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LOBPolicyNumberPolicy#SuffixPolicyIdEffectiveDateExpirationDate
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DeductibleAmount
InsuredNameBrokerNameClaimNumber
ClaimantStatus
LossDate
LossDescription
LossTypeDescLossLocationAdjusterName
OccupationClassCd
ResultingInjuryDesc
PartInjuredDesc
StateOfJurisdiction
ClosedDateReopenedDateReportedDate
IndemnityReserves
IndemnityPayments
IndemnityRecoveries
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MedicalReserves
MedicalPayments
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LossReservesLossPayments
LossRecoveries
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LegalPayments
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TotalIncurredClaimantNameClaimantDOB
ClaimantHireDate
ClaimantDepartment
DateFirstAware
Valuation_Date
Carrier
Delay in Claim Reporting to Carrier (In Days)
Cause - Hierarchy
Body Part - Hierarchy
2
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme1Closed01/03/23
EE fell from ladder injuring right shoulder.
Medical
Kingsburg, CA 93631
0016 0016
Fall or Slip - From Ladder or Scaffolding
Shoulder(s)CA00001608.281608.280.001,608.280.001,608.280383.02383.0201991.31991.3
Diaz, Juan Francisco
11/01/23
Southern Insurance Co
Fall, Slip or Trip Injury
Upper Extremities
3
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme2Closed01/06/23
The employee was cutting some branches from a tree that fell during the rain and he did not realize there was branches of poison ivy.
Indemnity
Kingsburg, CA 93631
0040 0040
Strain or Injury By - Miscellaneous (NOC)
Multiple Body Parts
CA087.6287.620460.03460.030.00547.650.00547.65020.2320.230567.88567.88
Escamilla, Francisco
11/01/23
Southern Insurance Co
Strain or Injury by
Multiple Body Parts
4
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme3Open01/17/23
The employee was picking up irrigation hose from the ground by the edge of the grape block and fell hurting his left leg and left
Indemnity
Kingsburg, CA 93631
0040 0040
Fall or Slip - Miscellaneous (NOC)
Multiple Body Parts
CA1828.113796.7215624.825542.756457.25120007,370.8520,253.970.0027,624.821680.63819.3725009051.4821073.3430124.82
Sanchez, Vicente
11/01/23
Southern Insurance Co
Fall, Slip or Trip Injury
Lower Extremities
5
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme4Closed01/21/23
EE stepped in a hole and twisted right ankle.
Indemnity
Kingsburg, CA 93631
0045 0045
Fall or Slip - Into Openings
AnkleCA02846.072846.0701879.751879.750.004,725.820.004,725.820454.55454.5505180.375180.37
Leon Rios, Esperanza
11/01/23
Southern Insurance Co
Fall, Slip or Trip Injury
Lower Extremities
6
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme5Closed01/23/23
Chest pain, Musculoskeletal
Indemnity
Kingsburg, CA 93631
0040 0040
Strain or Injury By - Repetitive Motion
Chest (Incl. Ribs, Strenum, & So
CA01/25/230000184.7184.70.00184.700.00184.7003.753.750188.45188.45Cruz, Jacinto11/01/23
Southern Insurance Co
2
Strain or Injury by
Trunk
7
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme6Closed01/24/23
EE lifted ATV and felt pain from right arm up to the shoulder.
Medical
Kingsburg, CA 93631
0172 0172
Strain or Injury By - Lifting
ElbowCA01/26/230000605.33605.330.00605.330.00605.330407.68407.6801013.011013.01
Magdaleno Torres, Jesus
11/01/23
Southern Insurance Co
2
Strain or Injury by
Upper Extremities
8
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme7Closed01/30/23
EE slipped and fell down on top of crate.
Medical
Kingsburg, CA 93631
0040 0040
Fall or Slip - From Different Level
Chest (Incl. Ribs, Strenum, & So
CA02/03/230000537.51537.510.00537.510.00537.510360.46360.460897.97897.97
Pascual Luna, Jose
11/01/23
Southern Insurance Co
4
Fall, Slip or Trip Injury
Trunk
9
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme8Closed01/30/23
Employee was ontop of crate working on tall vines when he got a cramp on his hands and feet falling back and hitting his head losing
Medical
Kingsburg, CA 93631
0040 0040
Fall or Slip - From Different Level
Multiple Head Injury
CA00001508.861508.860.001,508.860.001,508.860666601574.861574.86
Bravo, Reymundo
11/01/23
Southern Insurance Co
Fall, Slip or Trip Injury
Head
10
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme9Closed01/31/23
EE was hit in left eye by grape stem.
Medical
Kingsburg, CA 93631
0040 0040
Struck or Injured By - Object Lifted or Handled
Eye(s)CA02/02/230000488.88488.880.00488.880.00488.88025.1925.190514.07514.07Ortiz, Raul11/01/23
Southern Insurance Co
2
Struck or Injured by
Head
11
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme10Closed02/02/23
EE was hit on the lip with pruning shears.
Medical
Kingsburg, CA 93631
0045 0045
Strain or Injury By - Using Tool or Machinery
MouthCA0000475.55475.550.00475.550.00475.55024.8724.870500.42500.42
Banegas, Jorge
11/01/23
Southern Insurance Co
Strain or Injury by
Head
12
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme11Open02/04/23
Employee was checking irrigation pump. He bent down to pick up a bucket that is used to fuel the irrigation pump. The bucket was
Indemnity
Kingsburg, CA 93631
0016 0016
Strain or Injury By - Miscellaneous (NOC)
Multiple Upper Extremities
CA41398.7111149.3452548.0574839.09127339.88202178.97116,237.80138,489.220.00254,727.0227397.127301.0634698.18143634.92145790.28289425.2
Guzman Osuna, Enrique
11/01/23
Southern Insurance Co
Strain or Injury by
Upper Extremities
13
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme12Closed02/07/23
EE was stung by a bee on right side of the face (eyebrow).
Medical
Kingsburg, CA 93631
0040 0040
Misc. Causes - Foreign Matter (Body) in Eye(s)
Eye(s)CA0000346.86346.860.00346.860.00346.86060.6460.640407.5407.5Gaona, Jazmin11/01/23
Southern Insurance Co
MiscHead
14
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme13Closed02/07/23
EE jumped off ladder and felt pain to left knee.
Medical
Kingsburg,CA 93631
0045 0045
Strain or Injury By - Miscellaneous (NOC)
KneeCA00001342.591342.590.001,342.590.001,342.590500.95500.9501843.541843.54
Venancio, Mariano
11/01/23
Southern Insurance Co
Strain or Injury by
Lower Extremities
15
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme14Closed02/09/23
EE poked right eye with a pomegranate branch.
Medical
Kingsburg, CA 93631
0016 0016
Misc. Causes - Foreign Matter (Body) in Eye(s)
Eye(s)CA0000547.52547.520.00547.520.00547.52040.0940.090587.61587.61
Salinas Quintas, Lucia
11/01/23
Southern Insurance Co
MiscHead
16
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme15Open02/09/23
EE hit his head on a metal pipe.
Indemnity
Kingsburg, CA 93631
0172 0172
Strain or Injury By - Miscellaneous (NOC)
Multiple Upper Extremities
CA6613.3306613.3324723.382893.2127616.5931,336.712,893.210.0034,229.924458.731359.395818.1235795.444252.640048.04
Cisneros, Salvador
11/01/23
Southern Insurance Co
Strain or Injury by
Head
17
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme16Closed02/13/23
EE was climbing down a tractor and when he put his foot down, he twisted his ankle.
Indemnity
Kingsburg, CA 93631
0172 0172
Strain or Injury By - Twisting
AnkleCA02/15/2306580.426580.4207952.037952.030.0014,532.450.0014,532.450640.49640.49015172.9415172.94
Ortiz Martinez, Fabian
11/01/23
Southern Insurance Co
2
Strain or Injury by
Lower Extremities
18
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme17Closed02/14/23
EE got left over residue splashed onto his left side face and eye
Medical
Kingsburg, CA 93631
0040 0040
Misc. Causes - Foreign Matter (Body) in Eye(s)
Eye(s)CA00001229.721229.720.001,229.720.001,229.720358.21358.2101587.931587.93
Garcia Garcia, Hermelo
11/01/23
Southern Insurance Co
MiscHead
19
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme18Closed02/15/23
EE tripped and fell on right hand.
Indemnity
Kingsburg, CA 93631
0045 0045
Fall or Slip - On Same Level
Multiple Upper Extremities
CA026252625016557165570.0019,182.000.0019,182.0004076.134076.13023258.1323258.13
Martinez, Rigoberto
11/01/23
Southern Insurance Co
Fall, Slip or Trip Injury
Upper Extremities
20
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme19Closed02/20/23
Employee was at the press machine that loosens up the soles of the plants, He tried unclogging a tray that got stuck with his left hand
Indemnity
Kingsburg, CA 93631
0005 0005
Cut,Puncture, Scrape - Miscellaneus (NOC)
Finger(s)CA0345.67345.6701408.061408.060.001,753.730.001,753.73059.659.601813.331813.33
Lavin Delgado, Rosendo
11/01/23
Southern Insurance Co
Cut, Puncture, Scrape Injured by
Upper Extremities
21
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme20Closed02/20/23
Employee was spraying when he wanted to get off the tractor, he slipped on the last step and fell to the ground with all his weight on
Indemnity
Kingsburg,CA 93631
0016 0016
Fall or Slip - From Different Level
Multiple Lower Extremities
CA02105.942105.9401463.671463.670.003,569.610.003,569.610134.08134.0803703.693703.69
Perez, David Francisco
11/01/23
Southern Insurance Co
Fall, Slip or Trip Injury
Lower Extremities
22
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme21Open02/21/23
IW was helping coworker pull out almond sweeper with a tractor. IW was getting off the tractor when his co-worker crashed into IW
IndemnityCA0005 0005
Misc. Causes - Other (NOC)
Multiple Lower Extremities
CA1238.4513502588.458812.276187.731500010,050.727,537.730.0017,588.458145.413866.0412011.4518196.1311403.7729599.9
Murillo Garcia, Jose Antonio
11/01/23
Southern Insurance Co
Misc
Lower Extremities
23
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme22Closed03/01/23
EE got a small piece of metal in right eye.
Medical
Kingsburg, CA 93631
0172 0172
Struck or Injured By - Falling or Flying Object
Eye(s)CA0000580.09580.090.00580.090.00580.09024.1724.170604.26604.26Perez, Luis11/01/23
Southern Insurance Co
Struck or Injured by
Head
24
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme23Open03/08/23
EE was grabbing the electrical conveyer belt to roll inside the green house when another employee grabbed a forklift that was one side
Indemnity
Kingsburg, CA 93631
0005 0005
Struck or Injured By- Hand Tool or Machine in
FootCA2755.4620113.0222868.483822.9632437.0836260.046,578.4252,550.100.0059,128.524426.185084.319510.4911004.657634.4168639.01
Cruz Martinez, German
11/01/23
Southern Insurance Co
Struck or Injured by
Lower Extremities
25
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme24Closed03/28/23
EE was sprayed in the face by hose.
Medical
Kingsburg, CA 93631
0172 0172
Misc. Causes - Absorption/Ingestion/Inhalation
Other Head Soft Tissue
CA0000648.12648.120.00648.120.00648.120320.98320.980969.1969.1
Jimenez, Fernando
11/01/23
Southern Insurance Co
MiscHead
26
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme25Closed04/05/23
EE was checking the water irrigaton system when reversing from one field row to enter another row he pressed the gas pedal hard
Medical
Kingsburg, CA 93631
0016 0016
Motor Vehicle - Vehicle Upset
ElbowCA0000582.88582.880.00582.880.00582.88036.6236.620619.5619.5
Hernandez, Luis Osorio
11/01/23
Southern Insurance Co
Motor Vehicle
Upper Extremities
27
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme26Open04/06/23
EE was fixing a water block leak for the almonds and I slipped and twisted right knee
Indemnity
Kingsburg, CA 93631
2107 2107
Fall or Slip - On Same Level
KneeCA5564.819680.6425245.4414809.565190.442000020,374.3624,871.080.0045,245.444113.37386.63450024487.7325257.7149745.44
Nava De Jesus, Rene
11/01/23
Southern Insurance Co
Fall, Slip or Trip Injury
Lower Extremities
28
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme27Open04/13/23
Pls Verify injury
Indemnity
Kingsburg, CA 93631
0005 0005
Strain or Injury By - Miscellaneous (NOC)
Shoulder(s)CA3940126052002317.712682.2950006,257.713,942.290.0010,200.0070074002.1811009.1813264.717944.4721209.18
Acosta, Monica
11/01/23
Southern Insurance Co
Strain or Injury by
Upper Extremities
29
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme28Closed04/20/23
EE was poked in left eye by a branch.
Medical
Kingsburg,CA 93631
0016 0016
Struck or Injured By - Falling or Flying Object
Eye(s)CA0000492.04492.040.00492.040.00492.040320.27320.270812.31812.31
Lopez, Leobardo
11/01/23
Southern Insurance Co
Struck or Injured by
Head
30
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme29Closed05/08/23
EE was lifting sulfur sprayer machine and felt a pop/pain to lower back.
Medical
Kingsburg, CA 93631
0045 0045
Strain or Injury By - Lifting
Back Lower/ Lumbar / Sacral
CA0000506.78506.780.00506.780.00506.780424.93424.930931.71931.71
Garcia Camarillo, Claudio
11/01/23
Southern Insurance Co
Strain or Injury by
Trunk
31
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme30Closed05/11/23
EE was poked in right eye by branch.
Medical
Kingsburg, CA 93631
0045 0045
Strike Against/Step On - Object Handled or
Eye(s)CA0000587.37587.370.00587.370.00587.370317.69317.690905.06905.06Xula, Maria11/01/23
Southern Insurance Co
Striking Against or Stepping on
Head
32
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme31Closed05/12/23
Employee was walking out from the shop after taking his break when he began to feel dizzy and less than 2 seconds lost
Medical
Kingsburg, CA 93631
0045 0045
Fall or Slip - On Same Level
Soft TissueCA00001490.971490.970.001,490.970.001,490.97084.5384.5301575.51575.5
Urzua Ramirez, Marco Antonio
11/01/23
Southern Insurance Co
Fall, Slip or Trip Injury
Neck
33
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme32Closed05/16/23
EE was mixing pesticide chemicals and began to feel his face burn
Medical
Kingsburg, CA 93631
0045 0045
Burn or Scald - Chemicals
Other Head Soft Tissue
CA05/19/230000326.55326.550.00326.550.00326.55021.321.30347.85347.85
A Estevez, Jose
11/01/23
Southern Insurance Co
3
Burn or Scald - Heat or Cold Exposures - Contact With
Head
34
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme33Closed05/17/23
EE states :after finishing his work shift and went home he stated to have pain in his throat
Medical
Kingsburg, CA 93631
0045 0045
Misc. Causes - Absorption/Ingestion/Inhalation
Internal Organs
CA0000547.53547.530.00547.530.00547.5301239.241239.2401786.771786.77Avila, Salvador11/01/23
Southern Insurance Co
MiscMisc
35
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme34Open05/18/23
EE was setting up a 15 foot wooden post that weighs 60 lbs to get pounded in with a post pounder machine by his coworker as his
Indemnity
Kingsburg, Ca 93631,
0040 0040
Strike Against/Step On - Object Handled or
Back Upper/ Thoracic Spine
CA5455.154528.539983.684797.4420202.562500010,252.5924,731.090.0034,983.683498.2510024500.2513750.8425733.0939483.93
Gonzalez, Oscar
11/01/23
Southern Insurance Co
Striking Against or Stepping on
Trunk
36
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme35Closed05/20/23
Kings Medical Center5135 W Noble Ave , Visalia, Ca 93277
Indemnity
Kingsburg, CA 93631
0016 0016
Causes - Absorption/Ingestion/Inhalation
Shoulder(s)CA067.7167.710167.64167.640.00235.350.00235.35013.5913.590248.94248.94
Hernandez Paniagua, Angeles
11/01/23
Southern Insurance Co
Misc
Upper Extremities
37
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme36Closed06/01/23
EE was spraying pomegranites when the spray gun got jammed in the tire causing the gun to shoot pesticide everywhere . EE tried
Medical
Kingsburg, CA 93631
0040 0040
Misc. Causes - Absorption/Ingestion/Inhalation
Multiple Upper Extremities
CA0000282.04282.040.00282.040.00282.040306.04306.040588.08588.08
Aguilar, Manuel
11/01/23
Southern Insurance Co
MIsc
Upper Extremities
38
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme37Closed05/30/23
EE was removing wooden stakes that were very stuck onto the ground and as he pulled he fell backwards putting all his weight onto
Indemnity
Kingsburg,CA 93631
0016 0016
Strain or Injury By - Pushing or Pulling
FootCA05456.315456.3103346.123346.120.008,802.430.008,802.430407.55407.5509209.989209.98
Vasquez Rojas, Natalio
11/01/23
Southern Insurance Co
Strain or Injury by
Lower Extremities
39
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme38Closed05/29/23
EE got debris in right eye.
Medical
Kingsburg,CA 93631
0172 0172
Struck or Injured By - Falling or Flying Object
Eye(s)CA0000783.42783.420.00783.420.00783.420314.54314.5401097.961097.96
Vasquez, Delfino
11/01/23
Southern Insurance Co
Struck or Injured by
Head
40
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme39Open05/24/23
EE put the hose to the spray tank to fill up with pesticide chemical when he turned back to open the faucet he sat the tractor reversing
Indemnity
Kingsburg, CA 93631
0045 0045
Struck or Injured By - Object Handled by Others
Back Lower/ Lumbar / Sacral
CA10559.765456.316016.0620922.364077.642500031,482.129,533.940.0041,016.066557.411949.028506.4338039.5311482.9649522.49
Bravo, Jose Armando
11/01/23
Southern Insurance Co
Struck or Injured by
Trunk
41
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme40Closed05/23/23
Employee was tightening a screw with a wrench when his hand went loose and hit his elbow with a metal piece of the machinery he
Medical
Kingsburg, CA 93631
0040 0040
Strike Against/Step On - Object Handled or
ElbowCA00003073.13073.10.003,073.100.003,073.100143.91143.9103217.013217.01
Carrasco Bejarano, Jose Antonio
11/01/23
Southern Insurance Co
Striking Against or Stepping on
Upper Extremities
42
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme41Closed06/14/23
I was cutting a piece of tape with a knife , it slipped and it cut my left small finger
Medical
Kingsburg,CA 93631
2107 2107
Cut, Puncture, Scrape - Object Being
Finger(s)CA0000800.58800.580.00800.580.00800.580382.81382.8101183.391183.39Salinas, Miguel11/01/23
Southern Insurance Co
Cut, Puncture, Scrape Injured by
Upper Extremities
43
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme42Closed06/14/23
EE lacerated right ear with metal sheet.
Medical
Kingsburg, CA 93631
0040 0040
Cut, Puncture, Scrape - Object Being
Ear(s)CA0000430.85430.850.00430.850.00430.850339.67339.670770.52770.52
Carrasco Bejarano, Jose Antonio
11/01/23
Southern Insurance Co
Cut, Puncture, Scrape Injured by
Head
44
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme43Closed06/13/23
EE was operating a tractor with a grass grinder attachement and was looking back to make sure the job was getting done correctly
Indemnity
Kingsburg,CA 93631
0016 0016
Strain or Injury By - Twisting
Back Lower/ Lumbar / Sacral
CA0270.64270.640374.41374.410.00645.050.00645.05028.4128.410673.46673.46
Ayala Fuentes, Francisco
11/01/23
Southern Insurance Co
Strain or Injury by
Trunk
45
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme44Closed06/10/23
EE was driving a tractor and felt something go into her right eye she got off the tractor
Medical
Kingsburga, CA 93631
0045 0045
Struck or Injured By - Falling or Flying Object
Eye(s)CA0000769.56769.560.00769.560.00769.56023.4823.480793.04793.04Zepeda, Iris11/01/23
Southern Insurance Co
Struck or Injured by
Head
46
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme45Closed06/07/23
EE was filling a pesticide tank with a hose through the top. the hose had a lot of pressure when he opened the water hose lever he
Medical
Kingsburg, CA 93631
0045 0045
Misc. Causes - Foreign Matter (Body) in Eye(s)
Eye(s)CA0000330.1330.10.00330.100.00330.100311.07311.070641.17641.17
Avila Martinez, Luis
11/01/23
Southern Insurance Co
MiscHead
47
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme46Closed06/28/23
EE was at work using a torch when the flame exposed his bilateral eyes
Indemnity
Kingsburg, CA 93631
0016 0016
Struck or Injured By - Motor Vehicle
Eye(s)CA03566.683566.6802490.262490.260.006,056.940.006,056.940523.12523.1206580.066580.06Ramos, Robert11/01/23
Southern Insurance Co
Struck or Injured by
Head
48
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme47Closed06/23/23
EE was on the fourth step of a ladder when he pulled a branch loosing his balance falling off the ladder steps and landing on his left
Indemnity
Kingsburg, CA 93631
0079 0079
Fall or Slip - From Ladder or Scaffolding
WristCA01833.541833.540576.73576.730.002,410.270.002,410.27029.7929.7902440.062440.06
Nava Villa, Humberto
11/01/23
Southern Insurance Co
Fall, Slip or Trip Injury
Upper Extremities
49
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme48Closed06/21/23
EE was weed wacking around work property when he suddenly felt a sting to his left ear and right arm
Indemnity
Kingsburg, CA 93631
0040 0040
Struck or Injured By - Animal or Insect
Ear(s)CA074.8674.860197.54197.540.00272.400.00272.40013.3713.370285.77285.77
Marquez, Octavio
11/01/23
Southern Insurance Co
Struck or Injured by
Head
50
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme49Closed06/16/23
EE got chemical splashed onto right eye.
Medical
Kingsburg, CA 93631
0172 0172
Struck or Injured By - Object Lifted or Handled
Eye(s)CA0000525.95525.950.00525.950.00525.950333.35333.350859.3859.3
Cervantes, Gabriel
11/01/23
Southern Insurance Co
Struck or Injured by
Head
51
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme50Closed06/14/23
A Tractor was stuck co-workers were trying to pull it out with another tractor and chain , EE stepped back 20-25 feet when they started
Indemnity
Kingsburg, CA 93631
0045 0045
Struck or Injured By - Falling or Flying Object
Arm LowerCA099299202561.812561.810.003,553.810.003,553.810285.13285.1303838.943838.94Ramos, Jose11/01/23
Southern Insurance Co
Struck or Injured by
Upper Extremities
52
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme51Closed07/17/23
EE was driving on road Palm Ave south to north when he noticed a vehicle in the opposite direction head on driving at a high speed
Medical
Kingsburg, CA 93631
0045 0045
Struck or Injured By - Motor Vehicle
Neck Soft Tissue
CA0000117.26117.260.00117.260.00117.2602952950412.26412.26
Sanchez Acosta, Pedro
11/01/23
Southern Insurance Co
Struck or Injured by
Neck
53
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme52Closed07/17/23
EE states right flank pain with deep breaths worsened 2 days ago, ee was exposed to plant chemical spray but does not know name
Medical
King city,CA 93930
0016 0016
Misc. Causes - Absorption/Ingestion/Inhalation
LungsCA0000343.35343.350.00343.350.00343.35025.2125.210368.56368.56
Hernandez, Fernando Ortiz
11/01/23
Southern Insurance Co
MiscTrunk
54
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme53Open07/13/23
EE was walking through the field row when he tripped over a mole twisting his left ankle
Indemnity
Kingsburg,CA 93631
0040 0040
Strain or Injury By - Twisting
AnkleCA2131.917818.929950.8317611.52388.52000019,743.4110,207.420.0029,950.8311850.65149.351200031594.0610356.7741950.83
Escamilla, Jose
11/01/23
Southern Insurance Co
Strain or Injury by
Lower Extremities
55
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme54Closed07/09/23unknownMedical
Kingsburg, CA 93631
0016 0016
Motor Vehicle - Collision with Another Vehicle
No Physical Injury
CA0000000.000.000.000.0002952950295295Huerta, Isias11/01/23
Southern Insurance Co
Motor VehicleMisc
56
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme55Open07/07/23
EE began to water his work area when the hose got stuck and he pulled it to unclog it causing him to fall hitting his right knee on the
Indemnity
Kingsburg, CA 93631
0005 0005
Strain or Injury By - Pushing or Pulling
KneeCA3605.0703605.0718534.441465.562000022,139.511,465.560.0023,605.073370.05129.95350025509.561595.5127105.07
Madrigal Nava, Jesus
11/01/23
Southern Insurance Co
Strain or Injury by
Lower Extremities
57
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme56Closed07/31/23
EE injured left index finger.
Medical
Kingsburg, CA 93631
0005 0005
Strain or Injury By - Pushing or Pulling
Finger(s)CA00001866.981866.980.001,866.980.001,866.980628.17628.1702495.152495.15
Gonzalez, Marcelo
11/01/23
Southern Insurance Co
Strain or Injury by
Upper Extremities
58
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme57Open07/26/23
Employee states she was stepping down the tractor holding the tractor door when her left shoulder as she was walking down the
Indemnity
Kingsburg, CA 93631
0045 0045
Struck or Injured By - Motor Vehicle
WristCA1265.0701265.079682.14317.861000010,947.21317.860.0011,265.072456.9643.04250013404.17360.913765.07
Hernandez, Maria
11/01/23
Southern Insurance Co
Struck or Injured by
Upper Extremities
59
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme58Closed07/22/23
EE was performing an oil change on a tractor when he felt a strain to his neck after putting to much force on his shoulders
Indemnity
Kingsburg,CA 93631
0005 0005
Strain or Injury By - Pushing or Pulling
Neck Soft Tissue
CA01712.81712.802517.342517.340.004,230.140.004,230.14089.0689.0604319.24319.2
Garcia Jimenez, Jose Alonso
11/01/23
Southern Insurance Co
Strain or Injury by
Neck
60
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme59Closed07/18/23
EE was taking a picture of the water meter and had to climb on top of the water pump As he was climbing down the water pump he
Indemnity
Kingsburg, CA 93631
0045 0045
Strain or Injury By - Twisting
AnkleCA02128.892128.890885.1885.10.003,013.990.003,013.99019.4819.4803033.473033.47
Mauro, Rogelio
11/01/23
Southern Insurance Co
Strain or Injury by
Lower Extremities
61
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme60Closed07/18/23
EE was cleaning out the water filter for the sprayer machine , As he was cleaning out the filter left over residue fell into this left and
Indemnity
Kingsburg, CA 93631
0045 0045
Struck or Injured By - Object Lifted or Handled
HandCA0194.19194.190319.2319.20.00513.390.00513.39011.2711.270524.66524.66
Sanchez, Jose Luis
11/01/23
Southern Insurance Co
Struck or Injured by
Upper Extremities
62
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme61Open08/23/23
EE was working night shift and as he was turning on the light at her work station outside when she felt a mosquito go into her left eye
Indemnity
Kingsurg, CA 93631
0040 0040
Struck or Injured By - Animal or Insect
Eye(s)CA412.530412.533264.02235.9835003,676.55235.980.003,912.531491.38.715005167.85244.685412.53
Ruiz Quinteros, Maria Juana
11/01/23
Southern Insurance Co
Struck or Injured by
Head
63
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme62Closed08/18/23
EE was sharpening the tip of a shovel when his hand slipped causing him to lacerate his right wrist
Medical
Kingsburg, CA 93631
0016 0016
Struck or Injured By - Object Lifted or Handled
HandCA0000565.5565.50.00565.500.00565.500298.75298.750864.25864.25
Sanchez Guzman, Feliciano
11/01/23
Southern Insurance Co
Struck or Injured by
Upper Extremities
64
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme63Closed08/10/23
EE was trimming vines from the grape vineyards and as he knelled down he felt a trash go into his left eye
Medical
Kingsburg, CA 93631
0040 0040
Struck or Injured By - Object Lifted or Handled
Eye(s)CA0000127.46127.460.00127.460.00127.4608.538.530135.99135.99
Vidal Valentin, Adan
11/01/23
Southern Insurance Co
Struck or Injured by
Head
65
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme64Open08/08/23
CT Claim 1/22/23-8/8/23ADJ18315783Body Part 1 420 BACK - INCLUDING BACK MUSCLES, SPINE AND SPINAL CORD Body Part
Indemnity
Kingsburg, CA 93631
0005 0005
Misc. Causes - Cumulative (NOC)
CA10/16/23119800119801000001000021,980.000.000.0021,980.0035000350025480025480
SOLORIO TORRES, MAYRA
11/01/23
Southern Insurance Co
69MIscTrunk
66
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme65Closed08/04/23
EE jumped off ladder and felt a sharp pain to left hip and lower back.
Medical
Kingsburg, CA 93631
0016 0016
Fall or Slip - From Ladder or Scaffolding
Back Lower/ Lumbar / Sacral
CA0000438.49438.490.00438.490.00438.49021.7121.710460.2460.2
Madrigal Gaytan, Luis
11/01/23
Southern Insurance Co
Fall, Slip or Trip Injury
Trunk
67
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme66Open09/08/23
EE was pushing a grass mower machine and once he finished he stepped on the rail to jump to the other side when he slipped causing
Indemnity
Kingsburg,CA 93631
0016 0016
Struck or Injured By - Object Lifted or Handled
FootCA3856.072956.096812.1610031.8327468.173750013,887.9030,424.260.0044,312.164474.1825.82450018362.0830450.0848812.16
Rosales Valencia, Salvador Leonar
11/01/23
Southern Insurance Co
Struck or Injured by
Lower Extremities
68
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme67Closed08/29/23
EE was hit in left eye by metal bar.
Medical
Kingsburg, CA 93631
0040 0040
Struck or Injured By - Object Lifted or Handled
Eye(s)CA0000574.72574.720.00574.720.00574.720331.55331.550906.27906.27
Gonzalez Leon, Jilberto
11/01/23
Southern Insurance Co
Struck or Injured by
Head
69
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme68Closed08/28/23
EE fell and hurt left knee and right leg.
Medical
Kingsburg, CA 93631
0040 0040
Strain or Injury By - Twisting
KneeCA0000000.000.000.000.0002952950295295
Rivera, Onorato
11/01/23
Southern Insurance Co
Strain or Injury by
Lower Extremities
70
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme69Closed08/24/23
Employee stated that after washing out various containers that contained pesticide chemicals his overall suit was wet with pesticide
MedicalChowchilla, CA0045 0045
Misc. Causes - Other (NOC)
Multiple TrunkCA0000000.000.000.000.00000000
Alaniz Gamboa, Kevin Isaac
11/01/23
Southern Insurance Co
MiscTrunk
71
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme70Closed08/23/23
Employee states he was taking his break around 9:00am and suddenly started to feel his eyes (left and right) get itchy, at 11:00am
MedicalCA0045 0045
Misc. Causes - Foreign Matter (Body) in Eye(s)
Eye(s)CA000095950.0095.000.0095.0000009595
Juarez, Jacinto Luis
11/01/23
Southern Insurance Co
MiscHead
72
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme71Open09/15/23
Employee states he was shoveling normally when he suddenly began to feel a small pain in the middle of his back.
IndemnityCA0045 0045
Strain or Injury By - Using Tool or Machinery
Back Lower/ Lumbar / Sacral
CA2307.74923.143230.889540.21459.791000011,847.951,382.930.0013,230.883192.82307.18350015040.771690.1116730.88
Avendano Zarate, Esau
11/01/23
Southern Insurance Co
Strain or Injury by
Trunk
73
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme72Open09/13/23
EE was walking when he tripped over a water hose with his right leg ee tried placing his left leg forward but his left leg have out and
Indemnity
Kingsburg, CA 93631
0016 0016
Caught In or Between - Object Handled
Back Lower/ Lumbar / Sacral
CA2635.72777.665413.3614046.15953.851500016,681.853,731.510.0020,413.362470.8329.17250019152.683760.6822913.36Reyes, Ulises11/01/23
Southern Insurance Co
Caught In, Under or Between
Trunk
74
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme73Open09/13/23
EE felt a sting to her right side.
Medical
Kingsburg, CA 93631
8810 8810
Struck or Injured By - Animal or Insect
AbdomenCA0003689.74110.23799.943,689.74110.200.003,799.941195.824.1812004885.56114.445000
Lugo, Stephanie
11/01/23
Southern Insurance Co
Struck or Injured by
Trunk
75
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme74Open09/11/23
EE felt pain in lower abdomen.
Indemnity
Kingsburg, CA 93631
0045 0045
Strain or Injury By - Miscellaneous (NOC)
AbdomenCA469.210469.214675.58324.4250005,144.79324.420.005,469.211195.24304.7615006340.03629.186969.21
Lopez Diaz, Luz Alondra
11/01/23
Southern Insurance Co
Strain or Injury by
Trunk
76
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme75Open09/08/23
EE was greasing up a bearing belt and as the employee pulled on the belt to turn the bearing his right hand middle finger got caught
Indemnity
Kingsburg, CA 93631
0016 0016
Caught In or Between - Machine or Machinery
Finger(s)CA9878.871560.711439.5728106.351893.653000037,985.223,454.350.0041,439.574433.0866.92450042418.33521.2745939.57
Jimenez, Ernesto
11/01/23
Southern Insurance Co
Caught In, Under or Between
Upper Extremities
77
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme76Open10/06/23
unknown how it occured Lumbar Contusion, and right hip
Indemnity
Kingsburg, CA 93631
0016 0016
Strain or Injury By - Pushing or Pulling
Back Lower/ Lumbar / Sacral
CA3084.12590.63674.721500001500018,084.12590.600.0018,674.7225000250020584.12590.621174.72
Soto Sandoval, Luis
11/01/23
Southern Insurance Co
Strain or Injury by
Trunk
78
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme77Open10/06/23
EE was leaving the pit and headed out to the weighing area when he breathed in a smell like sulfur
Indemnity
Kingsburg, CA 93631
0040 0040
Misc. Causes - Absorption/Ingestion/Inhalation
No Physical Injury
CA866.310866.313500035004,366.310.000.004,366.311500015005866.3105866.31
Avendano Vasquez, Juan Daniel
11/01/23
Southern Insurance Co
MiscMisc
79
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme78Open09/27/23
Contusion of left elbow, abrasion of left elbow , Cellulitis of elbow , cellulitis of left elbow
Indemnity
Kingsburg,CA 93631
0040 0040
Fall or Slip - On Same Level
ElbowCA64206427354.47145.5375007,996.47145.530.008,142.002494.235.77250010490.7151.310642
Juarez, Yesenia
11/01/23
Southern Insurance Co
Fall, Slip or Trip Injury
Upper Extremities
80
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme79Open09/25/23
EE got an anxiety attack.
Medical
Kingsburg, CA 93631
0045 0045
Misc. Causes - Other Than Physical Cause or
Chest (Incl. Ribs, Strenum, & So
CA000847.96152.041000847.96152.040.001,000.00193.96306.045001041.92458.081500
Hernandez, Maria
11/01/23
Southern Insurance Co
MiscTrunk
81
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme80Open09/20/23
EE felt pain in right shoulder.
Medical
Kingsburg, CA 93631
0045 0045
Strain or Injury By - Pushing or Pulling
Shoulder(s)CA0003415.87384.1338003,415.87384.130.003,800.001181.5518.4512004597.42402.585000
Fuerte, Guillermo
11/01/23
Southern Insurance Co
Strain or Injury by
Upper Extremities
82
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme81Open10/24/23
EE states his right thumb was smashed between two metal pieces on his truck
Indemnity
Kingsburg, CA 93631
0172 0172
Caught In or Between - Object Handled
ThumbCA11934.01918.0412852.052500002500036,934.01918.040.0037,852.0545000450041434.01918.0442352.05Mejia, Cosme11/01/23
Southern Insurance Co
Caught In, Under or Between
Upper Extremities
83
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme82Open10/06/23
EE was leaving the pit and headed out to the weighing area when he breathed in a smell like sulfur
Indemnity
Kingsburg, CA 93631
0040 0040CA10/18/23602.950602.953500035004,102.950.000.004,102.951500015005602.9505602.95
Avendano, Albino
11/01/23
Southern Insurance Co
12
84
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2301/01/24Acme83Open10/06/23
EE was leaving the pit and headed out to the weighing area when he breathed in a smell like sulfur
Indemnity
Kingsburg, CA 93631
0040 0040CA10/18/23573.370573.373500035004,073.370.000.004,073.371500015005573.3705573.37
Vasquez Rios, Florencio
11/01/23
Southern Insurance Co
12
85
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2201/01/23Acme84Closed01/03/22
EE poked right eye with a branch.
Medical
Kingsburg, CA 93631
0040 0040
Strike Against/Step On - Object Handled or
Eye(s)CA0000392.55392.550.00392.550.00392.550314.87314.870707.42707.42
Rodriguez, Omar
11/01/23
Southern Insurance Co
Striking Against or Stepping on
Head
86
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2201/01/23Acme85Closed01/11/22
EE poked left eye with branch.
Medical
Kingsburg, CA 93631
0016 0016
Strain or Injury By - Pushing or Pulling
Eye(s)CA0000536.83536.830.00536.830.00536.830345.69345.690882.52882.52
Lopez Jimenez, Marcos
11/01/23
Southern Insurance Co
Strain or Injury by
Head
87
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2201/01/23Acme86Closed01/11/22
EE was poked in right eye by branch.
Medical
Kingsburg, CA 93631
0016 0016
Strike Against/Step On - Object Handled or
Eye(s)CA0000635.6635.60.00635.600.00635.600318.44318.440954.04954.04Rivera, Andres11/01/23
Southern Insurance Co
Striking Against or Stepping on
Head
88
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2201/01/23Acme87Closed01/27/22
EE was hit with the chisel on the right side of the face.
Indemnity
Kingsburg, CA 93631
0040 0040
Struck or Injured By - Falling or Flying Object
Multiple Body Parts
CA073.3973.390715.63715.630.00789.020.00789.020322.89322.8901111.911111.91Ramos, Robert11/01/23
Southern Insurance Co
Struck or Injured by
Multiple Body Parts
89
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2201/01/23Acme88Closed02/02/22
EE threw stakes and felt pain on his back.
Indemnity
Kingsburg, CA 93631
0040 0040
Strain or Injury By - Lifting
Back Upper/ Thoracic Spine
CA029607.3129607.31024040.9824040.980.0053,648.290.0053,648.29010710.8710710.87064359.1664359.16
Macias Dominguez, Jesus
11/01/23
Southern Insurance Co
Strain or Injury by
Trunk
90
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2201/01/23Acme89Closed03/02/22
EE got stung by bee in right eye area.
Medical
Kingsburg, CA 93631
0005 0005
Struck or Injured By - Animal or Insect
Eye(s)CA0000312.14312.140.00312.140.00312.140309.26309.260621.4621.4
Gonzalez, Felix Alberto
11/01/23
Southern Insurance Co
Struck or Injured by
Head
91
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2201/01/23Acme90Closed02/24/22
Employee was getting off the tractor as he was walking down he rolled his right ankle
Indemnity
Kingsburg, CA 93631
0040 0040
Strain or Injury By - Twisting
AnkleCA0357.1357.10790.27790.270.001,147.370.001,147.370373.94373.9401521.311521.31
Hernandez, Marcos
11/01/23
Southern Insurance Co
Strain or Injury by
Lower Extremities
92
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2201/01/23Acme91Closed02/17/22
EE tripped and fell hitting her chest and hand.
Indemnity
Kingsburg, CA 93631
0005 0005
Fall or Slip - On Same Level
Multiple Body Parts
CA0609.42609.4201609.431609.430.002,218.850.002,218.850586.7586.702805.552805.55
Camacho, Evangelina
11/01/23
Southern Insurance Co
Fall, Slip or Trip Injury
Multiple Body Parts
93
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2201/01/23Acme92Closed02/16/22
EE was walking when she tripped over a branch that was standing and fell down as she fell down she placed her right arm to try to
Indemnity
Kingsburg, CA 93631
0016 0016
Fall or Slip - From Different Level
Multiple Body Parts
CA0644.66644.660645.03645.030.001,289.690.001,289.690318.95318.9501608.641608.64
Torres Vivar, Claudia
11/01/23
Southern Insurance Co
Fall, Slip or Trip Injury
Upper Extremities
94
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2201/01/23Acme93Closed02/03/22
EE was tying trees when he pripped over a hose and fell hurting his back
Indemnity
Kingsburg, CA 93631
0016 0016
Fall or Slip - On Same Level
Back Lower/ Lumbar / Sacral
CA02489.952489.95013265.6713265.670.0015,755.620.0015,755.6206195.46156180.46021951.081521936.08
Esteves Martinon, Ignacio Roberto
11/01/23
Southern Insurance Co
Fall, Slip or Trip Injury
Trunk
95
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2201/01/23Acme94Closed03/16/22
EE's left great toe was smashed by trailer.
Indemnity
Kingsburg, CA 93631
0040 0040
Strike Against/Step On - Moving Parts of
FootCA016001600013996.813996.80.0015,596.800.0015,596.8002083.732083.73017680.5317680.53Valdivia, Juan11/01/23
Southern Insurance Co
Striking Against or Stepping on
Lower Extremities
96
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2201/01/23Acme95Closed03/15/22
EE was hit in left eye by grapevine.
Medical
Kingsburg, CA 93631
0040 0040
Struck or Injured By - Falling or Flying Object
Eye(s)CA0000189.54189.540.00189.540.00189.540311.02311.020500.56500.56Franco, Jesus11/01/23
Southern Insurance Co
Struck or Injured by
Head
97
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2201/01/23Acme96Closed03/15/22
EE was cutting string for the grape vinewhen her hand slipped causing her to cut he left index finger
Medical
Kingsburg,CA 93631
0040 0040
Cut, Puncture,Scrape - Object Being
Finger(s)CA00001185.791185.790.001,185.790.001,185.790382.64382.6401568.431568.43
Bautista Vasquez, Elia
11/01/23
Southern Insurance Co
Cut, Puncture, Scrape Injured by
Upper Extremities
98
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2201/01/23Acme97Closed03/14/22
EE bent over and felt a pull in lower back.
Medical
Kingsburg, CA 93631
0040 0040
Strain or Injury By - Twisting
Back Lower/ Lumbar / Sacral
CA00001191.832.871188.960.001,191.832.871,188.960691.12691.1201882.952.871880.08
Ortiz Lopez, Gabriel
11/01/23
Southern Insurance Co
Strain or Injury by
Trunk
99
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2201/01/23Acme98Closed03/03/22
EE got stung by multiple bees.
Indemnity
Kingsburg, CA 93631
0016 0016
Struck or Injured By - Animal or Insect
Facial BonesCA0121.39121.390449.95449.950.00571.340.00571.340607.66607.66011791179
Gonzalez, Carlos
11/01/23
Southern Insurance Co
Struck or Injured by
Head
100
Worker Compensation
XXXXXXXXXXXXXXXXXXXXXXXX01/01/2201/01/23Acme99Closed04/05/22
Working in vineyards tying wires to the vines for support for about 2 weeks and my thumbs were getting soar with time , I would
Medical
Kingsburg, CA 93631
0040 0040
Strain or Injury By - Twisting
ThumbCA00001013.051013.050.001,013.050.001,013.050324.25324.2501337.31337.3
Solano, Viviana
11/01/23
Southern Insurance Co
Strain or Injury by
Upper Extremities