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

Case No. ADJ8935865
Regular
Aug 21, 2014

JOSE ROBLES vs. HORIZON PERSONNEL SERVICES, COMPANION PROPERTY & CASUALTY, administered by CARL WARREN & CO.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of an administrative law judge's (WCJ) decision that denied applicant Jose Robles' claim for a wrist injury. The WCAB found that the WCJ erred by giving undue weight to the uncorroborated testimony of a supervisor who did not witness the incident and whose employer lacked personal knowledge of the incident details. Consequently, the WCAB rescinded the WCJ's findings and substituted its own, finding that Robles sustained an industrial injury to his right wrist and hand. One commissioner dissented, asserting the WCJ's credibility determination was based on substantial evidence.

AOE/COEIn pro perPetition for ReconsiderationFindings and OrderWCJApplicant's testimonyHearsay testimonyVideotape evidencePersonal knowledgeReasonable probability
References
Case No. MON 0307506
En Banc
Oct 26, 2005

VIRGINIA SANCHEZ vs. COUNTY OF LOS ANGELES, TRISTAR RISK MANAGEMENT

The Board holds that Labor Code section 4664 requires apportionment of overlapping permanent disabilities from a prior award for the same body region, with the defendant bearing the burden of proving the prior award and the applicant bearing the burden of disproving overlap.

SB 899Labor Code section 4664apportionmentprior industrial injurypermanent disabilityoverlapping disabilitiesen banc decisionpresumption of prior disabilityburden of proofmedical rehabilitation
References
Case No. ADJ3345507
Regular
Sep 18, 2014

ROBERT MOOS vs. CITY OF INGLEWOOD

This case concerns a lien claimant's petition for reconsideration of an order disallowing their lien. The claimant argued they did not receive notice of a lien conference, but the Workers' Compensation Appeals Board (WCAB) record indicated proper service by mail. The WCAB upheld the administrative law judge's decision, presuming the notice was received and that the lien claimant failed to rebut this presumption with sufficient evidence. As the lien claimant also failed to object to a subsequent Notice of Intent to Dismiss their lien, reconsideration was denied.

Petition for ReconsiderationLien ClaimantNotice of Lien ConferenceService of ProcessPresumption of ReceiptEvidentiary CodeWCABWCJOrder Disallowing LienNotice of Intent to Dismiss
References
Case No. STK 0188389(M) STK 0188391
Regular
Jul 24, 2008

CARLOS LOPEZ vs. CALIFORNIA ENGINEERING/MODERN CONTINENTAL, ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) rescinded a prior decision and returned the case to the trial level for further proceedings. The WCAB found that the administrative law judge (ALJ) improperly excluded medical reports and an MRI related to a prior injury from evidence, despite their relevance to apportionment. The WCAB determined these documents were part of the WCAB's legal file and thus subject to judicial notice, as requested by the defendant.

Workers' Compensation Appeals BoardReconsiderationJudicial NoticeLabor Code Section 5502Pretrial Conference StatementExhibitsRecord of ProceedingsLegal FileApportionmentPermanent Partial Disability
References
Case No. ADJ6820997
Regular
Feb 08, 2012

RODOLFO VILLALOVOS vs. ACE BEVERAGE COMPANY, TOPA INSURANCE COMPANY

This case involves a dispute over the admissibility of medical reports from a physician outside the defendant's Medical Provider Network (MPN) and the subsequent award of temporary and permanent disability benefits. The Appeals Board rescinded the original decision due to unresolved issues regarding the proper establishment and notice of the MPN. The case is returned to the trial level for further proceedings to determine the validity of the MPN and the admissibility of the medical evidence. The WCJ must also clarify whether certain QME reports were admitted into evidence, as reliance on unadmitted evidence is improper.

MPNValdezPrimary Treating PhysicianReconsiderationMedical Provider NetworkInadmissible ReportsStipulationTemporary DisabilityPermanent DisabilityMedical Treatment
References
Case No. SDO 339211 SDO 339212
Regular
Jul 23, 2007

RICHARD ESPINOZA vs. SAN DIEGO GAS & ELECTRIC

This case involved a petition to disqualify a Workers' Compensation Judge based on a prior admission of bias against the applicant's law firm. The Appeals Board denied the petition, finding that the applicant failed to present evidence of present bias or the appearance of bias. The Board reasoned that the prior admission of bias had been sufficiently attenuated by time and subsequent rulings, and that future disqualifications would require specific evidence.

Workers' Compensation Appeals BoardDisqualificationWCJBiasAppearance of BiasRecusalBlanket RecusalEthics ComplaintsCourt AdministratorMandatory Settlement Conference
References
Case No. ADJ3953602 (SRO 0260827) ADJ2646453 (SRO 0133845)
Regular
Nov 14, 2012

ROBERTO HERNANDEZ vs. MILL VALLEY SCHOOL DISTRICT, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) seeks reconsideration of an award finding the applicant totally permanently disabled due to industrial injuries sustained in 2004. The WCJ found the combined injuries greater than 70% and the second injury itself greater than 35%, entitling the applicant to SIBTF benefits. SIBTF argues the applicant's disability is solely due to the subsequent injury, thus disqualifying them from SIBTF benefits. The Appeals Board granted reconsideration to review the admissibility of two vocational reports and deposition transcripts, Exhibits M and N, which were previously marked for identification only. The Board intends to receive these documents into evidence unless timely objections are filed.

SIBTFPetition for ReconsiderationFindings and AwardPermanent DisabilityIndustrial InjuryVocational Rehabilitation EvaluationDiminished Future Earning CapacityDeposition TranscriptExhibits M and NWCJ Report
References
Case No. ADJ6908926
Regular
Jan 14, 2013

ALONSO RAMIREZ vs. ROYALTY LANDSCAPE, MEADOWBROOK INSURANCE GROUP

The Workers' Compensation Appeals Board granted reconsideration and rescinded the WCJ's decision, returning the case to the trial level. This was due to the improper exclusion of defendant's payroll records, which were relevant to determining applicant's employment status. The Board found that these records should have been admitted despite the lack of formal authentication, as workers' compensation proceedings allow for significant latitude in evidence admission. The case will be reheard for a proper admission of evidence and a new decision.

Workers' Compensation Appeals BoardReconsiderationFindings of Fact and OrderEmploymentGardenerBack InjuryShoulder InjuryNeck InjuryTerminationDue Process
References
Case No. ADJ1471935 (LAO 0872244)
Regular
Mar 26, 2014

JESUS RIOS vs. BRYAN JONES dba THE K GROUP, TOKIO MARINE, UNISURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to determine the admissibility of evidence obtained after the Mandatory Settlement Conference (MSC). The applicant sought to introduce supplemental medical reports from previously seen physicians and reports from new medical and vocational experts, arguing his condition worsened and the existing record was inadequate. The WCAB held that supplemental reports from the applicant's original physicians were admissible under Labor Code section 5502(d)(3) due to a changed condition, but reports from newly disclosed physicians and vocational experts were not. The majority affirmed the WCJ's decision to exclude the latter evidence, finding the applicant failed to demonstrate good cause or due diligence in obtaining it prior to the MSC.

Mandatory Settlement Conferencediscovery closurereopen recordsupplemental medical reportsvocational expertdue diligencegood causepermanent and stationaryAMA Guidesloss of earnings capacity
References
Case No. ADJ3912308 (LBO 0367834)
Regular
Nov 16, 2012

LEOPOLDO SIMOTA vs. AMERICAN NURSERIES, VIRGINIA SURETY, APPLIED RISK SERVICES

The Workers' Compensation Appeals Board denied the lien claimant's petition for reconsideration, upholding the administrative law judge's decision to disallow the lien. The lien claimant argued they had submitted sufficient evidence via EAMS, but the Board clarified that filing in EAMS does not equate to submitting admissible evidence for evaluation. The Board emphasized that proper evidentiary procedures must be followed, citing due process and fundamental rules of evidence submission. Consequently, the lien claimant's failure to properly present evidence led to the denial of their petition.

Workers' Compensation Appeals BoardLien claimantUniversity Imaging CenterPetition for ReconsiderationOrder denyingWCJEAMSsubmission of evidenceadmissibilitydue process
References
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