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

Case No. ADJ1856849
Regular
Aug 21, 2014

ROGELIO MERLOS vs. AJ SLENDERS DAIRY, ZENITH INSURANCE COMPANY

This Workers' Compensation Appeals Board (WCAB) notice indicates they are reconsidering a prior ruling that excluded defendant's exhibits A through M as irrelevant. The WCAB believes these exhibits may be relevant to the issues presented at trial. Absent timely written objection demonstrating good cause, these exhibits will be admitted into evidence. This decision will inform the final determination on the defendant's petition for reconsideration.

Petition for ReconsiderationExhibits A through MWCJNotice of Intention to Admit EvidenceWorkers' Compensation Appeals BoardWorkers' Compensation Administrative Law JudgeGood CauseWritten ObjectionDemonstration of Good CauseService of Notice
References
0
Case No. ADJ8944426, ADJ8942895
Regular
Dec 22, 2014

DAVID POSHOGLYAN vs. HOLLIDAY ROCK COMPANY, INC., INSURANCE COMPANY OF THE WEST, XL SPECIALTY INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of a decision finding applicant sustained injury arising out of and in the course of employment. Defendants argued certain exhibits were improperly admitted due to lack of service and that the decision was vague. The Board adopted the WCJ's report, which found the exhibits were properly admitted or any error was harmless, and that the decision adequately addressed the stipulated facts. The WCJ's report detailed why the exhibits were admissible despite service issues and explained that further clarification on body parts or liability was not required at this stage of the proceedings.

ADJ8944426ADJ8942895PoshoglyanHolliday Rock CompanyInsurance Company of the WestXL Specialty Insurance CompanySedgwickPetition for ReconsiderationDeniedWCJ Report
References
0
Case No. ADJ6929468, ADJ6929466
Regular
Apr 27, 2018

ISRAEL ZIRATE vs. YUM YUM DONUT SHOP, INC., BENCHMARK INSURANCE COMPANY, ILLINOIS MIDWEST INSURANCE AGENCY, LLC

This case involves a lien claimant seeking reconsideration of a joint findings and award which denied payment for medical treatment. The claimant argued the employer's Medical Provider Network (MPN) was invalid and that treatment was improperly denied. The Appeals Board admitted evidence confirming the MPN's validity and affirmed the original finding. The Board concluded the applicant's treatment was from an unauthorized provider and therefore not the employer's liability.

Workers' Compensation Appeals BoardMedical Provider NetworkMPNPetition for ReconsiderationJoint Findings and AwardLien ClaimantQualified Medical ExaminerQMECompromise and ReleaseIndustrial Injury
References
0
Case No. ADJ6451750
Regular
Oct 11, 2011

MARVOURNEEN VIRAMONTES vs. WENTE BROS., INC., LIBERTY MUTUAL INSURANCE COMPANY

This case involves a dispute over sanctions imposed by a Workers' Compensation Judge (WCJ) against Liberty Mutual Insurance Company. The WCJ found the carrier's denial of a psychiatric evaluation was unreasonable and imposed sanctions and ordered applicant's expenses be paid. Liberty Mutual sought reconsideration, arguing the WCJ relied on an incomplete record and acted in good faith. The Appeals Board is considering admitting additional medical reports from the applicant's orthopedic surgeon to determine if the carrier's actions were justified.

Workers' Compensation Appeals BoardConsequential InjuryPsychePsychiatric EvaluationQMEPQMESanctionsLabor Code Section 4062.2Labor Code Section 5813WCJ
References
0
Case No. ADJ557211 (LBO 0376159)
Regular
Jul 09, 2012

SUSAN SWANSON vs. JEB INDUSTRIES, INC., CHARTIS, INC.

The Appeals Board granted reconsideration of the WCJ's decision due to improper admission of crucial evidence, specifically exhibits 33 and 36. The WCJ's opinion incorrectly stated these exhibits were admitted when they were only marked for identification. Because the parties' arguments heavily relied on these documents, and the WCJ's decision lacked clear citation to admitted evidence, the Appeals Board rescinded the original award. The case is returned to the trial level for proper evidentiary rulings and a new decision based on a complete record.

Workers' Compensation Appeals BoardFindings Award and OrderPetition for ReconsiderationApportionmentMedical TreatmentPsychiatric Consultation ReportForensic Vocational Evaluation ReportSubstantial EvidenceAdmitted EvidenceLabor Code Section 5313
References
4
Case No. ADJ3390481 (LBO 0329915) ADJ4485849 (LBO 0338530) ADJ4560133 (LBO 0338531)
Regular
Feb 06, 2017

GILDARDO PATINO vs. TERRA PAVE, INC., ARROWOOD INDEMNITY COMPANY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted the defendant's Petition for Removal, rescinding a prior Findings and Order (F&O). The defendant argued the original F&O, which admitted all exhibits over objection and deferred further depositions, would cause significant prejudice. The WCAB agreed with the judge's report recommending removal and substituted its own order. This new order allows the defendant to conduct further depositions of the applicant and the Agreed Medical Evaluator, Roger Sohn, M.D., while still admitting all exhibits into evidence.

Petition for RemovalFindings and OrderAgreed Medical EvaluatorWCJWCABFurther DepositionsIndustrial InjuryTerra PaveArrowood Indemnity CompanyState Compensation Insurance Fund
References
1
Case No. ADJ282433 (LAO 0880367)
Regular
Jun 08, 2015

MICHAEL DUFFEY vs. CMH RECORDS, STATE FARM INSURANCE COMPANY

The Appeals Board granted reconsideration to admit previously excluded defendant exhibits, specifically the depositions and report of Drs. Miller and Saint Martin. Despite ruling the exhibits admissible, the Board affirmed the original finding that defendant failed to present substantial evidence to terminate applicant's continuing home health care. Dr. Miller's change of opinion was deemed unsubstantiated, and Dr. Saint Martin's opinion was deemed irrelevant to the specific terms of the prior stipulation. The Board emphasized that admitting the evidence ensures due process and reinforces the integrity of its decision.

Petition for ReconsiderationFindings and AwardHome Health CareSubstantial EvidenceAdmissible ExhibitsDepositionMedical ReportAgreed Medical EvaluatorPrimary Treating PhysicianDue Process
References
4
Case No. ADJ394613 (VNO 0530712) ADJ2266356 (VNO 0530710)
Regular
Apr 01, 2016

MARIA ESTRELLA vs. NATIONAL EXPRESS CORPORATION

The Workers' Compensation Appeals Board (WCAB) granted removal to a lien claimant after a judge excluded four exhibits. The WCAB found that two of the excluded exhibits, representing certifications and financial interest notifications, were sufficiently listed on the Pre-Trial Conference Statement. Therefore, the WCAB admitted these two exhibits into evidence, amending the judge's prior order. The remainder of the judge's order, excluding the other two exhibits, was affirmed.

Petition for RemovalLien ClaimantWorkers' Compensation Appeals BoardWCJExhibitsPrejudiceIrreparable HarmPre-Trial Conference StatementServiceNotification of Certification
References
1
Case No. ADJ7618189
Regular
Nov 26, 2012

RUBEN OROZCO vs. EXACT STAFF, INC.; TOWER/NSM INSUREX, Administered by YORK INSURANCE SERVICES GROUP

This case involves lien claimants Anderson Chiropractic and Santana Lopez seeking reconsideration of an order disallowing their liens. The Workers' Compensation Appeals Board granted reconsideration because a crucial exhibit, Exhibit 6, was incomplete in the record. Lien claimants are ordered to file a complete copy of Exhibit 6 within 10 days to allow the Board to properly review the case. This action is necessary for the Board to study the facts and applicable law concerning the disallowed liens.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien claimantsFindings and OrdersDisallowed liensExhibit 6Administrative law judgeWCJSupplemental pleadingSan Francisco
References
0
Case No. ADJ9854290
Regular
Apr 10, 2017

MARY VIEIRA vs. PASO ROBLES TANK, INCORPORATED., OLD REPUBLIC GENERAL INSURANCE CORPORATION, GALLAGHER BASSETT SERVICES

This case involves defendant's petition for reconsideration of a finding of total permanent disability due to an admitted industrial right ankle injury complicated by Complex Regional Pain Syndrome (CRPS). Defendant argues the Qualified Medical Evaluator's (QME) report lacks substantial evidence due to failure to review prior injury records and for not using DRE ratings. The Appeals Board granted reconsideration to admit a supplemental QME report that reviewed the prior injury records and did not alter the QME's opinions. The Board intends to admit this supplemental report unless good cause is shown within 15 days.

Complex Regional Pain SyndromeCRPSQualified Medical EvaluatorQMEsubstantial evidenceDRE ratingsAMA Guidessupplemental reportPetition for ReconsiderationFindings and Award
References
0
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