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

Case No. ADJ7370794
Regular
Nov 27, 2013

ALFREDO MONROY vs. CALIFORNIA PLASTERING, INC., PACIFIC COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded the WCJ's prior decision in Monroy v. California Plastering, Inc. The Board returned the matter for further proceedings and decision by the WCJ, as the prior decision was not a final determination on the merits. The Board noted that a preliminary injunction regarding lien activation fees was not relevant in this case as the fee had been paid.

Workers' Compensation Appeals BoardReconsiderationWCJPreliminary injunctionLien activation feeAngelotti ChiropracticRescindedFurther proceedingsTrial levelAlfredo Monroy
References
1
Case No. ADJ8691809
Regular
Apr 14, 2017

NICOLE BORAGNO vs. STATE OF CALIFORNIA, CDCR - CENTRAL CALIFORNIA WOMEN'S FACILITY CHOWCHILLA, STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

This case involves Nicole Boragno's workers' compensation claim against the State of California, CDCR. The applicant sought reconsideration of a decision denying the admission of a supplemental medical report. The WCAB denied reconsideration, adopting the WCJ's report which found the supplemental report inadmissible. This was because discovery had closed at the mandatory settlement conference, and the defendant failed to establish good cause for introducing evidence not previously disclosed. The WCJ noted there was no change in circumstances to warrant the late-filed report, distinguishing it from precedent that allows such reports.

WORKERS' COMPENSATION APPEALS BOARDPetition for Reconsiderationmandatory settlement conferencediscovery closureLabor Code section 5502(d)(3)good causesupplemental reportPQMEapportionmenttimeliness
References
2
Case No. MISSING
Regular Panel Decision

Official Committee of Unsecured Creditors of 360networks (USA) Inc. v. Public Utilities Commission of California (In Re 360networks (USA) Inc.)

The Official Committee of Unsecured Creditors of 360networks (USA) Inc. (Debtors) initiated an adversary proceeding against the Public Utilities Commission of the State of California (CPUC) seeking to avoid certain fee payments as preferential transfers under the Bankruptcy Code. The CPUC moved to dismiss the action, asserting Eleventh Amendment sovereign immunity and arguing the court lacked jurisdiction. Judge Allan L. Gropper denied the CPUC's motion, concluding that the court holds in rem jurisdiction over the debtor's property in a preference action. The Court determined that the exercise of this jurisdiction would not offend state sovereignty, citing various forms of potential relief available, including the disallowance of claims by other California state instrumentalities.

Bankruptcy LawSovereign ImmunityEleventh AmendmentIn Rem JurisdictionPreference ActionMotion to DismissPublic Utilities CommissionCalifornia Environmental Quality ActDebtor-Creditor RelationsFederal Jurisdiction
References
45
Case No. ADJ1888124 (SAL 0111884) ADJ3322590 (SAL 0079903)
Regular
Oct 20, 2016

MARIA NUNEZ vs. MANN PACKING COMPANY, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For FREMONT COMPENSATION INSURANCE COMPANY, In Liquidation; STATE OF CALIFORNIA

This case concerns the California Insurance Guarantee Association's (CIGA) liability for an applicant's workers' compensation claims after Fremont Compensation Insurance Company became insolvent. CIGA argued it should be relieved of liability because the State of California, as the applicant's employer through IHSS, constituted "other insurance" under Insurance Code Section 1063.1. The Appeals Board affirmed the WCJ's decision, holding that the State of California does not qualify as "other insurance" under the relevant statutes. This distinction is based on the State not being required to obtain workers' compensation insurance or a certificate of self-insurance like private or other public employers.

CIGAFremont Compensation Insurance Companyliquidationlegally uninsuredother insuranceInsurance Code Section 1063.1covered claimsIn-Home Supportive Services (IHSS)statutory limitationsself-insurance
References
5
Case No. ADJ17068636
Regular
May 19, 2025

KATHLEEN ZEPEDA vs. CALIFORNIA BAPTIST UNIVERSITY, CALIFORNIA RESTAURANT MUTUAL BENEFIT CORPORATION

Applicant Kathleen Zepeda claimed injury to her abdomen, back, and lower extremities while employed by California Baptist University. Lien claimant Medland Medical Group and defendant California Baptist University both sought reconsideration of a February 19, 2025 Findings and Award (F&A). The F&A entitled Medland Medical Group to payment for medical-legal costs related to an April 26, 2023 report but did not find an injury arising out of and in the course of employment (AOE/COE). The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for reconsideration, granted the lien claimant's petition for reconsideration, and affirmed the F&A with an amendment to explicitly state that the lien claimant failed to meet its burden of establishing injury AOE/COE.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings and AwardMedical-Legal ReportPrimary Treating PhysicianInjury AOE/COESubstantial EvidenceContested ClaimMedical Treatment Costs
References
5
Case No. ADJ4332905 (SAL 0109881)
Regular
Jan 20, 2016

JESUS RODRIGUEZ vs. BUD OF CALIFORNIA

California Physicians Network (CPN) and its representative, Dennise Mejia, were sanctioned $2,500.00 jointly and severally for filing a frivolous and untimely petition for reconsideration that lacked proper verification and contained erroneous facts. The Board dismissed their reconsideration request because it did not challenge a final order and was procedurally deficient. CPN and Mejia failed to respond to the Board's notice of intent to impose sanctions. The defendant's claim for additional trial-level costs and attorney's fees was deferred to the workers' compensation administrative law judge for initial determination.

ADJ4332905SAL 0109881Opinion and Decision After RemovalSanctionCalifornia Physicians NetworkDennise MejiaLien ClaimantLabor Code section 5813(a)Appeals Board Rule 10561Frivolous
References
6
Case No. ADJ2842535
Regular
May 27, 2011

JANE HUTZELL vs. UNIVERSITY OF CALIFORNIA at BERKELEY, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves a Petition for Reconsideration by applicant Jane Hutzell against the University of California at Berkeley. The Workers' Compensation Appeals Board denied reconsideration, adopting the judge's report. The judge found that vocational experts' opinions did not adequately address the impact of medical apportionment or the specifics of part-time work availability on the overall industrial disability rating. Therefore, the judge's rating, based on established schedules, was upheld.

Workers' Compensation Appeals BoardPetition for ReconsiderationVocational ExpertsLumbar Spine ConditionCumulative TraumaNon-Industrial FactorsObesityApportionmentBilateral Carpal Tunnel SyndromeBilateral Cubital Tunnel Syndrome
References
0
Case No. ADJ9433946
Regular
Feb 19, 2015

ELLEN REED vs. STATE OF CALIFORNIA, CDCR CALIFORNIA CORRECTIONAL CENTER, Legally Uninsured; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES, Adjusting Agency

In *Reed v. State of California, CDCR California Correctional Center*, the applicant, Ellen Reed, petitioned for reconsideration of a prior decision. The Workers' Compensation Appeals Board (WCAB) has granted this petition. The Board believes reconsideration is necessary to allow further study of the factual and legal issues to ensure a just and reasoned decision. Pending the decision after reconsideration, all filings must be submitted in writing directly to the WCAB Commissioners in San Francisco, not to any district office or via e-filing.

Workers' Compensation Appeals BoardPetition for ReconsiderationGranting PetitionStatutory Time ConstraintsFactual and Legal IssuesJust and Reasoned DecisionFurther ProceedingsOffice of the CommissionersElectronic Adjudication Management SystemRedding District Office
References
0
Case No. ADJ1857578
Regular
Jun 23, 2009

MIRNA LICEA vs. MINSON CORPORATION, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for PHICO INSURANCE COMPANY in liquidation

This case involves a lien claim by Missirian Orthopedic Medical Group, assigned to KM Financial Services, for medical treatment provided to Mirna Licea. The California Insurance Guarantee Association (CIGA), representing the insolvent insurer Phico Insurance Company, denied the lien based on Insurance Code § 1063.1(c)(9), which excludes claims by assignees. The Workers' Compensation Appeals Board denied reconsideration, affirming that the statute clearly prohibits payment to assignees, including medical providers who have assigned their accounts receivable. The Board relied on *Baxter Healthcare Corp. v. CIGA* for the principle that assigned claims are not "covered claims" under the Guarantee Act.

Workers' Compensation Appeals BoardCalifornia Insurance Guarantee AssociationCIGAPhico Insurance Companyliquidationinsolvent insurerlien claimantassigneecovered claimInsurance Code 1063.1(c)(9)
References
4
Case No. ADJ7598160
Regular
Nov 19, 2014

MAURICE JOHNSON vs. PHILADELPHIA EAGLES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for RELIANCE INSURANCE COMPANY, in liquidation, FAIRMONT PREMIER INSURANCE COMPANY

The Workers' Compensation Appeals Board reversed a lower decision, finding California lacked jurisdiction over a professional football player's cumulative trauma claim against the Philadelphia Eagles. The Board held that playing only two games in California did not create a sufficient connection to the injury to warrant applying California law, citing *Federal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)*. The applicant's limited physical presence and routine pre/post-game treatment in California were deemed de minimis. Therefore, the applicant took nothing on his California WCAB claim.

CIGAPhiladelphia EaglesReliance Insurance Companycumulative traumaprofessional football playerjurisdictionFederal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)administrative law judgepermanent disabilityapportionment
References
16
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