CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. MISSING
Regular Panel Decision

Main Evaluations, Inc. v. State

The claimant, Main Medical Evaluations, entered into contracts with the New York State Office of Temporary and Disability Assistance (OTDA) to perform consultative medical evaluations. OTDA terminated these contracts, alleging the claimant failed to disclose professional disciplinary proceedings against its chief medical officer, Arvinder Sachdev, and submitted false information during the bidding process. Following the dismissal of its claim in the Court of Claims, the claimant appealed. The appellate court affirmed the lower court's judgment, concluding that OTDA had legitimate grounds for termination due to the claimant's misrepresentations and failure to report substantial contract-related issues concerning Sachdev's integral role. Additionally, the court rejected the claimant's equal protection argument, finding no evidence of selective enforcement based on impermissible considerations.

Contract TerminationProfessional MisconductFalse RepresentationEqual ProtectionGovernment ContractsAppellate ReviewBreach of ContractMedical LicensingAdministrative ProceedingsDue Diligence
References
5
Case No. ADJ4406096 (LAO 0784412)
Regular

JOSE MORFIN vs. WHITE MEMORIAL MEDICAL CENTER

Defendant sought removal from a WCJ's order stipulating to two Agreed Medical Evaluators (AMEs), alleging the WCJ "forced" the agreement. Applicant's attorney and the WCJ countered that defense counsel had agreed to and proposed the AMEs, with the WCJ merely documenting the stipulation. The Appeals Board denied removal as defendant showed no prejudice, but initiated its own removal to address the attorney's alleged false statements and vexatious tactics. Consequently, the Board intends to impose sanctions of up to $2,500 on the defendant and its attorneys for filing a frivolous petition containing misrepresentations.

Workers' Compensation Appeals BoardPetition for RemovalAgreed Medical EvaluatorsWCJSanctionsBad Faith TacticsFrivolousUnnecessary DelayStipulationMisrepresentation of Facts
References
1
Case No. ADJ10091553
Regular
May 06, 2019

DWIGHT STILLWELL vs. WYLATTI RESOURCE MANAGEMENT, INC., STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the applicant challenged the administrative law judge's (WCJ) permanent disability rating of $76\%$. The applicant argued that the WCJ improperly combined medical impairments when an agreed medical evaluator suggested adding them for a higher rating of $88\%$. The WCJ acknowledged misinterpreting the medical evidence in their report, admitting that the agreed medical evaluator did indicate adding impairments was more appropriate. Consequently, the Workers' Compensation Appeals Board granted reconsideration to allow the WCJ to re-evaluate the permanent disability rating based on the correct understanding of the medical evidence.

Agreed Medical EvaluatorAMA GuidesPermanent Disability RatingPetition for ReconsiderationWorkers' Compensation Appeals BoardFindings and AwardCVCSchedule for Rating Permanent DisabilitiesOrthopedistIndustrial Injury
References
0
Case No. ADJ11408219 ADJ10230973 ADJ8720775 ADJ11048512
Regular
Jul 08, 2019

DAVE PIERSON vs. CITY OF FAIRFIELD FIRE DEPARTMENT

The Appeals Board granted removal and rescinded the WCJ's order allowing further discovery from Dr. McHenry. The Board held that an employee is not required to return to a previous agreed medical evaluator for subsequent injury claims, citing their en banc decision in *Navarro*. Labor Code section 4062.2 exclusively governs medical-legal evaluations, and Dr. McHenry lacked status in the current claims as he was neither an agreed nor panel qualified medical evaluator. The matter was returned to the trial level for discovery consistent with statutory requirements.

Petition for RemovalAgreed Medical EvaluatorPanel Qualified Medical EvaluatorLabor Code section 4062.2Labor Code section 3212Navarro v. City of MontebelloRescind OrderReturn to Trial LevelIndustrial InjuryFire Captain
References
1
Case No. ADJ3799579 (VNO 0474814) ADJ1009432 (VNO 0518597)
Regular
Jun 16, 2010

SHAWN PETTWAY vs. ANTELOPE VALLEY UNION HIGH SCHOOL DISTRICT

This case concerns whether Labor Code section 4062 or 4062.2 governs the medical evaluation process for applicant Shawn Pettway's injuries. The Workers' Compensation Appeals Board (WCAB) granted the defendant school district's petition for removal. The WCAB found that since Pettway's injuries occurred prior to January 1, 2005, the older section 4062 applies, entitling the defendant to select its own Qualified Medical Evaluator if an Agreed Medical Evaluator cannot be reached. Consequently, the WCAB rescinded the prior order compelling the parties to agree on an AME or panel.

Petition for RemovalAgreed Medical EvaluatorQualified Medical EvaluatorLabor Code Section 4062Labor Code Section 4062.2Industrial InjuriesCampus SupervisorBack InjuryInternal InjuryKidney Injury
References
1
Case No. ADJ6870507
Regular
Jun 24, 2010

ULISES FUENTES vs. DICKIE DOBINS CLEANERS, ILLINOIS WEST INSURANCE AGENCY, TOWER SELECT INSURANCE AGENCY

This case involves a dispute over the issuance of a Qualified Medical Evaluator (QME) panel in a workers' compensation claim. The applicant sought reconsideration of an order for a QME panel, alleging a deviation from an agreed medical evaluator process and lack of notice. The defendant presented a conflicting account of events, claiming the applicant's attorney conditioned the agreed medical evaluation on the defendant providing temporary disability benefits. The Appeals Board found the divergent factual accounts warranted removal and rescinded the QME panel order. The case is returned to the trial level for factual resolution and to determine if sanctions are appropriate.

WORKERS' COMPENSATION APPEALS BOARDRemovalQME PanelLabor Code § 4062.2Agreed Medical EvaluatorPetition to CompelEx parteNoticeSanctionsLabor Code § 5813
References
1
Case No. ADJ869205 (SAC 0294976) ADJ302322 (SAC 0354178)
Regular
Oct 11, 2010

Patricia Rush vs. The Permanente Medical Group; Athens Administrators Concord

This case involves Patricia Rush claiming cumulative trauma injuries to her knees and back, among other body parts, against The Permanente Medical Group. The Workers' Compensation Appeals Board granted reconsideration because the Administrative Law Judge's findings of industrial causation for knee injuries lacked substantial medical evidence, with conflicting and uncertain Qualified Medical Evaluator opinions. The Board rescinded the prior findings and ordered further development of the medical record, suggesting an Agreed Medical Examiner or a court-appointed physician to resolve the causation issue for the knee injuries. The matter is returned to the trial level for a new final determination after the record is further developed on all issues, including injury causation.

Workers' Compensation Appeals BoardPermanente Medical GroupAthens Administratorscumulative trauma injurykneesbackshouldershandswristsindustrial causation
References
0
Case No. ADJ7212946
Regular
Dec 13, 2012

JOSE QUINTERO vs. CORPORATE PERSONNEL NETWORK, NEW HAMPSHIRE INSURANCE CO., administered by CHARTIS

The Appeals Board granted reconsideration to address the admissibility of Dr. Konstat's psychiatric evaluation. The Board found Dr. Konstat's report inadmissible because it was a medical-legal evaluation obtained in violation of statutory procedures for represented employees, bypassing the requirement for an Agreed Medical Evaluator or Qualified Medical Evaluator. Consequently, the Board amended the prior award to exclude industrial injury to the psyche due to lack of substantial medical evidence. The applicant's award for orthopedic injuries and medical treatment was affirmed.

Workers' Compensation Appeals BoardJose QuinteroCorporate Personnel NetworkNew Hampshire Insurance Co.ChartisAmended Findings and Awardindustrial injuryleft shoulderneckback
References
1
Case No. ADJ9011624
Regular
Dec 13, 2019

ELISHA HARDEN vs. COUNTY OF SACRAMENTO

This case concerns whether specific medical reports obtained for a disability retirement claim are admissible in a workers' compensation proceeding. The Appeals Board rescinded the prior ruling, holding these reports are relevant and may be provided to the orthopedic Agreed Medical Evaluator (AME) and psychiatric Qualified Medical Evaluator (QME). The Board found the reports relevant to the medical issues, even though they were not obtained through the standard workers' compensation medical-legal evaluation process. Consequently, the applicant's objection to providing these reports to the evaluators was overruled.

RemovalReconsiderationAgreed Medical Evaluator (AME)Qualified Medical Evaluator (QME)Medical-legal evaluatorsMedical recordsLabor CodeFindings and Orders (F&O)Disability retirementPermanent impairment
References
9
Case No. SFO 0459441
Regular
Mar 11, 2008

FRANK DEOME vs. CALIFORNIA MEDICAL CENTER, INNOVATIVE CLAIMS SOLUTIONS, INC.

The Workers' Compensation Appeals Board rescinded the previous award and returned the case for further proceedings because the record was insufficient to determine permanent disability and apportionment. The Board found that the WCJ's analysis of apportionment, particularly regarding a prior 1993 injury, was based on insufficient medical evidence and did not align with current legal standards. The case is remanded for further development of the medical record, potentially through an Agreed Medical Evaluation, and the WCJ will revisit all contentions after new evidence is presented.

WORKERS' COMPENSATION APPEALS BOARDDEOMECALIFORNIA MEDICAL CENTERINNOVATIVE CLAIMS SOLUTIONSINDUSTRIAL INJURYBACK SURGERYPERMANENTLY DISABLEDCOMPLEX REGIONAL PAIN SYNDROMEVOCATIONAL REHABILITATIONPERMANENT AND STATIONARY
References
8
Showing 1-10 of 9,933 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational