CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. ADJ2931695 (VNO 0522520) ADJ1823406 (VNO 0546227)
Regular
Jul 16, 2012

SANDY CASTLE vs. CITY OF LOS ANGELES

The Workers' Compensation Appeals Board denied the applicant's Petition for Removal because it was untimely and unverified, violating WCAB Rules 10843(a) and 10844. The petition sought to rescind an order that took the case off calendar without ruling on the applicant's issues regarding an agreed medical evaluator's payment and a benefit printout. The Board adopted the judge's report and recommendation, finding the petition procedurally deficient. One commissioner dissented, arguing the judge should have ordered the benefit printout and payment of the AME's bill.

Petition for RemovalWorkers' Compensation Appeals BoardWCJDeclaration of Readiness to ProceedAgreed Medical EvaluatorAMEBenefit PrintoutWCAB Rule 10843(a)WCAB Rule 10844Untimely Petition
References
Case No. ADJ7232076
En Banc
Sep 26, 2011

Tsegay Messele vs. Pitco Foods, Inc.; California Insurance Company

The Appeals Board holds that the 10-day period for agreeing on an AME under Labor Code § 4062.2(b) is extended by five days when the initial proposal is served by mail, and clarifies the method for calculating this time period, finding both parties' panel requests premature.

Workers' Compensation Appeals BoardTsegay MesselePitco FoodsInc.California Insurance CompanyADJ7232076Opinion and Decision After ReconsiderationOrder Granting RemovalDecision After RemovalEn Banc
References
Case No. ADJ7830020
Regular
Aug 03, 2015

Jodi Hefner vs. FIRST BAPTIST CHURCH OF VENTURA, MARKEL SERVICES

Applicant sought removal to disqualify an Agreed Medical Examiner (AME) due to alleged bias and lack of expertise, and to challenge the defendant's use of multiple attorneys at depositions. The Appeals Board denied the petition, finding no significant prejudice or irreparable harm. The WCJ's report, adopted by the Board, found the AME's conduct and statements did not demonstrate bias or a lack of expertise. Issues regarding the defendant's attorneys can be addressed through future protective orders.

Petition for RemovalAgreed Medical Examiner (AME)Disqualification of AMEUnethical ConductBiasMedical ExpertisePre-trial ConferenceWCJ OrderIrreparable HarmSignificant Prejudice
References
Case No. ADJ1023653 (MON 0331335)
Regular
Feb 05, 2009

BARBARA ARANA vs. THE HOME DEPOT, SEDGWICK CMS

The Workers' Compensation Appeals Board affirmed a prior decision regarding applicant Barbara Arana's industrial injury at The Home Depot, which caused back and psyche injuries. The Board found that the Agreed Medical Evaluator's (AME) report provided substantial evidence for apportioning 33 1/3% of the applicant's lumbar disability to pre-existing conditions. While one commissioner dissented, arguing the AME's apportionment report lacked clarity on the causal link between prior conditions and current disability, the majority adopted the WCJ's findings. This decision upholds the original award of 39% permanent disability after apportionment.

Agreed Medical Evaluator (AME)ApportionmentIndustrial InjuryLumbar DisabilityPsychiatric DisabilityPermanent DisabilityReconsiderationFindings and AwardSubstantial EvidencePre-existing Conditions
References
Case No. ADJ10187704, ADJ10924724
Regular
May 17, 2018

STEVEN CASE vs. GOLDEN GATE BRIDGE HIGHWAY AND TRANSPORTATION DISTRICT

The Workers' Compensation Appeals Board granted reconsideration to increase applicant's permanent disability rating for bilateral shoulder injury from 9% to 38%. The Board found the Agreed Medical Evaluator's (AME) alternative rating, based on strength loss, was substantial medical evidence and properly considered within the AMA Guides. The WCJ erred in applying an overly restrictive interpretation of "complex or extraordinary" cases for deviating from strict AMA Guides ratings. The AME's use of strength loss data from the AMA Guides, even for an age outside the specified range, was permissible under the *Almaraz-Guzman* line of cases when justified by clinical judgment.

Workers' Compensation Appeals BoardJoint Findings and AwardPetition for ReconsiderationAgreed Medical Evaluator (AME)permanent disability ratingbilateral shouldersorthopedic AMEAMA GuidesAlmaraz-Guzmanstrength loss index
References
Case No. ADJ3057272 (RDG 0125821)
Regular
Dec 03, 2010

FIDEL NAZARENO vs. OLD DURHAM WOOD COMPANY, STATE COMPENSATION INSURANCE FUND

This case involves a defendant's petition for reconsideration of a permanent disability award, arguing the Agreed Medical Evaluator's (AME) impairment rating was inconsistent with AMA Guides. The Appeals Board granted reconsideration, rescinded the award, and returned the matter for further development of the record. Issues include the DEU rater improperly separating AME's combined whole person impairment and the AME needing to clarify his reasoning on grip loss and potential overlap with other impairments. The AME will also re-evaluate impairment without referencing prior DEU ratings.

WORKERS' COMPENSATION APPEALS BOARDAgreed Medical EvaluatorAMEpermanent disabilityAMA GuidesDEU raterrating instructionswhole person impairmentFindings and AwardPetition for Reconsideration
References
Case No. ADJ4494290 (SAL 0118345)
Regular
Apr 22, 2016

JEANETTE VAUGHN vs. CENTRAL COAST COMMUNITY HEALTHCARE, AMTRUST NORTH AMERICA

The Workers' Compensation Appeals Board granted the applicant's Petition for Removal, rescinding the WCJ's prior order allowing the Agreed Medical Evaluator (AME) to continue. This decision stemmed from the defendant's violation of Labor Code section 4062.3 and Rule 35 by providing the AME with a Consultative Rating without proper prior service on the applicant. Consequently, the applicant is entitled to select a new Qualified Medical Evaluator (QME) if a new AME cannot be agreed upon. Prior AME reports remain admissible if they predate the improper submission of information.

RemovalPetition for RemovalFindings and OrdersAgreed Medical EvaluatorAMEQualified Medical EvaluatorPQMELabor Code Section 4062.3Administrative Director Rule 35Consultative Rating
References
Case No. ADJ8415183
Regular
Apr 27, 2015

TIM HAGER vs. COUNTY OF SANTA CLARA CENTRAL FIRE DISTRICT

The Workers' Compensation Appeals Board granted reconsideration to correct a technical rating error in the applicant's permanent disability award. The Board affirmed the original finding that the applicant, a firefighter, sustained industrial injuries to his bilateral upper extremities and heart. However, the permanent disability rating was adjusted from 71% to 70% due to the correction of a specific rating modifier. The Board also found that the orthopedic Agreed Medical Evaluator's use of grip loss to rate the applicant's upper extremity impairment was supported by substantial evidence.

WCABPetition for ReconsiderationFindings and AwardPermanent DisabilityFirefighterBilateral Upper ExtremitiesHeart HypertensionAgreed Medical Evaluator (AME)Orthopedic AMEInternal Medicine AME
References
Case No. VNO 452114, VNO 452108
Regular
Aug 17, 2007

AURELIA SANCHEZ vs. PARACELSUS HEALTH CORP.

The Appeals Board granted reconsideration of the WCJ's decision, finding that the Agreed Medical Examiner's (AME) opinion regarding the applicant's neck injury was not substantial evidence. This was due to the AME's failure to review relevant medical records and consider the applicant's subsequent neck surgery. The case is returned to the trial level for further development of the record, including potentially obtaining a supplemental opinion from the AME or appointing a new medical examiner.

Workers Compensation Appeals BoardAurelia SanchezParacelsus Health Corp.industrial injurybilateral handswristsneck injuryorthopedic agreed medical examinerAMEDr. Jeffrey A. Berman
References
Case No. ADJ1162016
Regular
Jan 19, 2007

PHONE SENENOL vs. NOR CAL METAL FABRICATORS, SCIF INSURED PLEASANTON

The Workers' Compensation Appeals Board denied the applicant's Petition for Removal, affirming the WCJ's decision to deny the applicant's request to disqualify the Agreed Medical Examiner (AME). The Board found the applicant failed to demonstrate substantial prejudice or irreparable harm, and that the regulations regarding delinquent supplemental reports do not permit unilateral termination of an AME. The Board suggested deposition as the appropriate course of action to obtain the necessary information from the AME.

Workers' Compensation Appeals BoardPetition for RemovalAMEQMESupplemental ReportDelinquent ReportDepositionUnilateral TerminationAdministrative DirectorPrejudice
References
Showing 1-10 of 955 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational