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Case Law Database

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

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. 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. ADJ9625407
Regular
Sep 12, 2018

KEITH FIELD vs. CITY OF PINOLE

This case involves a firefighter who sustained bilateral carpal tunnel syndrome after retirement. The Appeals Board reversed the trial judge, holding that Labor Code section 4458.5 applies, entitling the applicant to permanent disability benefits calculated at the maximum indemnity rate. This applies regardless of the applicant's actual earnings or the fact that carpal tunnel syndrome is not a specifically enumerated presumptive injury. The case is remanded for determination of the precise date of injury to calculate the benefit rate.

Workers' Compensation Appeals BoardKeith FieldCity of PinolePermissibly Self-InsuredMunicipal Pooling AuthorityADJ9625407Opinion and Decision After Reconsiderationindustrial injuryfirefighterbilateral upper extremities
References
Case No. ADJ9466570
Regular
Dec 24, 2014

ELVIRA HERNANDEZ vs. NEWCO FOODS, INC., Operating As JACK IN THE BOX, SECURITY NATIONAL, Administered By AMTRUST NORTH AMERICA

The Workers' Compensation Appeals Board granted reconsideration to clarify an earlier decision regarding a Medical Provider Network (MPN). The Board affirmed the finding that the defendant failed to prove the existence of a valid MPN. Consequently, findings related to MPN access standards and transfer of care were rescinded, with the applicant permitted to continue treatment outside the invalid MPN with her chosen physician. This decision primarily hinges on the defendant's failure to establish a legally compliant MPN.

Medical Provider NetworkMPNFindings of Fact and AwardPetition for Reconsiderationprimary treating physiciantransfer of careself-procured medical treatmentTitle 8section 9767.5(b)Title 8
References
Case No. ADJ9170309
Regular
Nov 03, 2025

Miguel Mosqueda vs. City of Clearlake

Applicant Miguel Mosqueda sought reconsideration of a July 25, 2025 decision which found his injuries were not caused by the employer's serious and willful misconduct or violation of safety orders. Mosqueda, a maintenance worker, suffered catastrophic injuries, including paraplegia, after falling from a ladder while trimming a tree for the City of Clearlake. He contended that the employer violated several Cal. Code Regs., tit. 8 sections related to safety, training, and equipment. The Workers' Compensation Appeals Board, adopting the WCJ's report, denied the petition for reconsideration, concluding that the employer's actions did not constitute serious and willful misconduct and that no alleged safety violation was the proximate cause of the accident.

Serious and willful misconductPetition for reconsiderationFindings and OrderViolation of statuteViolation of safety orderCal. Code Regs. tit. 8 § 3203Cal. Code Regs. tit. 8 § 3276(d)(1)Cal. Code Regs. tit. 8 § 3276(e)(15)Cal. Code Regs. tit. 8 § 3421(b)Cal. Code Regs. tit. 8 § 3421(d)
References
Case No. LAO 860448, LAO 860449
Regular
Mar 07, 2008

DAVID MORRIS vs. CITY OF RIVERSIDE

The Workers' Compensation Appeals Board dismissed Dr. Khalid Ahmed's petition for reconsideration because it was untimely filed after the statutory deadline. The petition was also deemed insufficient due to its skeletal nature, lack of verification, and failure to meet regulatory requirements for supporting arguments with references to the record and law. Therefore, the Board found it lacked jurisdiction to consider the untimely and procedurally deficient petition.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationUnverified PetitionSkeletal PetitionUntimely PetitionLabor Code section 10609Labor Code section 4616Labor Code section 5902Labor Code section 5903
References
Case No. ADJ460672 (SFO 0499592), ADJ224818 (SFO 0499593)
Regular
Jul 11, 2012

HAMID KHAZAELI vs. SPEDIA.COM, INC., and SYSMASTER CORP., GREAT AMERICAN INSURANCE CO

Applicant Hamid Khazaeli has been declared a vexatious litigant under CCR Title 8, Section 10782, requiring pre-filing approval for any filings with the Workers' Compensation Appeals Board (WCAB) unless represented by an attorney. His "Petition for Reconsideration, Removal, Disqualification, and to Compel Testimony" filed on June 29, 2012, was reviewed. The WCAB did not accept this petition for filing, deeming it largely duplicative of prior dismissed and rejected filings. This decision reinforces the applicant's status as a vexatious litigant subject to strict pre-filing review protocols.

Vexatious LitigantPre-filing OrderCCR Title 8 Section 10782Petition for ReconsiderationRemovalDisqualificationCompel TestimonyJudicial OfficersQuasi-Judicial OfficersAppeals Board
References
Case No. ADJ6537787
Regular
Apr 08, 2013

LUIS RAMOS vs. WESTEND STAFFING SOLUTIONS, STATE COMPENSATION INSURANCE FUND

This case concerns a lien claimant, Long Beach Medical Center, whose petition for reconsideration was dismissed by the Workers' Compensation Appeals Board. The dismissal was based on multiple procedural deficiencies: the petition was skeletal, lacked a legally valid verification, and failed to provide proper proof of service on the defendant and other parties. The Board emphasized that failure to serve parties is a substantive omission, and an unverified petition also fails to meet statutory requirements. Therefore, the Board dismissed the petition for reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissalLien ClaimantSkeletal PetitionLack of VerificationProof of ServiceWCJLabor Code section 5902Labor Code section 5903
References
Case No. ADJ6766619 (MF) ADJ6766620
Regular
Feb 28, 2018

MARIA DURAN vs. FOREVER 21 RETAIL, INC., CHUBB GROUP

This case involves Maria Duran's request for home health care services, which was initially denied by utilization review (UR) and upheld by Independent Medical Review (IMR). The applicant argued that her need for assistance with household chores and personal hygiene fell outside the scope of the Medical Treatment Utilization Schedule (MTUS) guidelines as applied. While the Board acknowledges that the specific MTUS guideline used in this case was later found to be an invalid regulation in a related case, it affirmed the original decision. This affirmance was based on the finding that the initial request for services was too vague, lacking specific details on the type, frequency, and duration of care, and that a revised request could be made.

Workers' Compensation Appeals BoardMaria DuranForever 21 RetailInc.Chubb GroupOpinion and Decision After ReconsiderationIndependent Medical ReviewIMRUtilization ReviewUR
References
Case No. ADJ8278787
Regular
Mar 04, 2014

FERMINA GALLEGOS vs. KINDRED HEALTHCARE, SEDGWICK, CMS

The Workers' Compensation Appeals Board (WCAB) granted reconsideration for lien claimant Preferred Scan, Inc., who sought to set aside an order dismissing their lien due to non-appearance at a lien conference. The WCJ recommended granting the petition, citing excusable neglect for the lien claimant's miscalendaring. The WCAB further found procedural defects, including the failure to issue a notice of intention to dismiss and improper delegation of service. Consequently, the WCAB rescinded the dismissal order and returned the matter to the trial level for further proceedings.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Dismissing LienLien ConferenceExcusable NeglectNotice of Intention to DismissTitle 8 California Code of Regulations Section 10562Title 8 California Code of Regulations Section 10241Title 8 California Code of Regulations Section 10500Rescinded
References
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