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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
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. 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. ADJ11802539
Regular
Dec 03, 2019

LA TONYA RIDER vs. PRIDE INDUSTRIES, NORTH RIVER INSURANCE

The Appeals Board granted removal and rescinded the WCJ's order denying a replacement QME panel. Defendant sought a replacement due to the current QME's unavailability for deposition. The Board found the original order lacked an evidentiary basis, necessitating a return to the trial level. Further proceedings will establish an evidentiary record to adjudicate the QME replacement issue, considering relevant Administrative Director Rules.

Petition for RemovalQualified Medical Evaluator paneldeposition unavailabilityevidentiary recordsubstantial evidenceAdministrative Director Rule 31.5(a)Administrative Director Rule 35.5(f)trial levelrescinded orderReturn to trial
References
Case No. ADJ3702111 (VNO 0549040)
Regular
Nov 19, 2009

GEYRI AGUILAR vs. STAPLES, INC., ESIS

Defendant's petition for removal is denied because the panel QME substantially complied with the requirements of AD Rule 36(a), and WCAB Rule 10510 does not apply to the QME.

Petition for RemovalQualified Medical EvaluatorPQME PanelService of ReportTimelinessSubstantial ComplianceWCAB Rule 10510Administrative Director Rule 36(a)Administrative Director Rule 38(a)Claims Administrator
References
Case No. ADJ9997985, ADJ9997986, ADJ10037755
Regular
Apr 10, 2017

DAVID LIVINGSTON vs. SOUTHEAST PERSONNEL LEASING, INC.;, PACKARD CLAIMS ADMINISTRATION;, STATE NATIONAL INSURANCE

The Workers' Compensation Appeals Board (WCAB) dismissed a petition for removal filed by the defendant. The WCAB found the petition was untimely because it was filed one day after the 20-day deadline for removal following personal service. This deadline is jurisdictional, and the WCAB cannot consider petitions filed outside this timeframe. Therefore, the petition was dismissed with no request for supplemental pleading granted.

Petition for RemovalUntimely FilingPersonal ServiceWCJ DecisionAppeals Board RuleJurisdictional Time LimitSupplemental PleadingWCAB Rule 10848WCAB Rule 10843WCAB Rule 10507
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. ADJ6816825
Regular
Jun 14, 2010

KAI CHRISTOPHER vs. TIME WARNER CABLE, ESIS

The Appeals Board granted defendant's petition for removal, finding the WCJ erred in denying a QME panel request. This denial was based on Administrative Director Rule 30(d)(3), which previously stated only the employee could request a QME panel after a total denial of injury. However, the Board's recent en banc decision in *Mendoza v. Huntington Hospital* invalidated this rule as conflicting with Labor Code sections 4060(c) and 4062.2, which allow either party to request a QME panel. Therefore, the prior order was rescinded, and the matter returned to the trial level with instructions to issue a QME panel.

Petition for RemovalQualified Medical Evaluator (QME)Administrative Director RuleInvalid RuleMendoza v. Huntington HospitalLabor Code sections 4060(c)Labor Code sections 4062.2Denial of InjuryEither Party RequestMedical Director
References
Case No. ADJ9772365 (MF) ADJ10082338
Regular
Dec 06, 2016

Leonel Hidalgo vs. Hilbert Property Management, Technology Insurance Company

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's Petition for Reconsideration, treating it instead as a Petition for Removal. The WCAB granted removal, rescinded the Joint Findings of Fact, and returned the matter for further proceedings. This action was based on the Medical Director applying the incorrect standard when determining that an orthopedic QME panel was in the applicant's medical interest. The WCAB found that the Medical Director should have first determined if the applicant's chosen chiropractic specialty was medically or otherwise inappropriate, as required by Administrative Director Rule 31.5(a)(10).

Workers' Compensation Appeals BoardQualified Medical EvaluatorQME panelspecialty determinationorthopedicschiropracticMedical DirectorAdministrative Director RuleLabor CodePetition for Reconsideration
References
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