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

Case No. ADJ398757 (LBO 0393631)
Regular
Dec 24, 2010

GARY E. MORGAN vs. REYNOLDS BUICK, GMC & PONTIAC, ICW GROUP

The applicant sought removal, arguing that proceeding to trial on injury arising out of and occurring in the course of employment (AOE/COE) without a Qualified Medical Evaluator (QME) opinion would be prejudicial. The defendants asserted factual defenses and their due process rights. The Appeals Board granted removal, finding that the applicant carries the burden of proof for AOE/COE. Therefore, the Board amended the trial order to exclude AOE/COE, allowing only the issue of travel expenses for a QME evaluation to be tried.

Petition for RemovalAOE/COEQualified Medical EvaluatorPQMECompensabilityTravel ExpensesLabor Code Section 4060Burden of ProofIndustrial InjuryMedical-Legal Evaluation
References
Case No. ADJ6751788
Regular
Aug 16, 2010

MOISES ROBLES GARCIA vs. ABLE BUILDING MAINTENANCE, ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board granted reconsideration of a finding of industrial injury for applicant Moises Robles Garcia. Defendant Able Building Maintenance argued the applicant failed to prove injury arising out of and occurring in the course of employment (AOE/COE) and raised affirmative defenses of intoxication and material deviation. The Board rescinded the original decision and returned the case to the trial level for further proceedings, specifically to determine AOE/COE and consider the applicant's credibility and deposition transcripts. The WCJ must now make a determination on AOE/COE and potentially other defenses.

AOE/COEintoxication defensematerial deviationexcluded evidencedeposition transcriptswitness demeanorcredibilitypreponderance of the evidencecausal connectionrational incident of work
References
Case No. ADJ6875445
Regular
Aug 02, 2010

JOSE RIVAS vs. NNC MANAGEMENT, LLC/ADP TOTAL SOURCE, SPECIALTY RISK SERVICES

Defendant NNC Management, LLC/ADP Total Source sought removal of a WCJ's order to proceed to trial on both AOE/COE and temporary disability. The applicant claimed an injury in January 2009, and the employer denied it based on a post-termination defense. The defendant argues they were denied due process by being forced to litigate temporary disability without prior notice, as the initial proceedings focused solely on AOE/COE. The Appeals Board granted the petition for removal, amending the order to limit the August 4, 2010 trial to the AOE/COE issue only.

Petition for RemovalPost-termination defenseAOE/COETemporary DisabilityDue ProcessDeclaration of Readiness to ProceedPriority ConferenceMandatory Settlement ConferenceDiscoverySubstitution of Attorneys
References
Case No. ADJ10810340
Regular
Jan 04, 2018

DUSTIN RAMIREZ vs. VIASYSTEMS/TTM TECHNOLOGIES, TRAVELERS PROPERTY AND CASUALTY

This case concerns a Petition for Reconsideration by the defendant, Viasystems/TTM Technologies, challenging a Workers' Compensation Judge's (WCJ) findings. The WCJ's decision addressed statute of limitations, lack of prejudice, and date of injury, but not the ultimate issue of whether the applicant's injury arose out of and in the course of employment (AOE/COE). The Appeals Board denied the petition because it was filed from an interlocutory order, not a final decision on AOE/COE. While the Board agreed that the WCJ's findings on the statute of limitations, notice, and date of injury were appealable, it ultimately denied reconsideration based on the WCJ's report, which found that the record required further development on the crucial AOE/COE issue.

WCABPetition for ReconsiderationDenying PetitionWCJ ReportFinal OrderSubstantive RightsThreshold IssueStatute of LimitationsLabor Code Section 5405Date of Injury
References
Case No. ADJ12294911
Regular
Apr 14, 2025

KHADIJAH BROWN vs. REGINALD AJAKWE, MD, RAYMOND TATEVOSSIAN, MD, MID-CENTURY INSURANCE COMPANY

Applicant Khadijah Brown sought reconsideration of a WCJ's decision that she did not sustain a psychiatric injury arising out of and occurring in the course of employment (AOE/COE) and that a good faith personnel action defense was established. The Appeals Board granted reconsideration, finding that the WCJ erroneously concluded applicant did not sustain injury to her psyche AOE/COE and failed to recognize objective evidence of harassment. The Board rescinded the original findings and substituted new findings, determining that applicant did sustain injury to her psyche AOE/COE and that this injury resulted from actual events of employment. The issue of the defendant's good faith personnel action defense was deferred for further proceedings.

AOE/COEpsychiatric injuryLabor Code Section 3208.3(b)(1)actual events of employmentharassmentgood faith personnel actionVerga v. Workers' Comp. Appeals Bd.racial epithetsuspensiontermination
References
Case No. ADJ10887940
Regular
May 30, 2019

ONISSA DAVIS vs. KAISER FOUNDATION HEALTH PLAN, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to amend a previous decision. The Board found that the "going and coming rule" does not bar the applicant's claim. However, the issue of whether the injury arose out of and occurred in the course of employment (AOE/COE) was not litigated at trial. Therefore, the Board deferred the AOE/COE issue, allowing parties to proceed with it later if ready.

Petition for ReconsiderationGoing and Coming RuleInjury AOE/COEWorkers' Compensation Appeals BoardWCJFindings and OrderMinutes of Hearing and Summary of EvidenceIndustrial InjuryCompensabilitySubstantial Evidence
References
Case No. ADJ12304192
Regular
Mar 27, 2023

JOANNA ELLIOTT vs. PEPPERDINE UNIVERSITY, ADMINISTERED BY GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board granted reconsideration and amended the WCJ's decision. While the applicant is presumed to have sustained injury AOE/COE for asthma and digestive issues, the issue of lung disease and nose/throat injury AOE/COE was not properly framed for trial. Therefore, this specific issue has been deferred, pending further proceedings. The WCAB affirmed the WCJ's other findings based on the existing record.

AOE/COEPetition for ReconsiderationWorkers' Compensation Appeals BoardLung DiseaseAsthmaUpper Digestive SystemNose and Throat InjuryDeferred IssueFindings and OrderMedical Evidence
References
Case No. LBO 371891
Regular
Mar 03, 2009

ANNA GUTIERREZ vs. CEDARS-SINAI HEALTH SYSTEM

The Workers' Compensation Appeals Board granted reconsideration and reversed the WCJ's finding of injury AOE/COE, holding that the applicant failed to prove her injury arose out of and in the course of employment. The Board found no substantial evidence supported an AOE/COE injury, distinguishing defendant's denial letter as an acknowledgment of an accident, not an admission of industrial injury. The issue of medical/legal charges was deferred for further proceedings.

Workers Compensation Appeals BoardAnna GutierrezCedars-Sinai Health SystemFindings and AwardCompromise and ReleaseThomas FindingAOE/COElien claimantAndalib Chiropracticmedical treatment
References
Case No. ADJ8071249
Regular
Apr 30, 2013

Edward Camacho vs. CHEF'S FANCY, SENTINEL INSURANCE COMPANY

This case concerns Edward Camacho's workers' compensation claim against Chef's Fancy and Sentinel Insurance. The Appeals Board granted reconsideration of the original decision. The Board affirmed the prior decision, except it amended the finding of fact to specify injury AOE/COE to the right knee and right shoulder. The issue of injury AOE/COE to the left knee and left shoulder was deferred and ordered off calendar.

WORKERS' COMPENSATION APPEALS BOARDReconsiderationGranting ReconsiderationDecision After ReconsiderationAOE/COEInjury arising out of and in the course of employmentDishwasherRight knee injuryRight shoulder injuryDeferred issue
References
Case No. ADJ7336122
Regular
Sep 19, 2011

MAXIMINO ULTRERAS vs. COTTAGE HEALTH SYSTEMS

The defendant sought reconsideration and removal of an order vacating submission and appointing a physician due to inadequate medical evidence. The Appeals Board denied removal, finding no irreparable harm. However, it granted reconsideration to rescind the finding of injury arising out of and in the course of employment (AOE/COE). The Board determined that substantial medical evidence was lacking to support the AOE/COE finding and returned the matter to the trial level for further proceedings.

WCABRemovalReconsiderationVacating SubmissionAppointing Regular PhysicianL.C. § 5701AOE/COECumulative InjuryMedical EvidenceSubstantial Evidence
References
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