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

Case No. ADJ1160933 (SAL 0073085) ADJ1668595 (SAL 0073084)
Regular
Feb 17, 2012

MARIA AYALA vs. MANN PACKING COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, On Behalf of INDUSTRIAL INDEMNITY In Liquidation, Administered by SEDGWICK CMS

The Workers' Compensation Appeals Board granted CIGA's reconsideration request, overturning a prior order that denied CIGA relief from administering further medical treatment. The Board found that Zenith's joint and several liability under a 1999 Stipulated Award constituted "other insurance," relieving CIGA, as Industrial Indemnity's insolvency insurer, of its obligation. The court clarified that the settlement between Zenith and Industrial Indemnity addressed only their contribution claims, not Zenith's liability to the applicant. Consequently, Zenith is now responsible for administering the award of future medical treatment.

CIGAIndustrial IndemnityZenith InsuranceStipulated AwardJoint and Several LiabilityOther InsuranceInsurance Code Section 1063.1Covered ClaimsInsolvency InsuranceCumulative Trauma
References
4
Case No. ADJ6496249
Regular
Feb 04, 2019

GLADIS MORALES vs. QUAKE CITY; Administered by COMPWEST

Gladis Morales sought reconsideration of a prior Workers' Compensation Appeals Board decision. The Board denied her petition, finding no grounds to overturn the original finding. This ruling likely affirmed or modified an initial determination regarding Morales's claim against Quake City, administered by Compwest. The specific reasons for the denial are detailed within the full opinion.

Workers' Compensation Appeals BoardQuake CityCOMPWESTGLADIS MORALESADJ6496249Petition for ReconsiderationDenying PetitionLos Angeles District OfficeOpinion and OrderCalifornia Workers' Compensation
References
2
Case No. ADJ6413644
Regular
Apr 24, 2009

JANICE HOWELL vs. NATIONAL MENTOR HOLDINGS, dba COLE VOCATIONAL SERVICES, administered by ESIS

The Workers' Compensation Appeals Board dismissed the applicant's Petition for Reconsideration because it was not taken from a final order determining substantive rights or liabilities. The petition also sought removal, which was denied as the applicant failed to demonstrate substantial prejudice or irreparable harm. The underlying issues, such as an order compelling medical record production, are interlocutory procedural matters not subject to reconsideration. The Board adopted the WCJ's report and recommendation, denying both reconsideration and removal.

Petition for ReconsiderationFinal OrderInterlocutory OrderSubstantive RightRemovalWCJ Report and RecommendationStipulationsOrder Compelling Production of RecordsDiscovery ProcessPrivacy
References
11
Case No. ADJ2980699 (MON 0351671) ADJ1220548 (MON 0351672)
Regular
Jul 16, 2013

AURA DE LEON vs. MARRIOTT INTERNATIONAL, PSI and Self-Administered

This case involves a Petition for Removal filed by an applicant against Marriott International, PSI, and Self-Administered. The petitioner subsequently withdrew the petition. Consequently, the Workers' Compensation Appeals Board has ordered the Petition for Removal dismissed as no further action will be taken.

Petition for RemovalWithdrawn PetitionDismissed PetitionWorkers' Compensation Appeals BoardAura De LeonMarriott InternationalPSISelf-AdministeredADJ2980699ADJ1220548
References
0
Case No. ADJ10717582
Regular
Mar 28, 2023

SCOTT SEHORN vs. DAVE & BUSTER'S, INC., ACE AMERICAN INSURANCE COMPANY, ADMINISTERED BY ESIS

The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's Petition for Reconsideration as it did not appeal a final order or decision. The WCAB also denied the defendant's Petition for Removal, finding no abuse of discretion by the judge regarding the admission of an Agreed Medical Evaluator's (AME) reports and the restriction of ex parte communications with a physician. The Board concluded that the defendant failed to demonstrate irreparable harm or that reconsideration would be an inadequate remedy. Therefore, both petitions were dismissed and denied respectively.

Agreed Medical EvaluatorPetition for ReconsiderationPetition for RemovalAdministrative Director RuleDue ProcessIrreparable HarmSubstantial PrejudiceFinal OrderInterlocutory OrderTimeliness
References
12
Case No. ADJ6761550 ADJ6761551
Regular
Oct 29, 2010

JUAN SANCHEZ vs. CITY OF SANTA CLARA; PSI, administered by CAMBRIDGE

This case summary is for lawyer Juan Sanchez, who is seeking reconsideration from the Workers' Compensation Appeals Board (WCAB) concerning his claims against the City of Santa Clara and PSI, administered by Cambridge. The WCAB has granted Sanchez's Petition for Reconsideration, indicating that the initial decision warrants further review. Pending the final decision after reconsideration, all case-related communications must be directed to the WCAB's Office of the Commissioners in San Francisco, rather than any local office. The specific claims and underlying facts leading to this reconsideration are not detailed in this excerpt.

Petition for ReconsiderationGranting ReconsiderationWorkers' Compensation Appeals BoardDecision After ReconsiderationOffice of the CommissionersSan Francisco District OfficeADJ6761550ADJ6761551City of Santa ClaraPSI
References
0
Case No. ADJ12663627
Regular
Mar 18, 2025

JIAN KALLASH vs. MACYS, Permissibly Self-Insured, Administered by SEDGWICK CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board denied the Petition for Reconsideration filed by Macy's, administered by Sedgwick Claims Management. The petition challenged the WCJ's Findings and Award, which found medical treatment, specifically an anterior lumbar interbody fusion at L5-S1, to be reasonable and necessary for applicant Jian Kallash. The Board affirmed the WCJ's decision, concluding that the Utilization Review (UR) denial was untimely and that substantial medical evidence from treating physicians and a QME supported the medical necessity of the requested treatment after conservative measures failed. The decision was issued timely within the 60-day statutory period as outlined in Labor Code section 5909.

Petition for ReconsiderationLabor Code section 5909Appeals BoardWCJEAMSTransmission dateNotice of transmissionReport and RecommendationExpedited HearingUtilization Review (UR) denial
References
9
Case No. ADJ2691374 (LAO 0855825) ADJ2333516 (LAO 0883088)
Regular
Jun 27, 2013

ENRIQUE FELIX vs. CAPITAL DRYWALL, AIG, administered by CHARTIS, QUICK SERVE CARPET, REDWOOD FIRE AND CASUALTY INSURANCE COMPANY, administered by BERKSHIRE HATHAWAY, ENDURACE INSURANCE COMPANY, administered by FIRSTCOMP OF OMAHA, HAMMOND AND MASING, OLD REPUBLIC GENERAL INSURANCE COMPANY, administered by GALLAGHER BASSETT

The Workers' Compensation Appeals Board denied reconsideration of a judge's order finding statute of limitations and lack of jurisdiction defenses viable in one case, while confirming another case remained pending. The Board adopted the judge's report, denying the petition to reopen. Additionally, the Board issued a notice of intention to impose sanctions against applicant's attorney for violating procedural rules by attaching extraneous documents to the petition, creating an unnecessary burden on Board resources.

Workers' Compensation Appeals BoardStatute of LimitationsJurisdictionPetition to ReopenPetition for ReconsiderationWCJWCAB Rule 10842(c)Labor Code Section 5813SanctionBad Faith Actions
References
2
Case No. ADJ10108024
Regular
Jun 21, 2018

SUSAN N. GALLEGO vs. IHSS - CALIFORNIA DEPARTMENT OF SOCIAL SERVICES, Legally Uninsured, Administered by YORK RISK SERVICES GROUP

The Workers' Compensation Appeals Board granted the defendant's Petition for Reconsideration to correct the employer's identity. The Board amended the Findings of Fact to accurately reflect the employer as "IHSS - California Department of Social Services, Legally Uninsured, Administered by York Risk Services Group." This amendment supersedes the previous identification of the employer. Otherwise, the original Findings of Fact remain affirmed.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactLegally UninsuredYork Risk Services GroupJointly EmployedIHSSCalifornia Department of Social ServicesAdministrative Law JudgeDecision After Reconsideration
References
0
Case No. ADJ1160066 (MON 0261712)
Regular
Apr 29, 2014

ROBERT VILARINO vs. CHROMATICS, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, For FREMONT INSURANCE COMPANY, In Liquidation, Administered by SEDGWICK CMS

This case concerns a worker who sustained a permanent total disability after receiving a voluntary flu vaccination at his employer's premises. The employer sought a credit for the worker's third-party settlement against its workers' compensation liability. The Appeals Board rescinded a prior finding of employer negligence, concluding that the employer was not liable for the independent contractor's actions in administering the vaccine. The Board found no evidence of employer negligence and granted the full third-party settlement amount as a credit to the employer.

Transverse myelitisInfluenza vaccineThird party creditEmployer negligenceNon-delegable dutyIndependent contractorMedical malpracticeStandard of careVicarious liabilityReconsideration
References
16
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