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

Case No. ADJ7679237
Regular
Oct 27, 2017

VALERIE TRUJILLO vs. COLTON JOINT UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board granted reconsideration and amended a previous award. The Board found that the administrative law judge erred by failing to address the applicant's vocational expert evidence concerning permanent total disability. The Board also directed the judge to incorporate an agreed medical evaluator's opinion on right ankle impairment if the vocational evidence is rejected. Jurisdiction was reserved on the issue of permanent disability, allowing for further evaluation of the vocational evidence.

WCABPetition for ReconsiderationFindings and AwardSpecial Education AideLumbar SpineRight AnklePsychePermanent DisabilityAgreed Medical EvaluatorAMA Guides
References
8
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. ADJ7523911
Regular
Jun 21, 2018

JEAN BUDD vs. A.C. TRANSIT, YORK RISK SERVICES GROUP

The applicant sought removal of an order that took the case off-calendar to allow the defendant to obtain a vocational evaluation, arguing it caused prejudice and delay. The Appeals Board denied the petition, finding no substantial prejudice or irreparable harm, and that reconsideration would be an adequate remedy. The Board agreed with the WCJ that the defendant was not obligated to obtain a rebuttal vocational report until the applicant presented evidence that might rebut the Permanent Disability Rating Schedule. The applicant's delay arguments were deemed insufficient to warrant removal.

Petition for RemovalOff-Calendar OrderVocational EvaluationSubstantial PrejudiceIrreparable HarmDeclaration of ReadinessObjectionRebuttal Vocational EvaluationWCAB RulesPermanent Disability Rating Schedule
References
5
Case No. ADJ4420203 (SAL 0108544)
Regular
Apr 22, 2015

DORIS NOBLE vs. VEC FARMS, LLC, STATE COMPENSATION INSURANCE FUND

This case involves Doris Noble's workers' compensation claim for a bilateral knee injury. The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the Administrative Law Judge's (WCJ) finding of 100% permanent total disability. This decision relied heavily on the agreed medical evaluator's opinion and the vocational expert's assessment that the applicant's chronic pain, medication, and severe physical limitations rendered her unable to benefit from vocational rehabilitation. The Board also admonished the defense attorney for improperly citing an unpublished case.

Workers' Compensation Appeals BoardPetition for ReconsiderationAgreed Medical EvaluatorPermanent Total DisabilityVocational ExpertFuture Earning CapacitySheltered WorkshopOrthopedic InjuriesChronic Pain SyndromeMedication Intake
References
2
Case No. ADJ8595467
Regular
Sep 29, 2015

JESSICA RIVERA vs. GOOD SAMARITAN HOSPITAL, ACE AMERICAN INSURANCE COMPANY

This case involves a Petition for Removal filed by the defendant, Good Samaritan Hospital and Ace American Insurance Company, seeking to rescind an order closing discovery. The defendants argued that the order closing discovery would cause them substantial prejudice and irreparable harm by preventing them from obtaining a rebuttal vocational expert evaluation. The Workers' Compensation Appeals Board (WCAB) denied the petition, agreeing with the WCJ's report, but noted the defendant could request to proceed with the evaluation at trial. However, one Commissioner dissented, arguing the defendant's actions were diligent and the due process right to discovery was violated.

Petition for RemovalOrder Closing DiscoveryVocational ExpertRebuttal EvaluationDue ProcessSubstantial PrejudiceIrreparable HarmMandatory Settlement ConferenceAgreed Medical EvaluatorsGainfully Employed
References
0
Case No. ADJ7521436
Regular
Jun 24, 2013

ABEL RAMIREZ vs. CROWN WIRE COMMUNICATIONS, INC., TOWER SELECT INSURANCE COMPANY

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration because it was filed against a non-final discovery order. The Board then removed the case to itself and amended the original order. The amended order allows the parties 15 days to agree on an Agreed Medical Evaluator (AME) for the issue of diabetes aggravation, and if they cannot agree, they must request a Qualified Medical Evaluator (QME) panel. The Board found the WCJ's original appointment of a "regular physician" was premature.

Workers' Compensation Appeals BoardPetition for ReconsiderationRemovalAgreed Medical EvaluatorQualified Medical EvaluatorLabor Code Section 5701Labor Code Section 4062.2Industrial InjuryAggravation of DiabetesInternal Medicine
References
8
Case No. ADJ10856280
Regular
Aug 16, 2019

JOHN CAMPBELL, (deceased) vs. CITY OF RED BLUFF FIRE DEPARTMENT, YORK RISK SERVICES GROUP, INC.

The Workers' Compensation Appeals Board granted applicant's petition for removal, rescinding a prior order and finding all four Qualified Medical Evaluator (QME) panels invalid due to errors in claim numbers and procedural missteps. The Board determined that due to multiple panel failures and the employee's passing, the parties must agree to an Agreed Medical Evaluator (AME) within 15 days. If an AME cannot be agreed upon, the administrative law judge will appoint a physician.

Qualified Medical EvaluatorQME panelPetition for RemovalFindings and OrderAgreed Medical EvaluatorAMELabor Code Section 5701Administrative Director Rule 31.5Administrative Director Rule 30(c)Code of Civil Procedure Section 1013
References
2
Case No. ADJ7944187
Regular
Feb 19, 2014

LISA MENDOZA vs. RITE AID CORPORATION, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The defendant, Rite Aid Corporation, petitioned for removal after the WCJ quashed a deposition and set an unreasonably short deadline for a vocational evaluation. The Appeals Board granted the petition, finding merit in the defendant's arguments regarding discovery limitations. The Board amended the prior orders, keeping discovery open for the vocational evaluator's report and depositions of qualified medical evaluators. This allows the defendant to fully pursue its discovery related to impairment, apportionment, and recent sub rosa video evidence.

Petition for RemovalVocational Rehabilitation AssessmentQuashed DepositionPermanent ImpairmentApportionmentSub Rosa VideoQualified Medical EvaluatorsIra CohenDiscoveryWorkers' Compensation Appeals Board
References
0
Case No. ADJ7399938 ADJ7068967
Regular
Jun 23, 2015

OLENA GARCIA vs. RESIDENCE INN, NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PENNSYLVANIA

The Appeals Board granted reconsideration, rescinded the prior award, and returned the case for further development of the record. The initial award found permanent total disability based on a vocational expert's opinion, but the Board found this opinion lacked substantial medical evidence. Specifically, the medical expert's supplemental report was not based on a current evaluation, and the vocational expert's conclusions, relying on that report, were therefore also flawed. The matter is remanded to allow for a current medical evaluation and reassessment of vocational rehabilitation and diminished earning capacity.

Workers' Compensation Appeals BoardPermanent Total DisabilityJoint Findings and AwardVocational ExpertSubstantial EvidenceScheduled RatingFunctional Capacity EvaluationAgreed Medical ExaminerApportionmentModified Work
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
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