate court upheld a former bank employee's conviction for workers' compensation insurance fraud based on her testimony that she was unable to drive; a claim which was belied by surveillance video taken just days before the hearing at which she made this assertion.
Citation:	B231927
WCC Citation:	WCC 39402012 CA

Case Name:	People v. Henderson		10/15/2010
Summary:	Dodge saw Henderson in January 2006, he believed that Henderson could continue working. Dodge saw Henderson later that month, Henderson claimed to be in pain and unable to freely move his neck. Dr. Tontz concluded that Henderson had "slight restriction of range," and that Henderson could not work. In the meantime, unbeknownst to Henderson or his physicians, Henderson's employer learned that Henderson had been observed at a gym playing basketball. Dodge denied any conversation with Henderson in which he authorized or recommended that Henderson play basketball, Henderson claimed that Dr.
Note:	A trucker must repay a carrier $64,645 in benefits after a private investigator videotaped him regularly shooting jump shots and practicing lay-ups at the local gym.
Citation:	D055580
WCC Citation:	WCC 36802010 CA

Case Name:	People v. Hernandez		01/11/2018
Summary:	Ct. No. BA435685)   THE PEOPLE, Plaintiff and Respondent,   v.   LUIS HERNANDEZ, Defendant and Appellant.     A jury found defendant Luis Hernandez guilty of insurance fraud and attempted perjury. Within a month or two, defendant’s primary physician placed him on “total temporary disability. ”2 Defendant initiated a worker’s compensation proceeding against Farmer John. In early 2014, she was called to the company’s security shack to meet defendant, who was dropping off benefits paperwork. (People v. (Hernandez) Amaya (May 18, 2017, B278794. )
Note:	A California appellate court upheld a worker’s conviction and sentence for insurance fraud and attempted perjury after he lied about needing a cane because of a plethora of alleged on-the-job injuries.
Citation:	B279922
WCC Citation:	Los Angeles County Super. Ct. No. BA435685

Case Name:	People v. Javed		12/27/2011
Summary:	THE PEOPLE, Plaintiff and Respondent,v. NUSRAT JAVED, Defendant and Appellant. A jury convicted defendant Nusrat Javed of one count of general insurance fraud (Pen. Additionally, on September 25, 2006, defendant represented on her medical history form that she did not have a history of dizziness. It was later discovered that defendant took a trip to Pakistan from November 16 through December 24, 2006. Defendant was charged with one count of insurance fraud and six counts of workers' compensation fraud.
Note:	A malingering applicant should not have to repay all of the benefits received as criminal restitution, because she only started misrepresenting the extent of her symptoms after suffering a compensable injury.
Citation:	C064881
WCC Citation:	WCC 38372011 CA

Case Name:	People v. Jay Bryan Waterman		02/18/2010
Summary:	Ct. No. SCD205179) THE PEOPLE, Plaintiff and Respondent, v. JAY BRYAN WATERMAN, Defendant and Appellant. A jury convicted Jay Bryan Waterman of making false or fraudulent statements to obtain workers' compensation benefits (Ins. what [Waterman] said he couldn't do or how he felt and what we saw on examination. "Waterman reported continued severe headaches, increased pain in his back, neck and right foot, and numbness in his left arm and fingers. His former employer, Michael Mallonee, stated that before the accident Waterman worked long hours and afterwards he never saw Waterman engage in physical activities.
Note:	Videos and other evidence provided sufficient evidence to support a trial court's conviction of an injured worker on several fraud charges.
Citation:	D053479
WCC Citation:	WCC 35982010 CA

Case Name:	People v. Jones		05/04/2012
Summary:	PEOPLE v. JONES THE PEOPLE, Plaintiff and Respondent, v. MICHAEL PATRICK JONES, Defendant and Appellant. For the same reason, we concluded defense counsel was not ineffective for failing to object to the alleged misconduct. (People v. Jones (Sept. 5, 2007, F049837) [nonpub. (People v. Jones, review den. Defendant claimed newly discovered evidence established that the CHP and/or the prosecution had suppressed exculpatory evidence.
Note:	The conviction of a former Highway Patrol officer for workers' compensation fraud was upheld for a second time.
Citation:	F062094
WCC Citation:	WCC 38922012 CA

Case Name:	People v. Kamal		11/29/2007
Summary:	IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA SECOND APPELLATE DISTRICT DIVISION EIGHT No. B190006 November 29, 2007 THE PEOPLE, PLAINTIFF AND RESPONDENT, v. FADI Z. KAMAL, DEFENDANT AND APPELLANT. This opinion has not been certified for publication or ordered published for purposes of rule 8. 1115. Fadi Z. Kamal appeals from the judgment following his convictions for grand theft and receiving stolen property. FACTS AND PROCEEDINGS Appellant Fadi Kamal began working for Darden Dental Supply in 2002. When it terminated him, the company offered appellant $2,000 in severance pay if he would sign a waiver not to sue. In the meantime, company officials had started noticing about one month earlier that some items were inexplicably missing from its warehouse.
Note:	[Unpublished] Because the trial's outcome hinged on credibility factors, the prosecutor's improper attacks on appellant's credibility more likely than not affected the jury's deliberations and ultimate verdict. Appellant is therefore entitled to a retrial before a jury untainted by prosecutorial misconduct.
Citation:	B190006
WCC Citation:	WCC 32832007 CA

Case Name:	People v. Lias		12/31/1969
Summary:	IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA FOURTH APPELLATE DISTRICT  DIVISION TWO  .             THE PEOPLE, Plaintiff and Respondent, .             v. .             MICHELLE JANET LIAS, Defendant and Appellant. .             E067278 .             (Super. Ct. No. RIF1500177) .             O P I N I O N .             APPEAL from the Superior Court of Riverside County. .           Defendant and appellant, Michelle Janet Lias, pled guilty to fraudulently making a material statement and representation for the purpose of obtaining compensation. .           NOT TO BE PUBLISHED IN OFFICIAL REPORTS .           McKINSTER J. .           We concur: .           RAMIREZ P. J.
Note:	The 4th District Court of Appeal upheld a sentence ordering a worker to pay restitution for investigatory expenses incurred over the course of her admittedly fraudulent claim — not just the expenses incurred after her doctor determined she was "miking it."
Citation:	E067278
WCC Citation:	Super.Ct.No. RIF1500177

Case Name:	People v. Lucena		09/21/2010
Summary:	C059767 & C064415 September 21, 2010 THE PEOPLE, PLAINTIFF AND RESPONDENT, v. JUNE ANN LUCENA, DEFENDANT AND APPELLANT. Such activity was better than "just surviving" and not typical of patients with significant complaints of low back pain. His opinion would have been different if he had known of her level of activity as shown on the videotapes. On August 25, 2003, defendant indicated she continued to have pain in the same areas; there was no major change. Dr. Mann had no reason to believe that defendant's activities had changed from what she indicated on her first visit.
Note:	The 3rd District Court of Appeal affirmed most of a trial court's decision that convicted June Ann Lucena of workers' compensation fraud, attempted perjury, theft by false pretenses, and false claims.
Citation:	C059767
WCC Citation:	WCC 36722010 CA

Case Name:	People v. Montes		09/07/2011
Summary:	THE PEOPLE, Plaintiff and Respondent, v. RENE MONTES, Defendant and Appellant. Defendant Rene Montes seeks additional presentence conduct credits pursuant to Penal Code section 4019, as amended in January 2010. 1 We agree the amended statute applies retroactively to time defendant served in pretrial custody before the amendment became effective. It imposed a total term of 12 years in state prison and ordered more than $1. 75 million in restitution. a term of six days will be deemed to have been served for every four days spent in actual custody. "As amended, the statute granted to certain defendants two days of conduct credits for every four days in custody.
Note:	A surgery center owner who helped defraud American International Group and Matrix Absence Management out of $1.4 million will get an additional 271 days of credit toward his sentence.
Citation:	G044451
WCC Citation:	WCC 37982011 CA

Case Name:	People v. Moreno		02/08/2008
Summary:	IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA FOURTH APPELLATE DISTRICT DIVISION TWO THE PEOPLE, Plaintiff and Respondent, v. OSCAR CARDENAS MORENO, Defendant and Appellant. First, defendant denied ever being known by a name other than "Oscar Moreno Cardenas"; however, defendant filed a second workers' compensation claim under the name "Pedro Navaro Cabrera. "The attorney who deposed defendant read from the deposition transcript at trial, and testified that at the deposition defendant stated his name was "Oscar Moreno Cardenas. "We note that this case is filed under the name "Oscar Cardenas Moreno," and that during trial, defendant was referred to as "Mr. Accordingly, we infer that defendant's name is "Oscar Cardenas Moreno. "
Note:	[Unpublished] 'Unless testimony is physically impossible or inherently improbable, testimony of a single witness is sufficient' to establish that Defendant had the requisite intent in making false statements for the purpose of obtaining workers' compensation benefits.
Citation:	E041868
WCC Citation:	WCC 33152008 CA

Case Name:	People v. Navaei		01/19/2010
Summary:	The court stayed imposition of sentence and placed Navaei on five years of formal probation on certain conditions, including that he serve 120 days in county jail. Navaei testified to the physical attack under oath during a deposition in his workers' compensation case. The videotape showed a verbal altercation between Navaei and his employer but no physical attack. The minute order also inaccurately reflects the court's oral pronouncements concerning the condition prohibiting Navaei from associating with illegal drug users. =========FOOTNOTES========= *fn1 The People charged Navaei with attempted perjury rather than perjury because there was no evidence Navaei had signed his deposition transcript.
Note:	The court modified Navaei's probation conditions to be more specific.
Citation:	B210534
WCC Citation:	WCC 35912010 CA

Case Name:	People v. Parede - unpublished		02/18/2021
Summary:	INTRODUCTION A jury found Gonzalo Ernesto Paredes guilty of 35 counts of offering or delivering compensation for workers’ compensation patient referrals (Lab. Paredes also contends that the prosecutor committed further error during his closing argument by stating that Paredes had admitted paying kickbacks. In other words, the misconduct must be ‘of sufficient significance to result in the denial of the defendant's right to a fair trial. ’ [Citation. ]While Paredes uses the term prosecutorial misconduct, as do many courts, we refer to the claim as raising one of purported prosecutorial error. “[The prosecutor:] Did Gonzalo Paredes offer you an alternative arrangement[4] by which MRIs could be referred to Advanced Radiology in exchange for something?
Note:	A California appellate court upheld the sentence and conviction of a former office manager for his involvement in an illegal kickback operation.
Citation:	No. D076086
WCC Citation:	No. D076086

Case Name:	People v. Peebles		07/17/2009
Summary:	IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA SIXTH APPELLATE DISTRICT No. H031155 July 17, 2009 THE PEOPLE, PLAINTIFF AND RESPONDENT, v. WADE ELLIS PEEBLES ET AL. , DEFENDANTS AND APPELLANTS. He also found nothing to show that Gigi Peebles Corp. is a registered corporation. He was a signatory on a bank account but he did not personally sign a signature card for the account. Peter never had any dealings with defendant Gigi regarding Castle Rock business other than when she relayed instructions from defendant Wade. Several checks were made out to Gigi Peebles Corp. , with references to other specific or unknown individuals or to specific projects.
Note:	An appellate court upheld the convictions of a husband and wife who were convicted of more than 40 counts of insurance fraud in an unpublished decision.
Citation:	H031155
WCC Citation:	WCC 35462009 CA

Case Name:	People v. Ryles		09/09/2010
Summary:	No. B208070 September 9, 2010 THE PEOPLE, PLAINTIFF AND RESPONDENT, v. EUELL RYLES ET AL. , DEFENDANTS AND APPELLANTS. 1182142, 1225501)(Santa Barbara County) James F. Rigali, Judge Sanger & Swysen, Robert M. Sanger, Stephen K. Dunkle, for Defendant and Appellant Euell Ryles. Law Offices of Joseph D. Allen, and Joseph D. Allen, for Defendant and Appellant Linda Ryles. On May 23, 2006, appellants appeared with Funke-Bilu and filed their individual signed waivers on a form entitled "Waiver of Conflicts of Interest - Joint Representation of Witness" that bore the caption "The People of the State of California v. Euell Bertram Ryles & Linda Marie Ryles. "I did not tell Mr. Ryles that he has to only say 'It was my state of mind' or whatever.
Note:
Citation:	B208070
WCC Citation:	WCC 36672010 CA

Case Name:	People v. Straiton		01/12/2017
Summary:	This opinion has not been certified for publication or ordered published for purposes of rule 8. 1115.   COURT OF APPEAL, FOURTH APPELLATE DISTRICT DIVISION ONE STATE OF CALIFORNIA .             THE PEOPLE, Plaintiff and Respondent, .             v. .             KEVIN STRAITON, Defendant and Appellant. .             D070565 .             (Super. .             The San Diego County District Attorney filed an amended complaint alleging that Kevin Straiton committed 19 counts of grand theft (Pen. .           Subsequently, Straiton moved under section 995 seeking to strike count 18 because the evidence presented at the preliminary hearing was not sufficient to create probable cause to believe Straiton committed the offense. .           This claim is forfeited because Straiton did not move under section 995 to challenge count 7.
Note:	A California appellate court upheld an employer’s conviction for grand theft and failing to secure workers’ compensation insurance coverage for his consignment vehicle dealership.
Citation:	D070565
WCC Citation:	Super. Ct. No. SCD254770

Case Name:	People v. Sun		05/06/2011
Summary:	We only have medical for $2,000" even though liability was uncontested and the property damage significant, "[s]o we have to do something. "Sun said he had spoken to the Changs who were willing to see Dr. Shoung, but did not know the procedure. He mentioned that they had already returned to Dr. Shoung at his urging once after their treatments ended. Sun said that, "after consideration, [he] decided to contact Dr. Shoung to see if we can do something. ""1 Sun observed that Fong had "experience," and said, "I don't need to, you know, to tell you how to prepare it. "
Note:	The 2nd District Court of Appeal affirmed the conviction of an Arcadia-based attorney for insurance fraud and unauthorized practice of law.
Citation:	B222420
WCC Citation:	WCC 37612011 CA

Case Name:	People v. Svercsics		11/18/2011
Summary:	In 1998,1 while Svercsics was working as a chef at Station 55 in Gilroy, California, he slipped and fell. On October 17, 2005, Dr. Ignacio stated in her treatment plan that she wondered if Svercsics had "secondary gain" issues. On October 31, 2005, James McSweeney, an orthopedic surgeon, examined Svercsics to render an opinion as to Svercsics's July 2005 injury. Terry Piccirelli, the owner of a house where Svercsics resides, testified that Svercsics does not read or write English and had a good reputation in the community. It was alleged in count 3 that when attorney Romano asked Svercsics whether he had suffered any work-related injuries prior to 1998, Svercsics answered that he had not.
Note:	Evidence supported a trial court's decision to convict an applicant of fraud and order $9,500 in restitution.
Citation:	D057111
WCC Citation:	WCC 38282011 CA

Case Name:	Pereira v. WCAB		10/14/1987
Summary:	GAIL PEREIRA, Petitioner v. WORKERS' COMPENSATION APPEALS BOARD, R. BURKE CORPORATION et al. , Respondents (Opinion by Stone, P. J. , with Gilbert and Abbe, JJ. , concurring. )She did not return to her job with respondent employer, however, because she believed her knee was too weak. 1 The record does not reflect whether applicant ever filed a formal request for vocational rehabilitation with the Bwreau. Approximately four months later, however, Doctor Michael Baratta opined that applicant was permanent and stationary and could return to her former work without restriction. Doctor Strait reported on August 13, 1984, that he had reexamined applicant and applicant is a qualified injured worker.
Note:	Retroactive VRMA due if applicant QIW before prima facie showing of entitlement.
Citation:	196 Cal.App.3d 1
WCC Citation:	WCC 3831987 CA

Case Name:	Perez v. WCAB		02/21/1984
Summary:	No. 69688 February 21, 1984 JOSEPH PEREZ, PETITIONER, v. WORKERS' COMPENSATION APPEALS BOARD, MCDONNELL DOUGLAS CORPORATION ET AL. , RESPONDENTS Edward C. Reid for Petitioner. Woods [152 CalApp3d Page 62] Petitioner Joseph Perez seeks review of the order of respondent Workers' Compensation Appeals Board denying reconsideration of the order and findings of the workers' compensation judge disallowing benefits to Perez for injuries sustained while he was en route from his workplace to attend a specially called union meeting. No wages or other expenses were paid for time spent during this meeting or in traveling to or from it. *fn1 En route the automobile collided with another automobile, resulting in the serious injuries for which petitioner seeks compensation benefits. The WCAB found that the injury arose out of the course of employment.
Note:	Lack of evidence of special mission supports application of "coming and going" rule.
Citation:	152 Cal. App. 3d 60
WCC Citation:	WCC 30421984 CA

Case Name:	Permanente Medical Group v. WCAB		05/21/1987
Summary:	The Permanente Medical Group, Kaiser Foundation Hospitals, Petitioner v. Workers Compensation Appeals Board of the State of California; Le Roy Ford; Royal Insurance Company; and Terry Lennon, Respondents. Terry Lennon filed an application for workers' compensation benefits on 9/16/85. Kaiser Permanente provided medical treatment that was unpaid at the time the application was filed. Thereafter, Kaiser filed a lien claim and the workers' compensation judge denied it. The Appeals Board denied Kaiser's petition for reconsideration and said that a lien may not be allowed when there is nothing to attach.
Note:	Lien claim filed after C&R approved denied as there are no funds on which to attach.
Citation:	52 CCC 220 (Writ Denied)
WCC Citation:	WCC 28771987 CA

Case Name:	Perry v. WCAB		11/21/1972
Summary:	LEROY M. PERRY, Petitioner, v. WORKMEN'S COMPENSATION APPEALS BOARD, STATE OF CALIFORNIA et al. , Respondents (Opinion by Weinberger, J. , with Molinari, P. J. , and Elkington, J. , concurring. )[1] The case involves reconciliation of the provisions of Labor Code section 4850 and 4854. (See Austin v. City of Santa Monica (1965) 234 Cal. App. 2d 841, 844-845 [44 Cal. Rptr. 857]; City of Palo Alto v. Industrial Acc. [Fraide] (1965) 63 Cal. 2d 242, 253 [46 Cal. Rptr. 97, 404 P. 2d 801]; City etc. of S. F. v. Workmen's Comp. In the absence of an express direction that the former are in lieu of the latter, they should be considered cumulative.
Note:	Injured fireman entitled to full comp. for PD and paid leave of absence with no credit given to employer.
Citation:	28 Cal.App.3d 828
WCC Citation:	WCC 27051972 CA

Case Name:	Peterson v. CIGA		01/26/2009
Summary:	FACTS This matter is the conclusion of litigation that arose in 1998 when David Peterson, now deceased, was injured at work. Under that agreement, petitioner agreed, among other matters, to pay CIGA a certain percentage of David's net recovery in the tort case and to credit CIGA for a certain amount of payments made on David's behalf. It ordered CIGA "to refund $333,553. 00 less 25% of sums CIGA incurred" for medical expenses it had paid on behalf of David from October 29, 2003, to the time of his death. In June 2007, CIGA paid $257,072. 19, an amount agreed upon by the parties as representing the principal amount ordered by the court, $333,553, less 25 percent of sums CIGA had paid for David's medical expenses, or $76,480. 81. This is the exact amount of the offset CIGA took under the award: $333,553. 00 (the principal amount ordered by the court) less $76,480. 81 equals $257,072. 19, the amount CIGA refunded to petitioner.
Note:	The California Insurance Guarantee Association owes the family of a deceased worker 10% annual post-judgment interest on a trial court's award of $257,072 because the 2004 order contained a specific formula for damages.
Citation:	C057814
WCC Citation:	WCC 34852009 CA

Case Name:	Peterson v. State of CA., etc.		12/05/1995
Summary:	On July 13, 1993, Ms. Peterson was examined by Dr. Robert M. Tager, an agreed medical examiner. This application indicated a bona fide dispute with regard to a need for further medical treatment and permanent disability. The stipulations and issues framed at that time were essentially the same as the stipulations and issues at the MSC. The employee testified concerning her occupation and that her complaints were about the same as when examined by Dr. Tager. 217, 135 P. 966 aff'd 249 US 337, State Compensation Fund v. Workers' Compensation Appeals Board (McDowell) 76 Cal.
Note:	Assessment of atty. fee only after employer files appl. for adjudication.
Citation:	60 CCC 1206 (En Banc)
WCC Citation:	WCC 3651995 CA

Case Name:	Pettigrew v. WCAB		09/26/2006
Summary:	The workers' compensation judge (WCJ) and the WCAB found that Pettigrew was not acting as a peace officer at the time he stopped at the accident and that his job duties did not require him to stop and render aid and, therefore, Pettigrew was not within the course and scope of his employment when he was injured. Pettigrew did not introduce any evidence that he was paid with institutional time off for assisting at the accident. Pettigrew filed a petition for reconsideration with the WCAB. We conclude there is, thus Pettigrew fails to show there are grounds for annulment of the WCAB order. We conclude Pettigrew fails to show grounds for annulment of the WCAB order denying his petition for reconsideration.
Note:	The employee was not acting as a peace officer at the time he stopped at the accident as his job duties did not require him to stop and render aid.
Citation:	143 Cal. App. 4th 397
WCC Citation:	WCC 31832006 CA

Case Name:	Pham v. WCAB		02/25/2000
Summary:	NGOC HAI THI PHAM, an Incompetent Person, etc. , Petitioner, v. WORKERS' COMPENSATION APPEALS BOARD, CONCORDE FRENCH BAKERY, INC. , et al. , Respondents. In 1994, applicant's earnings from Bakery were $16,129. 48, and she earned $14,052. 40 working another part-time job for Monte G. Bish. As pointed out by [Bakery], the evidence regarding earnings shows a decrease in earnings between 1993 and 1995. 'A reasonable and fair determination of applicant's earning capacity is reflected in applicant's earnings at the time of injury. Subdivision (a) of section 4453 specifies the maximum and minimum levels for average weekly earnings for specified dates of injury.
Note:	Time of injury earnings used to reflect AWW and AWW capacity
Citation:	78 Cal.App.4th 626
WCC Citation:	WCC 23852000 CA

Case Name:	Pharris Sand & Gravel Inc. v. WCAB		12/23/1982
Summary:	No. 27959 December 23, 1982 C. L. PHARRIS SAND & GRAVEL, INC. , ET AL,. Employer is in the business of producing rock, sand and gravel and, as a member of an association of rock, sand and gravel producers, is a party to a [138 CalApp3d Page 587] collective bargaining agreement between the association and Local 12 of the International Union of Operating Engineers. The curriculum, the class schedules, the location and time of classes and class assignments are determined and made by the trust. 105, 495 P. 2d 433], and questioning whether applicant was in the employ of any of the defendants*fn2 while attending apprenticeship classes. "'Ordinarily, under the going and coming rule, an injury which occurs while an employee is driving to or from work is not compensable .
Note:	For special mission rule to apply, employer must have requested employee to undertake errand.
Citation:	138 Cal. App. 3d 584
WCC Citation:	WCC 30391982 CA

Case Name:	Phillips vs/ Sacramento Co. Utilities Dist.		08/04/1998
Summary:	WORKERS' COMPENSATION APPEALS BOARD STATE OF CALIFORNIA VINCE PHILLIPS (Deceased); TINA PHILLIPS, individually, and as Guardian ad Litem and Trustee for COLE PHILLIPS and JAKOB PHILLIPS, Applicants, vs. SACRAMENTO MUNICIPAL UTILITIES DISTRICT, Permissibly self-insured, Defendant. The decedent, Vince Phillips, was employed as a tree trimmer by the Sacramento Municipal Utilities District. But Labor Code section 4453 limits "average weekly earnings" to a maximum amount which depends on the date of injury. Relying on Labor Code section 4461. 5, the WCR awarded death benefits at rates of up to $441. 40 per week. Therefore, when the temporary disability rate is increased pursuant to section 4661. 5, the death benefit rate must similarly be increased.
Note:	Adjustment per LC 4661.5 applies to weekly death benefit rate.
Citation:	63 CCC 585. 595
WCC Citation:	WCC 29061998 CA

Case Name:	Phillips, Spallas & Angstadt, LLP v. Fotouhi		07/27/2011
Summary:	PHILLIPS, SPALLAS & ANGSTADT, LLP v. FOTOUHI PHILLIPS, SPALLAS & ANGSTADT, LLP et al. , Plaintiffs and Respondents, v. SHAHAB E. FOTOUHI et al. , Defendants and Appellants. [,]" Fotouhi, Epps, Hillger & Gilroy, P. C. (the Corporation); and (3) adding both the Partnership and the Corporation to the judgment against Fotouhi as his alter egos. FACTUAL BACKGROUND In November 2000, Fotouhi entered into a partnership agreement with Phillips, Spallas & Fotouhi, LLP (the Phillips firm). Fotouhi, Epps, Hillger & Gilroy, LLP registered as a limited liability partnership on March 25, 2004. *fn2 The superior court confirmed the arbitration award against Fotouhi and entered a $2. 4 million judgment in plaintiffs' favor on June 17, 2009.
Note:	An appellate court affirmed a charging order that will help one law firm collect a $2.4 million judgment against a firm that was created by a former partner.
Citation:	A129047
WCC Citation:	WCC 37842011 CA

Case Name:	Pizarro v. Superior Court		09/18/1967
Summary:	RAYMON PIZARRO, Petitioner, v. THE SUPERIOR COURT OF SANTA CLARA COUNTY, Respondent; ALBERT D. ALVES, Real Party in Interest. For authority, Greitz relied on Vickich v. Superior Court (1930) 105 Cal. App. 587 [288 P. 127], and Loustalot v. Superior Court (1947) 30 Cal. 2d 905 [186 P. 2d 673]. The court then reviewed in depth the legislative history of section 5955 and reiterated and emphasized that the superior court lacked jurisdiction to in any way interfere with any order of the commission. Without mentioning the decisions reviewed above, the respondent court relied instead for authority on Gamble v. Superior Court (1919) 39 Cal. App. 661 [179 P. 717] fn. An order of the Industrial Accident Commission may not be reviewed by a superior court even though it is erroneous.
Note:	Superior court had no equity jurisdiction to enjoin execution of judgment.
Citation:	254 Cal.App.2d 416
WCC Citation:	WCC 26111967 CA

Case Name:	Pizza Hut of San Diego, Inc. v. WCAB		01/13/1978
Summary:	PIZZA HUT OF SAN DIEGO, INC. , et al. , Petitioners, v. WORKERS' COMPENSATION APPEALS BOARD and BARBARA W. BAILEY, Respondents. Pizza Hut of San Diego, Inc. (Pizza Hut) seeks annulment of a workers' compensation award on the ground the applicant's claim is barred by the one-year statute of limitations established by Labor Code section 5405. fn. 1 Upon reconsideration the Workers' Compensation Appeals Board (Board) rejected Pizza Hut's claim of bar for two reasons: (1) Pizza Hut had failed to prove its affirmative defense based upon the statute of limitations, and (2) Pizza Hut was estopped to assert the statute of limitations under the doctrine announced in Reynolds v. Workmen's Comp. On May 20, 1974, Barbara W. Bailey slipped and fell on a wet floor at the Pizza Hut restaurant where she was employed as a store manager. The accident was witnessed by a regional manager of Pizza Hut.
Note:	Time limit for filing new and further disability extends until 5 years after employer last volunteered benefits.
Citation:	76 Cal.App.3d 818
WCC Citation:	WCC 27721978 CA

Case Name:	Placer Co. v. WCAB (Halkyard)		06/21/1995
Summary:	Placer County Office of Education, Claims Management, Inc. , Petitioners v. WorkersCompensation Appeals Board, Mary Halkyard, Respondents. The WCJ in his Report and Recommendation on Reconsideration relied upon Admin. With regards to earnings, Defendant argued that since Applicant earned zero wages off-season, Applicant's correct off-season earnings rate would be zero. The WCAB denied reconsideration, and Defendant's Petition for Writ of Review was also denied. The Board found that the WCJ should not have included unemployment compensation in computing Applicant's TD during her off season.
Note:	Applicant's testimony will support P&S finding; WCJ may estimate off season earn capacity.
Citation:	60 CCC 641(Writ Denied)
WCC Citation:	WCC 28811995 CA

Case Name:	PM&R Associates v. WCAB		04/27/2000
Summary:	[80 Cal. App. 4th 361] PM & R filed a petition for writ of review, claiming the decision of the WCAB is incorrect. Dr. Sharma and Dr. Wlasichuk set up an office in Visalia, California known as PM & R (Physical Medicine and Rehabilitation) Associates. By allowing the WCAB to determine this issue, PM & R contends there is a substantial risk of obtaining conflicting opinions. To the extent the WCAB cannot determine any of the issues without a case-by-case analysis, it should proceed with a case-by-case analysis. The WCAB is ordered to grant petitioner's petition for reconsideration and conduct further proceedings in accordance with this opinion.
Note:	WCAB jurisdiction over payment of med. treatment controversies includes allowing use of med. assistants in administering treatment.
Citation:	80 Cal.App.4th 357
WCC Citation:	WCC 26372000 CA

Case Name:	Polanco v. Truck Ins.		06/02/2010
Summary:	Filed 6/2/10 Polanco v. Truck Ins. IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA SECOND APPELLATE DISTRICT DIVISION THREE ROLANDO POLANCO Plaintiff and Appellant, v. TRUCK INSURANCE EXCHANGE, Defendant and Respondent. INTRODUCTION Plaintiff and appellant Rolando Polanco asserted causes of action for negligence and negligent infliction of emotional distress against defendant and respondent Truck Insurance Exchange. The trial court sustained defendant's demurrer to plaintiff's second amended complaint without leave to amend, and then entered an order dismissing plaintiff's action. "The elements of a cause of action for negligence are: duty; breach of duty; legal cause; and damages.
Note:	[Unpublished] Check issuer did not owe a duty to plaintiff, with the result that it's failure to confirm the genuineness of plaintiff's disability check.
Citation:	B216128
WCC Citation:	WCC 36322010 CA

Case Name:	Polinger v. Delta Airlines		08/10/2009
Summary:	Polinger was employed by DAL Global Services (DGS), a separate entity which contracted with Delta to provide ground services, including cargo loading, to Delta. The evidence showed that Delta trained Polinger on the use of the system, Polinger took special courses from Delta to become a trainer himself, and Polinger trained hundreds of people on the use of the system. * Similarly, Delta asked Polinger to "[a]dmit that Delta did not have the right to control the method Polinger used to perform his work in loading cargo for DGS," and Polinger responded, "Deny," making the same objections. Polinger answered, with respect to each of the two responses just quoted, as follows: "[A]though [Polinger] was not an employee of Delta, [DGS's] goals, targets, and work in and around Delta planes were set by Delta with the express goal of [DGS] pleasing [its] customer Delta. If Delta wished to obtain an admission from Polinger that it (Delta) had the right to control the manner or method in which he performed his work, it should have asked Polinger to admit precisely that.
Note:	[Unpublished] Triable issues of fact clearly exist on the question whether defendant was plaintiff's special employer, so summary judgment on that issue should not have been granted.
Citation:	B204958
WCC Citation:	WCC 35532009 CA

Case Name:	Pollock Stockton Shipbuilding Co. v. WCAB		01/26/1998
Summary:	Pollock Stockton Shipbuilding Company, Chubb/Pacific Indemnity Company, Petitioners v. Workers' Compensation Appeals Board, Robert D. Torres (Dec'd), Sue Torres (Widow), Respondents Deceased employee, Robert Torres, claimed a cumulative injury to his lungs and respiratory system from exposure to asbestos. The WCAB had a hearing on March 25, 1996, examining many issues such as the date of decedent's last expoure to asbestos, medical-legal bills, and approval of a C&R agreement. The presiding WCJ approved this C&R, and there was to be adjustment of contribution between Fireman's Fund and Chubb. The WCJ issued its Findings & Award on April 9, 1996, finding that decedent was last exposed to asbestos on September 30, 1943, while he was an employee for Pollock. The WCAB denied reconsideration, and defendant's petition for writ of review was also denied.
Note:	Request for credit for employee's 3rd party settlement must be made in a timely manner.
Citation:	63 CCC 212 (Writ Denied)
WCC Citation:	WCC 25991998 CA

Case Name:	Porter v. Board of Retirement Orange County		06/18/2008
Summary:	IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA FOURTH APPELLATE DISTRICT DIVISION THREE MARY PORTER, Plaintiff and Appellant, v. BOARD OF RETIREMENT OF THE ORANGE COUNTY EMPLOYEES' RETIREMENT SYSTEM, Defendant and Respondent. Ct. No. 03CC10643) OPINION Appeal from a judgment of the Superior Court of Orange County, Gregory H. Lewis, Judge. * * * This case deals with payment of disability retirement to plaintiff Mary Porter by defendant Board of Retirement of the Orange County Employees' Retirement System. (Porter v. Board of Retirement of the Orange County Employees' Retirement System (Dec. 23, 2005, G034319) [nonpub. Suffice it to say plaintiff was injured while driving a bus for the Orange County Transportation Authority.
Note:	[Unpublished] Because she filed this appeal before defendant held a hearing to determine the amount of workers' compensation paid to her and whether she could afford to repay it, plaintiff has not exhausted her administrative remedies and appeal is premature.
Citation:	G038450
WCC Citation:	WCC 33852008 CA

Case Name:	Portillo v. Commission on Professional Competence		06/17/2011
Summary:	PORTILLO v. COMMISSION ON PROFESSIONAL COMPETENCE SABELA PORTILLO, Plaintiff and Appellant, v. COMMISSION ON PROFESSIONAL COMPETENCE, Defendant and Respondent, LOS ANGELES UNIFIED SCHOOL DISTRICT et al. , Real Parties in Interest and Respondents. Proc. , § 1094. 5. )*fn1 Portillo's superior court petition sought to overturn a decision by the Commission on Professional Competence (the Commission) upholding the determination of the governing board of defendant and respondent Los Angeles Unified School District (the District) to dismiss Portillo as a certificated employee of the District. Pittsburg Unified School District v. Commission on Professional Competence (1983) 146 Cal. App. 3d 964, 971. "The "decision of a Commission on Professional Competence may be challenged in superior court by means of a petition for a writ of mandate. 313-314, italics added; accord Wilmot v. Commission on Professional Competence (1998) 64 Cal. App. 4th 1130, 1138-1139. )
Note:	The 2nd District Court of Appeal upheld the termination of a Los Angeles Unified School District employee who pled nolo contendre to workers' compensation fraud.
Citation:	B220735
WCC Citation:	WCC 37742011 CA

Case Name:	Portnov v. Farmers Insurance Exchange		12/09/2011
Summary:	INTRODUCTION Appellant Mikhail Portnov was an independent contractor insurance agent for respondent Farmers Insurance Exchange (Farmers). As part of Portnov's training, Farmers trained Portnov "to call, use and rely on Farmers' Workers' Compensation `1-800' Support telephone number/Customer Service for questions about writing his customers' Farmers' insurance policies. "Under the agreement, Portnov agreed to sell Farmers insurance policies and Farmers agreed to pay Portnov commissions for selling insurance. In January 2005, Concord General Insurance Services, Inc. (Concord), a retail insurance broker, contacted Portnov to seek workers' compensation insurance for Execair Maintenance, Inc. (Execair), a client of Concord's. Portnov alleges that "Farmers did in fact provide training, support, guidance, backing and consult from Rick Rasnick, Peter Young, Dawn Fields, Farmers Business Support Center Personnel employees, Farmers Home Office Management employees, Farmers websites/computer system, Farmers instructors, Farmers employees and agents and nameless employees that held themselves out as Farmers corporate employees or agents, either in person, writing or by telephone. "
Note:	Farmers Insurance Exchange did not breach its contract with an insurance agent who was forced to resign after failing to provide an employer with sufficient workers' compensation coverage.
Citation:	E050688
WCC Citation:	WCC 38312011 CA

Case Name:	Postural Therapeutics v. WCAB		03/31/1986
Summary:	POSTURAL THERAPEUTICS, Petitioner, v. WORKERS' COMPENSATION APPEALS BOARD, HOME INSURANCE COMPANY et al. , Respondents. [1a] Postural Therapeutics (PT) provided physiotherapy to Humberto A. who was injured while employed as a painter by Romero & Sons Painting Contractors. I have no reason to change my statements in any of my preceding reports based upon the findings in this report. '2 At trial, Humberto A. refused to produce Buehler's report, claiming it would be a 'violation of federal law. 'This is to include adjustment of the lien claim of Postural Therapeutics which claim is $5,190. '
Note:	Insurer's failure to serve physiotherapy provider with Petition for Recon. was grounds for dimissal; Failure to serve is not prejudicial error when party has notice/opportunity to argue once Petition is granted.
Citation:	179 Cal.App.3d 551
WCC Citation:	WCC 26771986 CA

Case Name:	Potter v. Ariz. So. Coach Lines, Inc.		06/15/1988
Summary:	JOSEPH L. POTTER et al. , Plaintiffs and Appellants, v. ARIZONA SOUTHERN COACH LINES, INC. , et al. , Defendants and Respondents (Opinion by Stone (S. [202 Cal. App. 3d 130] Joseph Potter and wife Rita appeal from an order dismissing Arizona Southern Coach Lines, Inc. (Arizona) and Michael Parzych as defendants after their demurrer to appellants' third amended complaint was sustained without leave to amend. At that time, Rita Potter was suffering from a life-threatening illness which required extensive and costly medical treatment; Joseph Potter had previously sustained a serious and permanent injury which would also require extensive medical expense. Neither Arizona nor the group insurers notified appellants of their statutory right to convert group to individual coverage without further proof of insurability. Proc. , § 452; Foster v. xerox Corp. (1985) 40 Cal. 3d 306, 312 [219 Cal. Rptr. 485, 707 P. 2d 858]. )
Note:	Civil action prohibited against employer for damages due to failure to notify of health insurance on termination.
Citation:	202 Cal.App.3d 126
WCC Citation:	WCC 3881988 CA

Case Name:	Potter v. WCAB		03/28/1991
Summary:	n1 Bertram Potter is the senior partner in Potter & Cohen and has many years of experience practicing workers' compensation law in California. Although it was standard office procedure for Potter & Cohen to file a lien claim, apparently no lien claim by Potter & Cohen was filed in applicant's case. Paul Potter customarily practices criminal law, but agreed to represent applicant because applicant is deaf and Paul Potter speaks sign language. Chairman Little determined Paul and Bertram Potter were guilty of contempt of the Board and imposed a $ 250 fine against Paul Potter and a $500 fine against Bertram Potter. Moreover, Paul Potter testified it was standard office procedure at Potter & Cohen for a lien claim to be filed, and no evidence was introduced to support a finding that Paul Potter intentionally delayed submitting the agreement to the Board.
Note:	Portion of indemnity placed in trust for potential attorney fee valid with WCAB approval.
Citation:	56 CCC 225
WCC Citation:	WCC 25161991 CA

Case Name:	Power Fabricating v. SCIF		10/29/2008
Summary:	* * * State Compensation Insurance Fund (State Fund) obtained summary judgment in an action filed by plaintiff Power Fabricating, Inc. , (Power), which sought declaratory relief and damages arising from State Fund's failure to defend it in a separate action against Power brought by the widow of a worker who died in an industrial accident. Power contends it presented a triable issue of fact on whether the decedent was employed by Power, a related entity, or a joint venture between the two entities. State Fund compensated Kryzak's widow under part 1, and Power does not contend part 1 created a duty to defend Power in the Kryzak action. In essence, Power seeks to aggregate the TPSI and Power entities to invoke ELI coverage, yet separate the two companies to avoid the ELI workers' compensation exclusion. On page 2, second sentence of the first full paragraph, beginning "Power contends it presented" is deleted and the following sentence is inserted in its place Power contends it presented a triable issue of fact on whether the decedent was employed by Power, an entity related to Power, or a joint venture between the two entities.
Note:	Employer liability insurance (ELI) coverage can accrue only if...(b) workers' compensation law either does not apply to the situation or the employer may be sued in a capacity other than as an employer. Because Power failed to raise a triable issue of fact on any of the conditions required in (b), ELI coverage cannot be triggered.
Citation:	G039635
WCC Citation:	WCC 34482008 CA

Case Name:	Power Fabricating v. State Compensation Ins. Fund		09/30/2008
Summary:	IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA FOURTH APPELLATE DISTRICT DIVISION THREE POWER FABRICATING, INC. , Plaintiff and Appellant, v. STATE COMPENSATION INSURANCE FUND, Defendant and Respondent. * * * State Compensation Insurance Fund (State Fund) obtained summary judgment in an action filed by plaintiff Power Fabricating, Inc. , (Power), which sought declaratory relief and damages arising from State Fund's failure to defend it in a separate action against Power brought by the widow of a worker who died in an industrial accident. Power tendered defense of the action to State Fund and Power's commercial general liability insurer, Liberty Surplus Insurance Corporation (Liberty). Power brought the present action for damages and declaratory relief against State Fund and Liberty, alleging they each had a duty to defend and indemnify Power in connection with the Kryzak action. State Fund compensated Kryzak's widow under part 1, and Power does not contend part 1 created a duty to defend Power in the Kryzak action.
Note:	[Unpublished] Employer liability insurance (ELI) coverage can accrue only if...(b) workers' compensation law either does not apply to the situation or the employer may be sued in a capacity other than as an employer. Because Power failed to raise a triable issue of fact on any of the conditions required in (b), ELI coverage cannot be triggered.
Citation:	G039635
WCC Citation:	WCC 34322008 CA

Case Name:	Power Fabricating, Inc. v. Liberty Surplus Insurance Corp.		10/30/2007
Summary:	This opinion has not been certified for publication or ordered published for purposes of rule 8. 1115. OPINION Plaintiff Power Fabricating, Inc. , (Power) challenges the judgment entered after the trial court sustained the demurrers of defendant Liberty Surplus Insurance Corporation (Liberty) without leave to amend. Power tendered defense of the action to its workers' compensation insurer, State Compensation Insurance Fund (State Fund) and its commercial general liability (CGL) insurer, Liberty. ), Power demurred to the complaint in the Kryzak action, arguing that Power employed Kryzak at the time of the accident. Attached to the complaint as exhibits were Kryzak's employment agreement with Power, a payroll check reflecting Power as his employer, and a W-2 form also reflecting Power as Kryzak's employer. Liberty demurred to the complaint, citing its CGL policy's exclusion for employees and claims covered by workers' compensation insurance.
Note:	[Unpublished] Whether the injured worker was the insured's employee acting within the course and scope of that employment is a mixed question of law and fact, and therefore does not constitute a binding judicial admission against the insured.
Citation:	G037648
WCC Citation:	WCC 32742007 CA

Case Name:	Powers v. WCAB (Vapor Cleaners)		09/14/1995
Summary:	Powers, applicant's Attorney O'Boyle sent a letter to defendant's Attorney Cohen asking for payment of Dr. Powers they were not going to pay the bill, because they questioned the medical necessity for the MRIs. Powers was billing for services which had actually been performed at a facility with which Powers had contracted to provide service, and declared they would only pay the direct, lesser charges of the facility. Powers because he had not provided defendant carrier with information about the charges of the facility with which Dr. Powers had contracted to perform the MRIs of applicant, defendant carrier would continue to contest the reasonableness of the billing.
Note:	Lien claimant denied due process if not afforded a hearing prior to approval of C&R which reduces lien.
Citation:	60 CCC 821
WCC Citation:	WCC 27501995 CA