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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. 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. 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. ADJ10348591 ADJ10349019
Regular
Jan 07, 2019

MIGUEL VELAZQUEZ, SERVANDO VELAZQUEZ vs. ARTEMIO ARCE, SOLOMON MARTINEZ

The Workers' Compensation Appeals Board denied a defendant's petition for reconsideration, upholding a prior finding that liens for interpreting services were not barred by AD rule 9792.5.5. This rule, requiring a second review request for fee schedule disputes, did not apply because the interpreter services were not subject to an applicable fee schedule at the time of service. Therefore, the lien claimant's failure to request a second review did not preclude the WCAB from adjudicating the lien dispute. The Board reasoned that AD rule 9792.5.5 and associated statutes only mandate the second review process for disputes concerning amounts under an "applicable fee schedule."

Workers' Compensation Appeals BoardAD Rule 9792.5.5Official Medical Fee ScheduleIndependent Bill ReviewExplanation of ReviewLabor Code section 4603.2Senate Bill 863Threshold IssueFee Schedule DisputeInterpreter Services
References
Case No. ADJ9561124
Regular
Jan 05, 2018

MARIO GUTIERREZ vs. MOLYCORP MINERALS, ZURICH

The Workers' Compensation Appeals Board dismissed the applicant's Petition for Reconsideration because the administrative law judge's order denying a new Qualified Medical Evaluator (QME) panel was not a final order. Applicant sought a new panel after the current QME's deposition was rescheduled due to a personal emergency, arguing the QME failed to appear within 120 days. The Board found the specific circumstances of the delay were not a listed ground for a replacement QME panel under the regulations. Furthermore, the Board denied the applicant's request for removal, finding no substantial prejudice or irreparable harm from the order.

Workers' Compensation Appeals BoardQualified Medical EvaluatorPetition for ReconsiderationPetition for RemovalFindings and OrderdepositionMedical UnitAdministrative Law Judgeinternal medicineapplicant
References
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