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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ9625407
Regular
Sep 12, 2018

KEITH FIELD vs. CITY OF PINOLE

This case involves a firefighter who sustained bilateral carpal tunnel syndrome after retirement. The Appeals Board reversed the trial judge, holding that Labor Code section 4458.5 applies, entitling the applicant to permanent disability benefits calculated at the maximum indemnity rate. This applies regardless of the applicant's actual earnings or the fact that carpal tunnel syndrome is not a specifically enumerated presumptive injury. The case is remanded for determination of the precise date of injury to calculate the benefit rate.

Workers' Compensation Appeals BoardKeith FieldCity of PinolePermissibly Self-InsuredMunicipal Pooling AuthorityADJ9625407Opinion and Decision After Reconsiderationindustrial injuryfirefighterbilateral upper extremities
References
Case No. ADJ2046608 (VNO 0502368)
Regular
Mar 07, 2012

NOE PEREZ vs. HERRICK CORPORATION

The Workers' Compensation Appeals Board granted Herrick Corporation's Petition for Removal, rescinding a WCJ order. The Board is now intending to dismiss Herrick's Petition for Contribution against SCIF. This is because Herrick's contribution claim is barred by the one-year statute of limitations under Labor Code section 5500.5(e). The Order Approving Compromise and Release was dated August 31, 2006, and Herrick's petition was filed over two and a half years later.

Petition for RemovalContributionCarve-out JurisdictionLabor Code Sections 3201.53201.7State Compensation Insurance Fund (SCIF)Alexander BuggyCompromise and ReleaseArbitratorJoint and Several Award
References
Case No. ADJ6779197, ADJ7472140, ADJ7964720
Regular
Feb 27, 2014

ISMAEL NAVARRO vs. CITY OF MONTEBELLO, CORVEL CORPORATION

This case concerns whether an applicant must return to the same Qualified Medical Evaluator (QME) for subsequent injury claims. The defendant argued that under Rule 35.5(e), the applicant should be evaluated by the original QME due to overlapping body parts and parties. The Appeals Board granted removal, intending to hold that the Labor Code does not require return to the same QME for new claims. Furthermore, the Board proposes that Rule 35.5(e)'s requirement to use the same QME for new injuries with the same body parts is inconsistent with the Labor Code and thus invalid. The Board is seeking further input from parties and the Division of Workers' Compensation before issuing a final en banc decision.

Workers' Compensation Appeals BoardRemovalFindings of FactQualified Medical EvaluatorRule 35.5(e)Labor CodeEn Banc DecisionCumulative InjurySpecific InjuryClaim Form
References
Case No. ADJ2154380 (SAC 0363541)
Regular
Jul 21, 2010

Spencer Davis vs. Clark & Sullivan, Inc., LWP Claims Sacramento, Berkshire Hathaway San Francisco, Berkshire Hathaway Pasadena

The defendant sought to disqualify the Qualified Medical Evaluator (QME) due to their unavailability for deposition within the regulatory 120-day timeframe. The Workers' Compensation Appeals Board (WCAB) denied the petition for removal, affirming the lower order. The WCAB found that Administrative Director (AD) Rule 31.5, concerning replacement panels, does not apply to QME unavailability for deposition. Furthermore, the Board found no demonstrable prejudice or irreparable harm, noting the defendant's own rescheduling of the deposition.

Petition for RemovalQualified Medical EvaluatorQME UnavailabilityDeposition SchedulingAdministrative Director RulesAD Rule 35.5(f)AD Rule 31.5(a)(5)AD Rule 33PrejudiceIrreparable Harm
References
Case No. ADJ864227 (LBO 350573) ADJ1635667 (LBO 350607)
Regular
Dec 29, 2008

LUIS ECHEVARRIA vs. FALCON WEST, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and reversed the trial judge's award of attorney's fees under Labor Code section 5814.5. The Board reasoned that section 5814.5 requires an award of attorney's fees to be "in addition to" increased compensation under section 5814, which was not sought or awarded here. Furthermore, the Board found that any delay in payment was not unreasonable due to a good-faith dispute over the net settlement amount.

WORKERS' COMPENSATION APPEALS BOARDLUIS ECHEVARRIAFALCON WESTINC.STATE COMPENSATION INSURANCE FUNDADJ864227ADJ1635667OPINION AND ORDER GRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONFindings and Orders
References
Case No. ADJ9466570
Regular
Dec 24, 2014

ELVIRA HERNANDEZ vs. NEWCO FOODS, INC., Operating As JACK IN THE BOX, SECURITY NATIONAL, Administered By AMTRUST NORTH AMERICA

The Workers' Compensation Appeals Board granted reconsideration to clarify an earlier decision regarding a Medical Provider Network (MPN). The Board affirmed the finding that the defendant failed to prove the existence of a valid MPN. Consequently, findings related to MPN access standards and transfer of care were rescinded, with the applicant permitted to continue treatment outside the invalid MPN with her chosen physician. This decision primarily hinges on the defendant's failure to establish a legally compliant MPN.

Medical Provider NetworkMPNFindings of Fact and AwardPetition for Reconsiderationprimary treating physiciantransfer of careself-procured medical treatmentTitle 8section 9767.5(b)Title 8
References
Case No. LAO 0815296, LAO 0815298
Regular
Jul 29, 2008

MARIA LIEVANOS vs. GOLDEN STATE FOODS, BROADSPIRE (CRAWFORD & COMPANY) CNA/RSKCO

The Workers' Compensation Appeals Board (WCAB) granted reconsideration, reversing a prior decision that found Crawford's petition for contribution untimely. The WCAB determined that the parties' Compromise and Release (C&R) agreement, specifically paragraph 14, constituted a final judgment of contribution between Crawford and RSKCo, setting forth their respective liabilities. Therefore, the WCAB held that Labor Code section 5500.5(e) did not bar Crawford's claim for reimbursement as the C&R itself provided the basis for contribution.

Workers' Compensation Appeals BoardPetition for ContributionTimelinessStatute of LimitationsCompromise and Release (C&R)Order Approving Compromise and Release (OACR)Apportionment of LiabilityDeclaratory JudgmentContinuing JurisdictionLabor Code Section 5500.5(e)
References
Case No. SFO 0492831
Regular
Jan 23, 2008

ELIAS MONTOYA vs. ASTON BARNES, INC., STATE COMPENSATION INSURANCE FUND

The Board granted reconsideration to clarify the application of Labor Code section 4656 regarding temporary disability indemnity limits. The Board held that "new and further" disability does not extend the 104-week limit under section 4656(c)(1), nor do spinal disc excisions and bone grafts qualify as "amputations" under section 4656(c)(2)(C). Consequently, the applicant is entitled to temporary disability indemnity only up to two years from the date of the first payment.

Workers' Compensation Appeals BoardElias MontoyaAston Barnes Inc.State Compensation Insurance FundSFO 0492831Opinion and Decision After ReconsiderationTemporary Disability IndemnityIndustrial InjuryThoracic SpineChest Injury
References
Case No. ADJ8733591
Regular
Mar 13, 2017

ANELLA MILES vs. RALPHS GROCERY COMPANY, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for removal, rescinding the original order. The WCAB found the original order, which replaced a Qualified Medical Examiner (QME) for alleged unavailability for deposition, was improperly issued due to a lack of a proper record. The WCAB emphasized that a complete record, including stipulations and admitted evidence, is essential for decisions. Therefore, the case was returned to the WCJ for further proceedings with a proper evidentiary record.

Petition for RemovalReplacement QME PanelWCJDepositionCal. Code Regs. §35.5PrejudiceIrreparable HarmMSC Minutes of HearingRule 35.5(f)Mandatory Settlement Conference
References
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