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

Case No. ADJ10257811
Regular
Dec 18, 2020

JORGE ANDRADE vs. CECILIO ARREDONDO TERREZAS, STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board affirmed the judge's decision finding the applicant was not an employee at the time of injury, concluding he failed to meet his burden of proof. The applicant did not provide evidence establishing an employment relationship with the labor contractor or its associated individuals, and evidence indicated he paid for his own transportation. A dissenting opinion argued the board and judge incorrectly shifted the burden of proof, stating the applicant is presumed an employee and the employer must prove otherwise. The dissent would have rescinded the decision for failure to meet the employer's burden.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and OrderEmployee StatusLabor ContractorBurden of ProofEmployment RelationshipPresumption of EmployeeLabor CodeRebuttal of Presumption
References
5
Case No. ADJ13475083
Regular
Feb 28, 2025

Miguel Garcia Perez vs. Opportunity Staffing, Inc.

Applicant Miguel Garcia Perez and defendant Opportunity Staffing, Inc. both sought reconsideration of a "Second Amended Findings and Award" from November 26, 2024. The Appeals Board granted the applicant's petition for reconsideration and denied the defendant's, also affirming the "Second Amended Findings and Award" with specific amendments. Key issues included applicant's earnings, temporary disability period, supplemental job displacement benefits, attorney's fees, and apportionment. The Board found the WCJ erred in not honoring the parties' stipulation of applicant being a maximum earner, deferred the issues of temporary disability length and attorney's fees for further development, and determined the defendant failed to meet the burden of proof for apportionment under Labor Code sections 4664 and 4663.

StipulationMaximum EarnerApportionmentTemporary DisabilityPermanent DisabilityAttorney's FeesPetition for ReconsiderationLabor CodeMedical EvidenceCausation
References
17
Case No. ADJ6969460
Regular
Mar 17, 2017

MARIA TORRES ORTIZ vs. GNS INC. dba GOOD NUTRITION #2, EYAD ABUDAWAS, SERENA ABID, WALID ABID

In this workers' compensation case, the Appeals Board dismissed the defendant's Petition for Reconsideration as untimely, as it was filed outside the jurisdictional deadline. The Board also denied the applicant's Petition for Reconsideration, adopting the WCJ's reasoning that the applicant failed to meet her burden of proof regarding temporary disability. The applicant did not demonstrate entitlement to temporary disability by a preponderance of the evidence.

WCABPetition for ReconsiderationTimelinessJurisdictionalPreponderance of the evidenceTemporary disabilityBurden of proofUntimely petitionWCJ reportDismissed
References
5
Case No. ADJ13057590; ADJ13058223
Regular
Aug 25, 2025

HEATHER RAMOS vs. PIH HEALTH, ATHENS ADMINISTRATORS

Applicant Heather Ramos sought reconsideration of a WCJ's Findings of Fact and Orders (F&O) which found defendant PIH Health and Athens Administrators had provided proof of service for a supplemental job displacement voucher (SJDV). The WCJ applied the presumption of timely mailing and receipt, finding applicant failed to rebut it and was not entitled to a penalty. Applicant contended there was no valid proof of service, and defendant did not meet the burden to invoke the presumption, thus entitling her to a penalty and attorney's fees. The Appeals Board upheld the WCJ's decision, concluding that the defendant's proof of service was valid, and applicant's evidence was insufficient to overcome the mailing presumption, therefore denying reconsideration.

Supplemental Job Displacement VoucherPresumption of ReceiptMailbox RuleProof of ServiceRebuttal EvidenceWCABPetition for ReconsiderationPenaltiesAttorney's FeesLabor Code Section 5814
References
13
Case No. ADJ9173159
Regular
Dec 09, 2016

GARY COTTLE vs. TONY'S EXPRESS, CALIFORNIA TRUCKERS' SAFETY ASSOCIATION

The Workers' Compensation Appeals Board (WCAB) granted the applicant's petition for reconsideration of a prior administrative law judge's (WCJ) order. This order addressed penalties for unreasonable delay in payment and sanctions for bad faith litigation. Crucially, the WCAB has not received a petition for reconsideration from defendant CTSA and requires them to submit a copy of their petition and proof of timely filing within 20 days. Failure to comply will result in the WCAB proceeding with only the applicant's petition.

WCABPetition for ReconsiderationLabor Code Section 5814Unreasonable DelayCompensation PaymentLabor Code Section 5813Bad Faith LitigationLienTimely FiledProof of Service
References
0
Case No. ADJ7800258 ADJ7800270
Regular
Jun 03, 2013

DEBRA NICKELL vs. PKB INVESTMENTS, INC., dba HOME INSTEAD, CARE WEST INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and amended a prior finding. The amended decision clarifies that the applicant met her burden of proof for reaching maximum medical improvement on July 19, 2011, and for a 15% whole person impairment rating based on an Agreed Medical Evaluator's opinion. However, the applicant did not meet her burden of proof for injury to other claimed body parts. The case is returned to the trial level for further proceedings.

WORKERS' COMPENSATION APPEALS BOARDPKB INVESTMENTSINC.HOME INSTEADCARE WEST INSURANCE COMPANYPEGASUS RISK MANAGEMENTDEBRA NICKELLPetition for ReconsiderationFindings of FactOrder
References
7
Case No. ADJ9920215
Regular
Dec 12, 2017

ALICIA OLMOS vs. JM CONSTRUCTION AND ENGINEERING, INSURANCE COMPANY OF THE WEST

This Workers' Compensation Appeals Board (WCAB) decision denies the applicant's petition for reconsideration. The WCAB adopted the WCJ's report, finding the applicant failed to prove causation for her claimed industrial injury by a preponderance of the evidence. Although the WCAB can amend pleadings to conform to proof, the applicant still bears the burden of proof. Additionally, the applicant's attorney was admonished for citing evidence not admitted into the record.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeAmendment of PleadingsBurden of ProofIndustrial InjuryCausationEvidence AdmittedAppeals Board Rule 10842(c)Advocacy Letter
References
0
Case No. ADJ7546371
Regular
Aug 13, 2018

PEGGY BREWER, vs. COUNTY OF SAN BERNARDINO,

This case involved a lien claimant, Physical Rehabilitation Services, seeking payment for medical treatment provided to applicant Peggy Brewer. The original decision denied the lien claimant's claim, finding they failed to meet their burden of proof regarding the necessity of the treatment and proper appeal procedures. The lien claimant petitioned for reconsideration, arguing that Independent Medical Review (IMR) was not required for services rendered in 2011 and that the WCJ exceeded their authority. The Appeals Board granted reconsideration solely to correct a clerical error referencing IMR procedures, which were not applicable to the services. The original decision, that the lien claimant did not meet their burden of proof for the treatment provided, was otherwise affirmed.

Lien claimantUtilization review denialIndependent Medical Review (IMR)Petition for ReconsiderationFindings and Order (F&O)Workers' Compensation Appeals Board (WCAB)Administrative law judge (WCJ)Burden of proofSubstantial medical evidenceExhaustion of remedies
References
2
Case No. ADJ18961005
Regular
Sep 23, 2025

JAQUELINE GARCIA vs. AMAZON.COM, INC.; LIBERTY MUTUAL

Applicant Jaqueline Garcia petitioned for reconsideration after a Workers' Compensation Administrative Law Judge (WCJ) determined she was an independent contractor, not an employee of Amazon.com, Inc., when she sustained injuries. The Appeals Board granted the petition, citing concerns over the WCJ's application of the burden of proof regarding employment status and the evidential weight given to the 'Amazon Flex Independent Contractor Terms of Service' document. The Board emphasized that the record did not clearly establish if the applicant met her initial burden or if the defendant successfully rebutted the employment presumption under applicable codes. Consequently, a final decision on the merits of the reconsideration is deferred to allow for further review of the factual and legal issues.

Amazon FlexIndependent ContractorProposition 22ABC TestDynamexBusiness and Professions Code 7451ReconsiderationFindings of FactPetition for ReconsiderationWorkers' Compensation Appeals Board
References
26
Case No. ADJ6929350, ADJ7133107, ADJ8881791
Regular
Aug 16, 2019

TIMOTHY RODRIGUEZ vs. DEPARTMENT OF CORRECTIONS, CALIFORNIA MEN'S COLONY, STATE COMPENSATION INSURANCE FUND

The Appeals Board rescinded the WCJ's decision, finding legal error in requiring proof of conspiracy for workers' compensation claims. The WCJ incorrectly applied the burden of proof and failed to adequately consider medical opinions regarding applicant's claims of physical and psychiatric injuries. The case is remanded for further proceedings and a new decision, requiring the WCJ to analyze each claimed injury and body part separately under the correct burden of proof and to further develop the medical record as necessary.

AOE-COEAgreed Medical Evaluatorhostile work environmentconspiracy theoryburden of proofpreponderance of the evidencespecific injurycumulative traumapsychiatric injurygood faith personnel action
References
11
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