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

Case No. ADJ7713711
Regular
Mar 11, 2016

JULIANA MASTERS vs. STATE OF CALIFORNIA, DEPARTMENT OF MOTOR VEHICLES

The Appeals Board denied reconsideration of the WCJ's decision, upholding the finding that applicant's sleep impairment, though present, was subsumed by the physical upper extremity impairments and thus not separately ratable. The Board found the Agreed Medical Examiner's opinion on sleep disorder impairment was not substantial evidence as it was predicated on pain already accounted for in the physical injury ratings per the AMA Guides. Therefore, the applicant's permanent disability rating remained at 69%. A dissenting opinion argued the Agreed Medical Examiner's opinion should be followed, as it addressed distinct impairments beyond pain and was supported by relevant case law.

Workers' Compensation Appeals BoardAmended Findings of Fact and AwardsIndustrial InjuryUpper ExtremitiesPsycheBook BinderSleep ImpairmentAMA GuidesPermanent DisabilityAgreed Medical Examiner
References
Case No. ADJ13840656
Regular
Feb 14, 2023

JOSEPH GROSS vs. VALLEY TRUCK & TRAILER, INC., AMGUARD INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of a decision finding an injury to Joseph Gross compensable. The applicant alleged injury while performing off-the-books work for cash after being laid off, with the employer denying employment and the injury. The Workers' Compensation Judge's credibility determinations, based on witness demeanor and supporting documentation, were adopted and incorporated into the Board's decision. The Board found no substantial evidence to overturn the Judge's findings, which included a finding of injury arising out of and in the course of employment.

AOE/COEPetition for ReconsiderationCredibility DeterminationsWCJ ReportGarza v. Workmen's Comp. Appeals Bd.Medical Treatment EntitlementCOVID PandemicOff-the-Books PaymentQME EvaluationContradictory Evidence
References
Case No. ADJ107733
Regular
May 03, 2011

ALFREDO GUTIERREZ vs. VIKING COMPANY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted the applicant's petition to disqualify Administrative Law Judge (ALJ) James Hopkins. The applicant's attorney claimed the ALJ demonstrated animosity and bias by stating the case was rescheduled "Because, it's you" when referring to the attorney. Although the ALJ cited administrative difficulties, he did not deny making the statement. The WCAB found this statement sufficient to establish an appearance of bias, warranting disqualification. The case will be reset for trial before a different ALJ, with priority given due to the repeated postponements.

Petition for DisqualificationWCJ biasappearance of biasattorney biasLabor Code section 5311mandatory settlement conferencedouble bookedanimosity and gamesmanshipprocedural historyexpedited hearings
References
Case No. ADJ1332416 (WCK 0031685), ADJ3521523 (WCK 0322592), ADJ4017994 (WCK 0029276)
Regular
May 16, 2014

PAMELA ZEILSTRA vs. TARGET STORES, SEDGWICK CMS

This case involves a Petition for Reconsideration filed by Pamela Zeilstra against Target Stores and Sedgwick CMS. The Workers' Compensation Appeals Board dismissed the petition because it was untimely and not filed from a final order, as required by Labor Code section 5900. The Board clarified that interlocutory procedural orders, which do not determine substantive rights, are not subject to reconsideration. Therefore, the petition was dismissed.

Petition for ReconsiderationUntimely PetitionFinal OrderInterlocutory OrderSubstantive RightLiability DeterminationWCABWorkers' Compensation Appeals BoardAdministrative Law JudgeReport and Recommendation
References
Case No. ADJ999430 (PAS 0009969), ADJ3798683 (LAO 0577997), ADJ1783473 (LAO 0785005)
Regular
Aug 15, 2014

KARIN CHEN vs. STATE OF CALIFORNIA, DEPARTMENT OF TRANSPORTATION, STATE COMPENSATION INSURANCE FUND, STATE CONTRACT SERVICES

This case involves a second Petition for Reconsideration filed by applicant Karin Chen challenging a prior Appeals Board decision. The Board is dismissing this petition because a party cannot file successive petitions for reconsideration after the Board has already ruled on a matter without admitting new evidence. Such an action is procedurally improper and requires a petition for writ of review instead. Therefore, the current Petition for Reconsideration is dismissed.

Petition for ReconsiderationDismissalConsecutive PetitionSuccessive PetitionPetition for DisqualificationWorkers' Compensation Appeals BoardAdministrative Law JudgeWrit of ReviewAppeals Board Decision*Crowe Glass Company v. I.A.C.*
References
Case No. ADJ729488 (LAO 0855346) ADJ2727815 (LAO 0855347)
Regular
Dec 07, 2012

GLADYS GENOVES vs. CONTINENTAL BINDER & SPECIALTY CORP., STATE COMPENSATION INSURANCE FUND

This case involves disputed workers' compensation liens filed by MRI Center and Dr. Roger M. Kerr. The Workers' Compensation Appeals Board (WCAB) granted reconsideration of an order dismissing these liens. The primary issue concerns the proper representation and authorization of Pinnacle Lien Services to act on behalf of the lien claimants. The WCAB found the record insufficient to determine the relationships between the entities involved. Therefore, the dismissal order is rescinded, and the matter is returned for a new lien conference where representatives from Pinnacle and Professional Accounts Management, Inc. must appear with documentation.

Workers' Compensation Appeals BoardLien ClaimantCompromise and ReleaseDeclaration of Readiness to ProceedLien ConferencePretrial Conference StatementPetition for ReconsiderationWCJNotice of Intention to DismissObjection to Notice of Intention
References
Case No. ADJ8797865, ADJ8796878
Regular
Jul 10, 2017

DANIEL BOOKE vs. GRANGER CONTRACTING AND AMERISURE MUTUAL INSURANCE, administered by YORK RISK SERVICES GROUP, INC.

The Workers' Compensation Appeals Board denied the Applicant's Petition for Removal. Removal is an extraordinary remedy only granted if substantial prejudice or irreparable harm will result and reconsideration will not be an adequate remedy. The Board found no such showing was made, adopting the reasoning of the Workers' Compensation Judge. Therefore, the petition was denied as removal is not warranted in this case.

Petition for RemovalWorkers' Compensation Appeals BoardWCJ Reportsubstantial prejudiceirreparable harmreconsiderationextraordinary remedyCortezKleemannGRANGER CONTRACTING
References
Case No. ADJ6714992
Regular
Dec 17, 2010

JILL RUTH HAMILTON vs. DOHERTY EMPLOYMENT GROUP, INC., WAUSAU INSURANCE

The Workers' Compensation Appeals Board granted reconsideration and reversed the WCJ's decision, finding the applicant's claim for psychiatric injury barred under Labor Code section 3208.3(d). The Board clarified that "employment" for the six-month rule means actual performance of services, not just being on the company's books or receiving benefits. The applicant's actual paid work period was 179 days (5 months and 26 days), falling short of the required six months. Therefore, her claim for psychological injury was dismissed.

Workers' Compensation Appeals BoardReconsiderationLabor Code section 3208.3(d)Cumulative trauma injuryPsychiatric injurySix-month employment ruleActual servicesRemuneratedSudden and extraordinary employment conditionDate of injury
References
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