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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ8290334
Regular
May 23, 2016

MARTHA GALVEZ vs. HEY BABY OF CALIFORNIA, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted the lien claimant's petition for removal, rescinding a WCJ's order that continued a lien trial to obtain documents from the anti-fraud unit regarding a potential Labor Code section 4615 stay. The Board found that with the Department of Industrial Relations now publishing relevant documents online, discovery should be reopened for the parties to review these materials. This action aims to resolve the section 4615 issue efficiently and obviate the need for the WCJ's direct involvement with the anti-fraud unit. If a dispute persists after reviewing the online documents, parties can seek a new hearing.

Workers' Compensation Appeals BoardPetition for RemovalAnti-Fraud UnitLabor Code Section 4615Due ProcessWCJDepartment of Industrial RelationsLien ClaimantStay of LienIndicted Provider
References
Case No. ADJ7232076
En Banc
Sep 26, 2011

Tsegay Messele vs. Pitco Foods, Inc.; California Insurance Company

The Appeals Board holds that the 10-day period for agreeing on an AME under Labor Code § 4062.2(b) is extended by five days when the initial proposal is served by mail, and clarifies the method for calculating this time period, finding both parties' panel requests premature.

Workers' Compensation Appeals BoardTsegay MesselePitco FoodsInc.California Insurance CompanyADJ7232076Opinion and Decision After ReconsiderationOrder Granting RemovalDecision After RemovalEn Banc
References
Case No. ADJ8897034
Regular
May 03, 2018

MARIA CUELLAR DE PATLAN vs. GELSONS MARKET, SPRINGFIELD INSURANCE COMPANY

Lien claimant Mesa Pharmacy's petition for removal was granted because the WCJ erred in continuing the lien trial to notify the anti-fraud unit (AFU), as this violated due process and the AFU lacked standing. The Appeals Board rescinded the WCJ's order, finding that documents now available on the DIR website likely obviate the need for AFU involvement. The matter was taken off calendar to allow parties to review these documents, with a new hearing to be scheduled if a dispute regarding Labor Code section 4615 remains.

RemovalLien ClaimantAnti-Fraud Unit (AFU)Labor Code Section 4615Due ProcessElectronic Adjudication Management System (EAMS)Stayed LienPetition for RemovalWorkers' Compensation Appeals Board (WCAB)Administrative Law Judge (WCJ)
References
Case No. ADJ7047387
Regular
Dec 17, 2012

CECILIA ALAS vs. G & G APPAREL aka B FRIEND, INC., ACE PROPERTY & CASUALTY Administered By ESIS

This case involves a petition for reconsideration filed by a defendant in a workers' compensation matter. The petitioner subsequently withdrew their petition. The Workers' Compensation Appeals Board is dismissing the petition due to its withdrawal. The Board also admonishes the e-filing petitioner for failing to notify the Reconsideration Unit via email of the withdrawal, which led to wasted Board resources.

ADJ7047387Petition for Reconsiderationwithdrawndismissede-filerControl UnitReconsideration UnitEAMS Reference GuideElectronic FilingDWC website
References
Case No. ADJ3976429 (AHM0117091) & ADJ2299501 (AHM0140858)
Regular
Feb 04, 2010

MARY JO WILLIAMS vs. ARTHUR J. GALLAGHER & CO.; HARTFORD SPECIALTY RISK SERVICES, administered by GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant sought to set aside a previous award based on allegations of fraud and physical improvement, but failed to provide sufficient evidence. The Board found the defendant's evidence of fraud unpersuasive and that a recent deposition did not establish such claims. Consequently, the petition for reconsideration was denied.

Petition for ReconsiderationStipulated Findings and AwardDue DiligenceFraudContinuous TraumaAOE/COEPermanent DisabilityStellate Ganglion BlocksRestless Leg SyndromeIntentional Fraud
References
Case No. ADJ9188852
Regular
Oct 24, 2014

MAURICIO FLORES vs. AMPAM PARKS MECHANICAL, AMERICAN INTERNATIONAL GROUP, INC.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a dismissal order of the applicant's claim. This decision followed the applicant's assertion that their request for voluntary dismissal was procured by fraud. The WCAB adopted the trial judge's recommendation to return the case for further proceedings concerning the fraud allegations. Despite procedural defects in the petition, the WCAB exercised its discretion to grant reconsideration on the merits.

Petition for ReconsiderationOrder For Dismissal of Claim Without Prejudicefraudvoluntary dismissalWCJWCAB Rulesverification requirementsAppeals Board Rule 10856rescindedreturned for further proceedings
References
Case No. ADJ2941365 (BGN 0131581)
Regular
May 22, 2019

JOCELYN JOHNSON vs. COCA COLA BOTTLING COMPANY, KEMPER NATIONAL INSURANCE

The Workers' Compensation Appeals Board denied Jocelyn Johnson's petition for reconsideration of a prior decision that found no fraud in the procurement of earlier findings and awards. Johnson alleged an incorrect injury date, insufficient medical evaluation, and denial of due process. The Board found that Johnson failed to demonstrate extrinsic fraud, as the issues raised could and should have been litigated in prior proceedings or appeals. Therefore, good cause did not exist to reopen the 1996 and 2002 findings and awards.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFraudDate of InjuryAgreed Medical EvaluatorDue ProcessLabor Code Section 5803Continuing JurisdictionExtrinsic Fraud
References
Case No. ADJ8490774
Regular
Jan 06, 2014

JAIME ROSPIGLIOSI vs. UNITED AIRLINES

The Workers' Compensation Appeals Board (WCAB) denied United Airlines' petition for removal. The defendant's request for a new Qualified Medical Examiner (QME) was denied because the original QME selection process was valid and timely. The WCAB found the petition lacked merit, bordered on frivolous, and admonished defense counsel for failing to include their State Bar number. The existing QME's reports will stand, and the case will proceed without further delay.

Petition for RemovalWCABUnited AirlinesGallagher Bassett ServicesPQMEPanel QMEDr. CremetaMedical Unit8 CCR 30(b)duplicative request
References
Case No. ADJ7390255
Regular
Jan 03, 2023

DARNELLA SCOTT STREET vs. SAN FRANCISCO BAY AREA RAPID TRANSIT DISTRICT, ATHENS ADMINISTRATORS

The Workers' Compensation Appeals Board denied reconsideration of a decision allowing a lien claim for an H-Wave machine. The applicant found more relief with the H-Wave than a TENS unit. The Agreed Medical Examiner opined that while not convinced the H-Wave was superior to other inferential stimulation units, it was superior to a TENS unit. The WCAB found the lien claimant met its burden of proof regarding the medical necessity of the H-Wave.

Workers' Compensation Appeals BoardSan Francisco Bay Area Rapid Transit DistrictAthens AdministratorsPetition for ReconsiderationWorkers' Compensation Administrative Law Judgesubstantial evidenceElectronic Waveform LabsH-WaveTENS unitinferential stimulation unit
References
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