WCPanelIQ
PanelDenied

Cabrera, Felix

FELIX CABRERA, Applicant vs. OAA INVESTMENTS, INC.; ET AL.; CALIFORNIA RESTAURANT MUTUAL BENEFIT CORP., self-insured, administered by LWP CLAIMS SOLUTIONS, Defendants

ADJ number
ADJ11114421
Decision date
Jun 4, 2025
District office
San Diego
WCJ
Jim Hopkins (Workers' Compensation Administrative Arbitrator)
Claim administrator
LWP Claims Solutions (administering for California Restaurant Mutual Benefit Corporation, self-insured)
Commissioners
JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: head, neck, back

LC §5900LC §5902LC §5903LC §5905CCR §15489.1CCR §15420CCR §15480CCR §10510

Summary

Applicant Felix Cabrera, a tree trimmer, claimed an industrial injury to his head, neck, and back on November 22, 2017, while working for OAA Investments, which had purchased Josephine Development (insured by CRMBC) on October 13, 2017. CRMBC accepted three monthly premium payments from OAA (October-December 2017) totaling $6,635.16 and never returned them, but later issued a February 14, 2018 cancellation letter with a retroactive cancellation date of October 14, 2017, after learning of the injury. The arbitrator (WCA) found the cancellation premature and unsupported, holding that under Insurance Code section 676.8 CRMBC could not cancel until at least 30 days after notice of intent, making January 27, 2018 the earliest cancellation date—after the injury. The Appeals Board affirmed, finding CRMBC waived its reporting requirements by accepting payments and was equitably estopped from denying coverage, and remained liable through the 45-day notice period under AD Rule 15480. The Board treated the petition as one for reconsideration and affirmed the F&O.

Issues

Member is $25/month or $250/year and includes full case search.

Holding

Member is $25/month or $250/year and includes full case search.

Analysis

Member is $25/month or $250/year and includes full case search.

Applicant takeaway

Member is $25/month or $250/year and includes full case search.

Defense takeaway

Member is $25/month or $250/year and includes full case search.

Provider takeaway

Member is $25/month or $250/year and includes full case search.

Similar decisions

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.