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

Case No. ADJ10321614
Regular
Nov 17, 2017

KURT SAALFELD vs. CITY OF TRACY

The Appeals Board denied applicant's Petition for Removal seeking a replacement Qualified Medical Evaluator (QME) panel. Applicant objected to defendant's letter to the QME via email, but defendant had previously informed applicant they do not accept email service. The Board found applicant's email objection improperly served as there was no agreement for electronic service. Therefore, the Board concluded that applicant failed to demonstrate substantial prejudice or irreparable harm to warrant removal.

Workers' Compensation Appeals BoardPetition for RemovalFindings and OrderQualified Medical EvaluatorQME panelLabor Code section 4062.3(b)Rule 10505service by emailobjection to QME letterpeace officer
References
2
Case No. ADJ1054155 (LAO 0854446) ADJ1247741 (LAO 0854447) ADJ1895803 (LAO 0854448)
Regular
May 03, 2011

HIRITI OKUAMICHAEL vs. PAUL OWENS SHOES INC., STATE FARM FIRE AND CASUALTY COMPANY, STATE COMPENSATION INSURANCE FUND

This amended order clarifies that the Workers' Compensation Appeals Board has granted the applicant's petition for reconsideration of the February 8, 2011 Findings and Awards. This reconsideration aims to allow the Board to thoroughly study the factual and legal issues, including those to be raised in the applicant's supplemental petition. The applicant's request to file a supplemental petition has also been granted and reaffirmed. All future communications regarding these cases should be directed to the Office of the Commissioners of the WCAB.

Supplemental PetitionReconsiderationAppeals Board Rule 10848Findings and AwardsDecision After ReconsiderationOffice of the CommissionersWCABADJ1054155ADJ1247741ADJ1895803
References
0
Case No. ADJ9016733
Regular
May 03, 2016

TYSON CONGER vs. CARE AMBULANCE, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration of a prior award concerning industrial injuries to his low back and psyche. The applicant argues the original findings did not properly weigh evidence and support a higher permanent disability rating. The Board also permitted the applicant to file a supplemental petition to address new information, allowing defendants an opportunity to respond. Reconsideration was granted to ensure a complete review of the record and a just decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationSupplemental PetitionEmergency Medical TechnicianLow Back InjuryPsyche InjuryTemporary DisabilityFuture Medical TreatmentPermanent DisabilityApportionment
References
1
Case No. VNO 0438915
Regular
Oct 23, 2008

Applicant vs. University of Southern California

This case concerns an applicant's Petition for Reconsideration of a WCAB decision denying injury claims against the University of Southern California (USC). The applicant alleged a physical altercation with his supervisor, Mr. Pickering, during a meeting on September 20, 2001, which he claims caused various injuries. However, the WCJ found the applicant lacked credibility due to inconsistencies in his testimony and failure to report the incident promptly. The WCJ relied on testimony from witnesses who stated Mr. Pickering merely touched the applicant's shoulders and noted the applicant's history of prior injuries and medical issues not fully disclosed.

WCABPetition for ReconsiderationUniversity of Southern CaliforniaBiological Safety Specialistspecific injuryanimositycredibility issuesshoulder touchingprior injurieshypertension
References
0
Case No. ADJ6958416
Regular
May 19, 2011

Norma Zell vs. ALAMEDA COUNTY, SEDGWICK CMS

The Workers' Compensation Appeals Board granted the applicant's first petition for reconsideration, amending the original award to increase her permanent disability rating from 20% to 24% based on corrected medical calculations. The Board denied the applicant's second petition for reconsideration regarding her left wrist injury, adopting the judge's reasoning that it was not a compensable industrial injury. The original finding of a cumulative industrial injury to the right wrist during her employment as a deputy sheriff was affirmed. The award was amended to reflect the 24% permanent disability rating and adjusted attorney fees.

Workers' Compensation Appeals BoardCumulative Industrial InjuryRight Wrist InjuryDeputy SheriffPermanent Disability RatingAMA GuideWhole Person ImpairmentPetition for ReconsiderationFindings and AwardDecision After Reconsideration
References
0
Case No. ADJ6729105
Regular
Sep 16, 2009

, ## Applicant, vs. , ## Defendant(s).

The Workers' Compensation Appeals Board denied reconsideration of a ruling that utilization review for the applicant's shoulder surgery was timely. The applicant argued she did not receive the denial letter within the required timeframe, but the Board found that the denial was properly sent to the treating physician and carbon-copied to the applicant within the statutory period. The Board clarified that WCAB Rule 10505(d) regarding official address records did not apply at the time of the denial because no claim application was yet filed. Therefore, the carrier's obligation was to communicate the denial in writing within the specified time, which they did.

Workers' Compensation Appeals BoardCadbury SchweppesGallagher Bassett ServicesUtilization ReviewPetition for ReconsiderationApplication for Adjudication of ClaimWCAB Rule 10505(d)Labor Code Section 4610ArthroscopyBiceps Tenodesis
References
0
Case No. ADJ1812731 (LBO 0352930), ADJ4306876 (LBO 0297758)
Regular
Mar 19, 2014

Applicant vs. Defendant

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's Petition for Reconsideration. The dismissal was based on the applicant's failure to file proof of service with the petition, a mandatory procedural requirement. Even if the merits were considered, the WCAB would have denied the petition based on the Judge's report. The applicant had sought reconsideration of a denial for a Petition to Reopen and claimed new and further disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition to ReopenFindings and OrderAgreed Medical EvaluatorNew and Further DisabilityTemporary DisabilityBad FaithProof of ServiceDismissal
References
0
Case No. ADJ8643967, ADJ10070125, ADJ10069887, ADJ10525090
Regular
Sep 28, 2018

Applicant vs. Calgary Flames, et al.

The Workers' Compensation Appeals Board denied an applicant's petition for removal of a prior order granting a continuance. The applicant, a hockey player alleging industrial injuries, claimed the continuance would cause significant prejudice and irreparable harm. However, the Board found that the applicant's attorney had filed a petition to withdraw, making the continuance necessary for the applicant to secure new counsel. Therefore, removal was deemed inappropriate and the petition was denied.

ADJ8643967ADJ10070125ADJ10069887ADJ10525090Santa Ana District OfficeCALGARY FLAMESOPINION AND ORDERDENYING PETITION FOR REMOVALworkers' compensation administrative law judgeWCJ
References
1
Case No. MISSING
Regular Panel Decision
Aug 19, 1993

Claim of Dukes v. Capitol Formation, Inc.

A claimant was injured in an automobile accident in 1971 while on a business trip, resulting in a compensable injury. Over the next two decades, numerous hearings were held regarding medical bill payments and related compensation issues. The parties eventually entered into a stipulated settlement, which included a $75,000 lump-sum payment under Workers’ Compensation Law § 15 (5-b). The Workers’ Compensation Law Judge denied the claimant’s request to set aside this stipulation, a decision affirmed by the Workers’ Compensation Board. The claimant's subsequent application for reconsideration was also denied by the Board. The appeals court dismissed the appeal of the Board’s June 7, 1993 decision as untimely, and affirmed the Board’s August 19, 1993 decision, finding no abuse of discretion in denying the application for reconsideration.

Workers' CompensationStipulated SettlementLump-Sum SettlementReconsiderationUntimely AppealAbuse of DiscretionFraudCollusionMistakeTotal Disability
References
7
Case No. ADJ9290138
Regular
Jul 14, 2016

MATT JACOBS vs. PARSEC, INC./BUDCO; ACE USA

This case denied an applicant's petition for reconsideration of a decision upholding an Independent Medical Review (IMR) denial of knee surgery authorization. The applicant argued the IMR determination was invalid due to untimeliness, but the Board found the statutory timeframes for IMR decisions are directory, not mandatory. Therefore, a delay in the IMR decision does not invalidate it, and the applicant remains bound by the IMR's finding on the medical necessity of the proposed treatment. The Board affirmed the WCJ's decision, denying the applicant's petition for reconsideration.

Workers' Compensation Appeals BoardIndependent Medical ReviewLabor Code section 4610.6(h)Utilization ReviewTotal ArthroplastyTimelinessAdministrative DirectorPlainly Erroneous Finding of FactDirectory vs. MandatoryMargaris
References
4
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