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

Case No. ADJ8138407
Regular
Nov 19, 2014

SCOTT LOWE vs. ADT, SEDGWICK CMS

The applicant is Scott Lowe, and the defendants are ADT and Sedgwick CMS. The defendants sought Social Security earnings records from 2005 to the present, claiming it was proper discovery. The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for removal of the judge's order denying this discovery. The WCAB found that the requested earnings information, starting seven years prior to the injury, was not relevant and removal is an extraordinary remedy requiring a showing of substantial prejudice or irreparable harm.

Petition for RemovalSocial Security earnings recordsdiscoverydue processtemporary total disabilitysubstantial prejudiceirreparable harmreconsiderationadministrative law judgeWorkers' Compensation Appeals Board
References
2
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
5
Case No. ADJ1029994 (LBO 0391256)
Regular
Sep 09, 2004

WALTER PEARCE vs. LAIDLAW EDUCATION SERVICES, SEDGWICK CMS

This order dismisses Laidlaw Education Services' and Sedgwick CMS' petition for removal. The Workers' Compensation Appeals Board adopted and incorporated the administrative law judge's report in reaching this decision. The petition for removal is therefore dismissed.

Petition for RemovalDismissalReconsiderationWorkers' Compensation Appeals BoardAdministrative Law Judge ReportLAIDLAW EDUCATION SERVICESSEDGWICK CMSADJ1029994LBO 0391256
References
0
Case No. ADJ2147971
Regular
Sep 21, 2012

JOEL DE LEON vs. BIG LOTS; SEDGWICK CMS

This case involves a petition for reconsideration and removal by applicant Joel De Leon against Big Lots and Sedgwick CMS. The Workers' Compensation Appeals Board dismissed the petition for reconsideration because it was not filed from a "final" order that determined substantive rights or liabilities. The Board also denied removal, finding no showing of substantial prejudice or irreparable harm, and adopted the Judge's reasoning. Therefore, the petition was dismissed, and removal was denied.

Petition for ReconsiderationDismissalDenial of RemovalFinal OrderSubstantive RightLiabilityInterlocutory OrderProcedural DecisionEvidentiary DecisionPre-trial Order
References
8
Case No. ADJ2655171 (LAO 0886561) ADJ1429155 (LAO 0862514)
Regular
May 22, 2012

GUILLERMO HERNANDEZ vs. MCKESSON CORPORATION, SEDGWICK CMS, INC.

This case involves reconsideration sought by both applicant Guillermo Hernandez and defendant McKesson Corporation/Sedgwick CMS, Inc., regarding prior decisions. The Workers' Compensation Appeals Board (WCAB) granted reconsideration because an initial review indicated the need for further study of the factual and legal issues to ensure a just and reasoned decision. Pending the decision after reconsideration, all communications must be filed in writing with the WCAB Commissioners in San Francisco, not with any district office or e-filed.

Workers' Compensation Appeals BoardReconsideration GrantedMcKesson CorporationSedgwick CMSInc.Guillermo HernandezStatutory Time ConstraintsFactual IssuesLegal IssuesJust and Reasoned Decision
References
0
Case No. ADJ14346787, ADJ9216939, ADJ10470278
Regular
Mar 03, 2025

DANNY REGALADO vs. COUNTY OF LOS ANGELES, SEDGWICK CMS

The Workers' Compensation Appeals Board has granted both the applicant, Danny Regalado, and the defendant, County of Los Angeles/Sedgwick CMS, petitions for reconsideration regarding a 'Findings, Award, and Order' issued on December 3, 2024. The original F&A addressed industrial injuries to Regalado's lumbar spine (cumulative trauma ending January 15, 2016) and right upper extremity (specific injury on September 20, 2013), awarding temporary and permanent disability benefits. The WCJ admitted errors in the initial ruling, recommending corrections to the temporary disability period for ADJ14346787 and the permanent disability rate for ADJ9216939. A final Decision After Reconsideration is deferred pending further review of the merits of the petitions and the entire record.

ADJ14346787ADJ9216939ADJ10470278Petition for ReconsiderationFindings Award and Ordercumulative traumatemporary disabilitypermanent partial disabilityapportionmentanti-attribution clause
References
20
Case No. ADJ474396
Regular
Apr 26, 2013

VADIM KOVALENKO vs. PESP dba ACTION PRODUCTION, CIGA by SEDGWICK CMS for LEGION INSURANCE COMPANY, in liquidation, LUMINATIONS INC., ST PAUL FIRE & MARINE INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration of an order dismissing a lien claimant's lien with prejudice. The lien claimant failed to appear at a lien conference and provide proof of paying the required lien activation fee as mandated by Labor Code section 4903.06(a)(4). Despite the claimant's argument of not being aware of the conference date, the WCJ found this claim not credible based on the record. The Board adopted the WCJ's reasoning, affirming that no relief was available for the failure to pay the fee.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ OpinionReport and RecommendationDeniedApplicantDefendantsCIGALegion Insurance CompanyLiquidation
References
1
Case No. ADJ2309063, 2603988
Regular
Jun 24, 2010

RAINIE JAEGER vs. APOTHE-CARE, INC., dba OWENS PHARMACY, FIREMAN'S FUND INSURANCE COMPANY, AMERICAN AUTO INSURANCE COMPANY, RISK ENTERPRISE MANAGEMENT, WALGREEN'S, AMERICAN MOTORISTS INSURANCE COMPANY, SEDGWICK CMS, Fairmont Premier Insurance Company, American Motorist Insurance Company adjusted by Sedgwick

This case involves a dispute over a worker's compensation claim for a low back injury determined to be a compensable consequence of a prior bilateral carpal tunnel injury. The Board granted reconsideration to correct the date of the compensable consequence injury to October 5, 2004. Furthermore, Fireman's Fund was ordered to reimburse Sedgwick CMS for benefits paid after that date, with the right to seek contribution from Fairmont Premier/REM. The Board rescinded prior findings and substituted new ones, clarifying liability for medical treatment and benefits.

compensable consequence injurybilateral carpal tunnellow back injuryspinal surgeryAgred Medical Evaluator (AME)Fireman's FundSedgwick CMSjoint and several liabilityreimbursementcontribution
References
0
Case No. ADJ10663212
Regular
Dec 18, 2017

Applicant vs. Sedgwick CMS, Sedgwick CMS

This case concerns a Petition for Removal filed by an applicant. The Workers' Compensation Appeals Board (WCAB) denied the petition, finding that the applicant failed to demonstrate substantial prejudice or irreparable harm. The WCAB also determined that reconsideration would be an adequate remedy should an adverse final decision be issued. Therefore, the Board adopted the WCJ's report and denied removal as an extraordinary remedy.

Petition for RemovalExtraordinary RemedySubstantial PrejudiceIrreparable HarmReconsiderationAdequate RemedyWCJ ReportAdopt and IncorporateDenial of RemovalAppeals Board
References
2
Case No. ADJ8308192 ADJ11314956
Regular
Sep 12, 2019

LILY LOPEZ vs. ST PASCHAL BAYLON CATHOLIC CHURCH, YORK RISK SERVICES GROUP

The Workers' Compensation Appeals Board rescinded the trial judge's decision finding mutual mistake regarding a Medicare Set Aside (MSA) and CMS approval. The Board determined that CMS does not mandate MSA review, negating the finding of mutual mistake. However, due to concerns about the applicant being adequately advised of potential future Medicare benefit impacts without CMS review, the case is returned to the trial level for further proceedings. The applicant's petition for penalties was denied.

Medicare Set AsideMSACMS approvalmutual mistakejudicial errorCompromise and Releasenull and voidPetition to Set Asiderescindedvacated
References
7
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