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

Case No. ADJ8217279
Regular
May 05, 2017

PETER BOURASSA vs. DOLLAR TREE, SEDGWICK

The Appeals Board affirmed the WCJ's decision regarding applicant Peter Bourassa's workers' compensation claim. The lien claimant, Monrovia Memorial Hospital, sought payment exceeding $\$58,272.00$ for services rendered. The Board clarified that facility fees for long-term care hospitals exempt from the Official Medical Fee Schedule (OMFS) must be paid on a "reasonable cost basis." The lien claimant failed to meet its burden of proving the reasonableness of its charges under relevant case law.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderLien ClaimantReasonable Cost BasisOMFSKunz studyAffirmAffirmAffirm
References
Case No. ADJ9115073
Regular
Jul 21, 2014

JOSE CANALES vs. MURRAY COMPANY, OLD REPUBLIC GENERAL INSURANCE

This case involves Jose Canales, an applicant for workers' compensation, who claimed cumulative trauma injury to his neck, arms, and back from his work as a warehouseman/tool maintenance. The defendant, Murray Company, contested the claim, arguing insufficient medical evidence of industrial causation and a post-termination filing defense under Labor Code section 3600(a)(10). The Appeals Board affirmed the WCJ's decision, finding that Canales sustained an industrial injury and that his claim was not barred. The Board concluded that Canales first suffered disability on May 10, 2013, after his termination, when he was diagnosed with temporary total disability by his chiropractor. Therefore, the post-termination affirmative defense was inapplicable, and the petition for reconsideration was denied.

Cumulative trauma injuryLabor Code section 3600(a)(10)Post-termination defenseIndustrial causationSubstantial medical evidenceTreating chiropractorIndustrial nature of injuryDate of injuryCompensable consequenceTemporary disability
References
Case No. ADJ6751788
Regular
Aug 16, 2010

MOISES ROBLES GARCIA vs. ABLE BUILDING MAINTENANCE, ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board granted reconsideration of a finding of industrial injury for applicant Moises Robles Garcia. Defendant Able Building Maintenance argued the applicant failed to prove injury arising out of and occurring in the course of employment (AOE/COE) and raised affirmative defenses of intoxication and material deviation. The Board rescinded the original decision and returned the case to the trial level for further proceedings, specifically to determine AOE/COE and consider the applicant's credibility and deposition transcripts. The WCJ must now make a determination on AOE/COE and potentially other defenses.

AOE/COEintoxication defensematerial deviationexcluded evidencedeposition transcriptswitness demeanorcredibilitypreponderance of the evidencecausal connectionrational incident of work
References
Case No. ADJ10500948
Regular
Dec 18, 2017

ERNESTO VELEZ vs. GENEVA STAFFING, ZURICH NORTH AMERICA

This case concerns applicant Ernesto Velez's workers' compensation claim for an injury sustained in January 2015, prior to his termination on July 7, 2016. The Workers' Compensation Appeals Board granted reconsideration, finding that the applicant failed to prove his injury arose out of and occurred in the course of employment due to a lack of credible testimony and substantial medical evidence. Furthermore, the Board affirmed the finding that the claim is barred as a post-termination claim under Labor Code section 3600(a)(10) because the applicant did not demonstrate any exceptions applied. The applicant therefore took nothing.

AOE/COELabor Code § 3600(a)(10)post-termination defensepetition for reconsiderationcredibility determinationsubstantial medical evidenceaffirmative defenseburden of proofdate of injuryexceptions to defense
References
Case No. ADJ8115072
Regular
Jan 23, 2023

MIGUEL HUITRON vs. GREEN WASTE RECOVERY, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant sought to overturn an award of penalties, arguing it was barred by a two-year statute of limitations under Labor Code section 5814(g). The WCJ found this argument was an affirmative defense that was waived because it was not raised until the petition for reconsideration, not during trial or prior proceedings. Therefore, the Board adopted the WCJ's report and denied the petition.

WORKERS' COMPENSATION APPEALS BOARDPETITION FOR RECONSIDERATIONDENYING RECONSIDERATIONLABOR CODE SECTION 5814LABOR CODE SECTION 5814(g)2-YEAR STATUTE OF LIMITATIONSAFFIRMATIVE DEFENSEWAIVER OF DEFENSEFINDINGS AND AWARDAUDJORY ADMINISTRATIVE LAW JUDGE
References
Case No. ADJ10450656
Regular
Sep 27, 2017

ALEX RONALD PADILLA vs. INTERNATIONAL PAPER COMPANY

The Workers' Compensation Appeals Board denied the petition for reconsideration. The Board affirmed the WCJ's finding that the applicant's injury was not barred by the defense of intoxication. While drug tests showed the applicant tested positive for controlled substances, there was insufficient medical or expert evidence to prove intoxication or impairment at the time of the injury. The WCJ's credibility determinations, particularly regarding the applicant's testimony about his intoxication level and the employer's failure to present conclusive evidence, were given great weight.

ADJ10450656Petition for ReconsiderationWorkers' Compensation Appeals BoardWCJ credibility determinationintoxication defenseaffirmative defenseburden of proofcontrolled substancesdrug screen reportssurveillance film
References
Case No. ADJ1805486 (GOL 0100327)
Regular
Apr 30, 2010

SUZANNE SINGER vs. DISNEYLAND, DISNEY WORLD WIDE SERVICES, Permissibly Self-Insured

This case involves an employee, Suzanne Singer, injured in a car accident after attending an employer-sponsored service award dinner. The employer, Disneyland, argued the injury was non-industrial due to a major deviation from a special mission exception to the going and coming rule and intoxication. While the Appeals Board agreed the injury occurred after a substantial deviation from the special mission, they noted the employer failed to prove intoxication was the proximate cause of the accident and might be estopped from raising that defense. Ultimately, the Board affirmed the finding of no industrial injury but deleted the intoxication finding.

Special mission exceptionGoing and coming ruleDeviationIntoxication defenseEstoppelCredibility determinationCourse of employmentArising out of employmentCumulative trauma injuryService award dinner
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. ADJ19549540; ADJ16500248
Regular
Oct 22, 2025

MARIA A LEYVA TORRES vs. ESPARZA ENTERPRISES, INC., PACIFIC CLAIMS MANAGEMENT

Defendant petitioned for removal of a Workers' Compensation Administrative Law Judge (WCJ) order that took the matter off calendar, arguing for prior consideration of a post-termination defense. The Workers' Compensation Appeals Board reviewed the petition and the WCJ's report, ultimately denying removal. The Board found no substantial prejudice or irreparable harm to the defendant and determined that reconsideration would be an adequate remedy if needed. The decision affirmed the WCJ's discretion in not bifurcating a Labor Code section 3600(a)(10) issue, emphasizing that removal is an extraordinary remedy.

Petition for RemovalOff-Calendar OrderPost-Termination DefenseSubstantial PrejudiceIrreparable HarmReconsiderationAdmitted EvidenceSubstantial EvidenceBifurcationLabor Code Section 3600(a)(10)
References
Case No. ADJ20331276, ADJ20331280
Regular
Sep 24, 2025

BRITNEY OWENS vs. CVS PHARMACY, ACE AMERICAN INSURANCE COMPANY

Applicant Britney Owens filed a petition for removal challenging an order setting the matter for trial, arguing that discovery was incomplete. The Workers' Compensation Appeals Board (WCAB) denied the petition, affirming that removal is an extraordinary remedy and finding no evidence of substantial prejudice or irreparable harm. The Board emphasized that parties would have ample opportunity at trial to develop the record and present evidence, including on the appropriateness of further discovery. Additionally, the Board observed that if the defendant lacks evidence to establish the date of injury, they proceed at their own peril concerning the post-termination defense.

Petition for RemovalPost-termination defenseBifurcated trialDiscovery completenessSubstantial prejudiceIrreparable harmReconsideration remedyAdmitted evidenceSubstantial evidenceDevelop the record
References
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