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

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
8
Case No. ADJ15071496
Regular
Aug 18, 2025

VI TRI LIEU, CHAI SAECHAO vs. BOTTLING GROUP dba PEPSICO, ACE AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration in the case of Vi Tri Lieu (deceased) and Chai Saechao against Bottling Group dba Pepsico and Ace American Insurance Company. The petition challenged a WCJ's Findings of Fact and Order (F&O) from June 5, 2025, concerning injury AOE/COE and the submission of Dr. Mahmud's report to a QME. The Board rescinded the F&O, removing the finding of injury AOE/COE, but affirmed the order allowing Dr. Mahmud's report and applicant's cover letter to be sent to Panel QME Dr. McClintock-Greenberg for review. The matter was returned to the trial level for further proceedings.

AOE/COEPetition for RemovalPetition for ReconsiderationQualified Medical EvaluatorPanel QMEDr. Mahmud reportDr. McClintock-Greenbergsubstantial prejudiceirreparable harmthreshold issue
References
19
Case No. ADJ9163440
Regular
Oct 05, 2015

INOCENCIO PEDROSA vs. KAISER FOUNDATION HEALTH PLAN

This case concerns a workers' compensation claim where the applicant alleged injury to his right ankle and cervical spine from operating a pallet jack. The defendant disputed the injury AOE/COE, primarily citing surveillance footage and alleged inconsistencies in applicant's testimony. The WCJ found injury AOE/COE based on Dr. Sadler's report, which interpreted the surveillance video as confirming applicant's head hitting a wall, despite the WCJ finding Dr. Sadler's report not substantial due to his failure to consider prior injuries. The Appeals Board granted reconsideration, rescinded the WCJ's decision, and returned the matter for further development of the record, finding no substantial evidence to support the injury finding. Additionally, defense counsel was admonished for improperly submitting extraneous documents with the Petition for Reconsideration.

AOE/COEPetition for ReconsiderationWCJsubstantial evidencecredible witnesssurveillance footagedeposition testimonyprimary treating physicianpanel qualified medical examinersupplemental report
References
7
Case No. ADJ16007451
Regular
Aug 25, 2025

MINA RADJABI vs. CENTURY COMMUNITIES, INC./INSPIRE HOME LOAN; BERKSHIRE HATHAWAY HOMESTATE INSURANCE COMPANY dba BERKSHIRE HATHAWAY HOMESTATE COMPANIES

The applicant, Mina Radjabi, alleged a cumulative trauma injury to multiple body parts from July 2019 to February 2022 while employed by Century Communities, Inc./Inspire Home Loan. The case initially settled by Compromise and Release in March 2023, with the defendant maintaining a denial of injury AOE/COE. A lien claimant, Woodland Psyche Center, represented by PureMD Group Lomita, filed a petition for reconsideration after its lien for treatment was denied by a Workers' Compensation Administrative Law Judge (WCJ). The WCJ denied the lien because Woodland Psyche Center failed to prove injury arising out of and in the course of employment (AOE/COE) and its medical reports did not comply with regulatory requirements for proving a contested claim. The Appeals Board, after reviewing the petition and the WCJ's report, adopted the WCJ's findings and denied the petition for reconsideration, concluding that the lien claimant did not establish causation or due process violations, and that the treatment provided was outside the employer's Medical Provider Network.

Workers' Compensation Appeals BoardPetition for ReconsiderationLabor Code section 5909TimelinessTransmission Date60-Day RuleNotice of TransmissionElectronic Adjudication Management System (EAMS)Report and RecommendationLien Claimant
References
10
Case No. ADJ2010922
Regular
Sep 07, 2010

MICHAEL ROSADO vs. KJM ELECTRONIC WORKS, INC., STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration and rescinded the WCJ's finding of industrial injury AOE/COE due to lack of substantial evidence. Key issues include a deficient record, absence of a medical-legal report connecting the injury to employment, and significant inconsistencies in the applicant's testimony regarding the date of injury, treatment, and the mechanism of injury. The case is remanded for further proceedings and a new decision by the WCJ, emphasizing the applicant's burden to prove injury AOE/COE.

AOE/COEsubstantial evidencereconsiderationrescindedreturn to trial levelburden of proofmedical-legal reportcredibilitymechanism of injuryindustrial injury
References
7
Case No. ADJ7104046
Regular
May 17, 2011

TOMMIE WRIGHT vs. SUPREME COURT OF CALIFORNIA, CORVEL CORPORATION, INC.

In this workers' compensation case, the defendant petitioned for removal, arguing the trial should not proceed due to issues with the Agreed Medical Evaluator's (AME) review and deposition scheduling, as well as the applicant's failure to raise the injury AOE/COE in her declaration of readiness. The Appeals Board granted the petition, finding the applicant's omission of AOE/COE from her DOR problematic. Consequently, the Board redesignated the scheduled trial as a mandatory settlement conference to allow for further resolution, especially after the AME provided a supplemental report.

Petition for RemovalAgreed Medical Evaluator (AME)Declaration of Readiness to Proceed (DOR)Mandatory Settlement Conference (MSC)Injury Arising Out of and Occurring in the Course of Employment (AOE/COE)Supplemental ReportDepositionPretrial Conference StatementWorkers' Compensation Administrative Law Judge (WCJ)Workers' Compensation Appeals Board (WCAB)
References
0
Case No. ADJ9859900
Regular
Dec 24, 2018

KRSYTOL LARTEY vs. FOREVER 21, FEDERAL INSURANCE COMPANY

This case involves a workers' compensation claim where the applicant alleged injury to her throat and voice due to her employment with Forever 21. The defendant sought reconsideration of the WCJ's finding of injury arising out of and occurring in the course of employment (AOE/COE), arguing the medical examiner's opinion lacked substantial evidence. The Board denied reconsideration, finding the QME's reports and deposition testimony provided a reasoned opinion based on examination and history. The Board concluded that the QME's opinion constituted substantial evidence supporting the AOE/COE finding.

AOE/COEOtolaryngology QMEAlfred N. RovenMethicillin-resistant Staphylococcus aureusMRSAIndustrial causationPetition for ReconsiderationWorkers' Compensation Appeals BoardWCJDust exposure
References
2
Case No. ADJ7392610
Regular
Apr 21, 2014

SAYED SHAH vs. AUTOMOBILE CLUB OF SOUTHERN CALIFORNIA, THE HARTFORD, administered by SEDGWICK CMS

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding the finding that the applicant did not sustain an injury arising out of and in the course of employment (AOE/COE) to his back, internal system, psyche, or sleep disorder. The Board affirmed the administrative law judge's (WCJ) determination that the applicant's trial testimony was not credible, and that the medical reports relied upon by the applicant were based on an inaccurate history. The Board also found that the issue of AOE/COE injury was properly raised for trial, as the applicant had placed benefits contingent on an industrial injury in dispute.

Workers' Compensation Appeals BoardAOE/COEFindings and OrderPetition for ReconsiderationWCJCredibility DeterminationDr. Daniel CapenDr. Satish KadabaQualified Medical ExaminerPretrial Conference Statement
References
1
Case No. ADJ11406698
Regular
Feb 03, 2020

JOSE MORENO vs. GREEN VALLEY LABOR INC., STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, affirming the WCJ's finding that the applicant sustained a back injury arising out of and occurring in the course of employment. The Board found that the Qualified Medical Examiner's (QME) reports provided substantial evidence for injury AOE/COE based on the "reasonable probability" standard. However, the Board found the QME's apportionment opinion lacked the necessary reasoning and detail to be considered substantial evidence. Therefore, the WCJ's findings regarding AOE/COE and the lack of substantial evidence for apportionment were upheld.

AOE/COEPetition for ReconsiderationQualified Medical ExaminerQMECumulative traumaPermanent disabilityApportionmentSubstantial evidenceWorkers' Compensation Appeals BoardWCJ
References
5
Case No. ADJ1966949 (GOL 0095232)
Regular
Mar 19, 2012

ARMANDO OROZCO (ARMANDO OROZCO JUAREZ) vs. PACIFIC VINEYARD COMPANY, STATE COMPENSATION INSURANCE FUND

This case involves a defendant employer's petition for reconsideration of a finding that the applicant sustained an injury arising out of and in the course of employment (AOE/COE). The employer contended the AOE/COE finding lacked substantial evidence, particularly questioning the applicant's account of falling off a tractor and being run over. The Workers' Compensation Appeals Board (WCAB) denied the petition, adopting the WCJ's report which found the applicant's testimony persuasive, supported by employer witnesses attesting to his trustworthiness, and contradicted by unreliable defense expert testimony. The WCJ also noted a prior employer letter disputing the *nature* of the injury, not its occurrence, and the fact the applicant showed scarring.

AOE/COEPetition for ReconsiderationFinding of FactCompromise and Releasesubstantial evidenceWCJdefendant employerapplicantState Compensation Insurance Fundinjury
References
1
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