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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ10298988
Regular
Jan 31, 2018

BRIAN BERRY vs. HOSPICE OF THE FOOTHILLS, ALPHA FUND

The Appeals Board rescinded the prior decision and returned the case to the trial level for further proceedings. The Board found that the record was insufficient to determine if the applicant voluntarily retired or was constructively terminated from his employment. Further development of evidence is needed to establish whether the applicant intended to permanently leave the labor force or if his industrial injury prevented him from continuing to work. This determination is crucial for assessing his entitlement to additional temporary disability benefits and potentially permanent disability benefits.

Workers' Compensation Appeals Boardindustrial injuryright shouldertemporary disability indemnityvoluntarily retiredlabor forcedue processself-representedadmission of evidenceexclusion of evidence
References
Case No. ADJ8944426, ADJ8942895
Regular
Dec 22, 2014

DAVID POSHOGLYAN vs. HOLLIDAY ROCK COMPANY, INC., INSURANCE COMPANY OF THE WEST, XL SPECIALTY INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of a decision finding applicant sustained injury arising out of and in the course of employment. Defendants argued certain exhibits were improperly admitted due to lack of service and that the decision was vague. The Board adopted the WCJ's report, which found the exhibits were properly admitted or any error was harmless, and that the decision adequately addressed the stipulated facts. The WCJ's report detailed why the exhibits were admissible despite service issues and explained that further clarification on body parts or liability was not required at this stage of the proceedings.

ADJ8944426ADJ8942895PoshoglyanHolliday Rock CompanyInsurance Company of the WestXL Specialty Insurance CompanySedgwickPetition for ReconsiderationDeniedWCJ Report
References
Case No. ADJ10443669
Regular
Oct 04, 2017

Donna Carter vs. Rose International Group, OneBeacon Insurance Group

The Appeals Board affirmed the Workers' Compensation Judge's finding that Donna Carter sustained an industrial injury to her right knee and left wrist on May 18, 2016. Despite inconsistencies in the applicant's testimony regarding a slip and fall incident, her account was corroborated by a witness who found her on the floor. Medical records from the day of the incident also supported the applicant's claim, establishing a clear mechanism of injury. The Board found that the common sense nature of a slip and fall does not require expert medical opinion to establish industrial causation for the incident itself.

ADJ10443669Rose International GroupOneBeacon Insurance GroupDonna CarterWorkers' Compensation Appeals BoardOpinion and Decision After Reconsiderationslip and fallindustrial injuryright kneeleft wrist
References
Case No. ADJ7485185, ADJ9885267
Regular
Sep 18, 2017

LAURA ORTIZ vs. FARMERS INSURANCE GROUP, MID CENTURY INSURANCE

This Workers' Compensation Appeals Board decision denies a petition for reconsideration, affirming the applicant's timely invocation of jurisdiction to seek additional benefits. The Board adopted the WCJ's reasoning that the applicant's filings of an Application for Adjudication of Claim and an Amended Application, along with documented medical evidence of worsening condition, satisfied the requirements for reopening and seeking further compensation. These actions put the defendants on notice of the applicant's intent to pursue increased benefits, even without a formal petition to reopen.

Petition for ReconsiderationLabor Code section 5410Application for Adjudication of ClaimRiel v. State of CaliforniaBeaida v. Workers' Comp. Appeals Bd.stipulated awardpro perfuture medical treatmentincreased symptomsworsening condition
References
Case No. ADJ7159838 ADJ7550047
Regular
Jul 29, 2014

ALMA PELAYO vs. ASSOCIATED LIEN SERVICES

Applicant Alma Pelayo sought reconsideration of a prior decision that found no violation of Labor Code section 132(a) and ordered her to take nothing further. Pelayo argued the judge erred in this finding and in failing to rule on the admissibility of her Exhibit 15. The Appeals Board granted reconsideration solely to admit Pelayo's Exhibit 15 and defendant's Exhibits A1, A2, and A3. The Board otherwise affirmed the original decision, meaning Pelayo still takes nothing further.

Workers' Compensation Appeals BoardLabor Code section 132(a)Findings and OrderPetition for ReconsiderationWCJApplicant's Exhibit 15Defendant's Exhibits A1A2A3admissible evidence
References
Case No. ADJ2519091 (LAO 0824930) ADJ4160066 (LAO 0824931) ADJ188382 (LAO 0828971)
Regular
Aug 18, 1941

MARIA MARXUACH vs. WESTIN BONAVENTURE HOTEL, ZURICH NORTH AMERICAN INSURANCE

The Workers' Compensation Appeals Board denied reconsideration in this case, upholding the judge's decision. Discovery closed by operation of law on September 12, 2007, and the applicant's attorneys failed to demonstrate due diligence in listing crucial medical reports as exhibits prior to this closure. Despite numerous continuances and attempts to amend the exhibit list, discovery was never formally reopened. The Board adopted the judge's reasoning that the applicant did not establish why the exhibits could not have been presented with reasonable diligence before discovery closed.

Mandatory Settlement ConferencePre-trial conference statementdiscovery closureadministrative law judgePetition for Reconsiderationreopen discoverydue diligenceexhibition listWCJ reportWorkers' Compensation Appeals Board
References
Case No. ADJ7281695
Regular
Feb 02, 2017

MARIA COSME HERNANDEZ vs. CARDENAS MARKET, INC., PENNSYLVANIA MANUFACTURERS ASSOCIATION INSURANCE GROUP, GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The Board affirmed the WCJ's finding that the applicant was not a credible witness, giving great weight to the WCJ's observation of her demeanor. The Board also found no substantial evidence to overturn the credibility determination and noted the applicant's failure to meet her burden of proof by a preponderance of the evidence. Furthermore, any objection to the admissibility of defendant's Exhibit A was deemed waived due to the lack of objection at trial.

Petition for ReconsiderationCredibility DeterminationDemeanor on the StandSubstantiality of EvidenceBurden of ProofPreponderance of EvidenceIndustrial InjuryAdmissibility of EvidenceWaived ObjectionWorkers' Compensation Appeals Board
References
Case No. ADJ9749961
Regular
Oct 11, 2017

ROMEL MAAIA vs. REDNECK TRAILER SUPPLY, INC., NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURG, PA.

In this workers' compensation case, the Appeals Board granted reconsideration to address the applicant's entitlement to treat outside the defendant's Medical Provider Network (MPN). The defendant contested that the applicant's chosen physician, Dr. Shaw, qualified as a "regular physician" under Labor Code section 4600(d). Specifically, the defendant argued the applicant failed to prove the predesignation notice was submitted to the employer before the injury, and that Dr. Shaw was indeed the applicant's regular physician who retained his records. The Board found the record insufficient to definitively rule on these issues and remanded the case to the WCJ for further development of the evidence.

Predesignation of Personal PhysicianMedical Provider NetworkRegular PhysicianLabor Code section 4600Workers' Compensation Appeals BoardFindings of FactOpinion and Decision After ReconsiderationDevelop the RecordDue ProcessNimish Shah M.D.
References
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