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

Case No. ADJ7176930, ADJ7170139
Regular
Aug 20, 2015

ROBERT GAONA vs. CAPITAL BUILDERS HARDWARE, SOUTHERN INSURANCE COMPANY, ENDURANCE REINSURANCE CORPORATION OF AMERICA, FIRSTCOMP

This case involves a petition for reconsideration filed by the defendant regarding a Workers' Compensation Appeals Board decision. The Board granted reconsideration to allow for a more thorough review of the factual and legal issues. Further proceedings will be determined after this in-depth study. All subsequent filings related to the petition must be submitted directly to the Board's San Francisco office, not to district offices or via e-filing.

Workers' Compensation Appeals BoardPetition for ReconsiderationCapital Builders HardwareSouthern Insurance CompanyEndurance Reinsurance Corporation of AmericaFirstcompLos Angeles District OfficeStatutory time constraintsFactual and legal issuesJust and reasoned decision
References
Case No. ADJ7170139, ADJ7176930
Regular
Mar 22, 2017

ROBERT GAONA vs. CAPITAL BUILDERS HARDWARE, SOUTHERN INSURANCE COMPANY, ENDURANCE REINSURANCE CORPORATION OF AMERICA

This case involves Robert Gaona's workers' compensation claims against Capital Builders Hardware and their insurers. The Court of Appeal previously annulled its writ of review and remanded the case to the Workers' Compensation Appeals Board (WCAB). The WCAB has now affirmed its prior decision from March 24, 2016, which dismissed the defendants' Petition for Reconsideration and denied their Petition for Removal. Therefore, the original Joint Findings and Orders issued by the WCJ on June 5, 2015, stand affirmed.

Workers' Compensation Appeals BoardRemittiturCourt of AppealPetition for ReconsiderationPetition for RemovalJoint Findings and OrdersAdministrative Law JudgeAnnulledAffirmedSubstitution of Commissioner
References
Case No. ADJ367320 (VNO 0476303) ADJ566883 (LAO 0740861)
Regular
Jun 16, 2015

CRISTINA UGARTE vs. FLINKMAN REALTY, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board (Appeals Board) reconsidered a prior decision that denied separate reimbursement for implanted hardware for lien claimant Pacific Hospital of Long Beach. The Appeals Board found that the WCJ misinterpreted regulations regarding hospital billing and reimbursement. Specifically, the Appeals Board determined that implanted hardware is separately reimbursable under section 9789.22(g) regardless of whether the inpatient services qualify as a cost outlier. Therefore, the Board rescinded the WCJ's decision and returned the case for further proceedings to calculate the correct payment for the implanted hardware.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderLien claimantReimbursementImplanted hardwareOutlier feesRegulationsCost outlierInpatient hospital services
References
Case No. ADJ16808789
Regular
Jun 06, 2025

VERONICA GONZALEZ vs. ECLIPSE RTO, LLC, STAFFPAY INC., STATE COMPENSATION INSURANCE FUND, INSURANCE COMPANY OF THE WEST

The Appeals Board considered a petition for reconsideration/removal regarding a Workers' Compensation Administrative Law Judge's (WCJ) decision. The WCJ's decision included a finding on employment, which is a threshold issue, making it a final order subject to reconsideration. Although the petitioner only challenged an interlocutory finding, the Board applied the removal standard for review. The Board was not persuaded that significant prejudice or irreparable harm would result if removal were denied, nor that reconsideration would be an inadequate remedy. Therefore, the Appeals Board denied the petition for reconsideration/removal.

Petition for ReconsiderationRemoval standardThreshold issueInterlocutory findingLabor Code § 5909EAMSCase transmissionNotice of transmissionSignificant prejudiceIrreparable harm
References
Case No. ADJ10948281
Regular
Mar 06, 2023

HELODORO ZAMORA PEREZ vs. RMT CONTRACTING, INC., INSURANCE COMPANY OF THE WEST

This case involves a petition for reconsideration filed by Helodoro Zamora Perez against RMT Contracting, Inc. The Workers' Compensation Appeals Board (WCAB) dismissed the petition because it was not timely filed. The WCAB explained that a decision resolving a "threshold" issue is a final order, and any challenges must be made through a timely petition for reconsideration. Since the WCJ's decision addressed a threshold issue, it was a final order subject to timely reconsideration. Furthermore, the WCAB stated that even if the petition had been timely, it would have been denied on its merits.

Petition for ReconsiderationThreshold IssueFinal DecisionInterlocutory IssuesRemoval StandardExtraordinary RemedySignificant PrejudiceIrreparable HarmAdequate RemedyWCAB
References
Case No. ADJ11279401
Regular
Nov 19, 2019

NANCY PLOTKIN vs. FRASCO, INC.; EVEREST NATIONAL INSURANCE COMPANY, administered by GALLAGHER BASSETT

This case involves a Petition for Reconsideration by the defendant, Frasco, Inc. and its insurer, which the Workers' Compensation Appeals Board (WCAB) denied. The WCAB found that although the Workers' Compensation Judge's (WCJ) decision resolved a threshold issue, making it a final order, the petitioner was only challenging an interlocutory finding. Applying the removal standard for non-final decisions, the WCAB denied removal because the petitioner failed to demonstrate significant prejudice or irreparable harm. Therefore, the Petition for Reconsideration/Removal was denied.

Petition for ReconsiderationThreshold IssueFinal DecisionInterlocutory IssueRemoval StandardSignificant PrejudiceIrreparable HarmReconsideration Inadequate RemedyWCJAppeals Board
References
Case No. ADJ3180323 (VNO 0425253) ADJ3602025 (VNO 0425255) ADJ4336300 (VNO 0429778) ADJ1492342 (VNO 0362819)
Regular
Mar 02, 2016

PAUL NEYER vs. MISSION LINEN SUPPLY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ARROWPOINT CAPITAL

The Workers' Compensation Appeals Board dismissed CIGA's Petition for Reconsideration as untimely, as it was filed well beyond the jurisdictional 20-day limit after the December 16, 2015 Findings and Award. Arrowpoint Capital's Petition for Reconsideration was also dismissed as moot due to a subsequent amendment by the arbitrator addressing their concerns about bill review expenses. The Board found CIGA's petition was also procedurally defective for failing to serve the Workers' Compensation Arbitrator. Therefore, both petitions were dismissed.

California Workers CompensationWorkers' Compensation Appeals BoardMission Linen SupplyCalifornia Insurance Guarantee AssociationCIGAArrowpoint CapitalSecurity Insurance Company of HartfordPaul NeyerFindings and AwardPetition for Reconsideration
References
Case No. ADJ10296202, ADJ10296203
Regular
Jan 29, 2020

ANDRIA STREETER vs. GOODWILL SERVING THE PEOPLE OF SOUTHERN LOS ANGELES, UNITED STATES FIRE INSURANCE COMPANY

This case concerns defendant's petition for reconsideration or removal of a Workers' Compensation Appeals Board decision. The Board denied the petition, finding the decision contained both a threshold issue (injury AOE/COE) making it final for reconsideration, and an interlocutory issue (treatment outside the medical provider network). Because the petition primarily challenged the interlocutory issue, it was evaluated under the more stringent removal standard. The Board found no evidence of significant prejudice or irreparable harm justifying removal.

Workers' Compensation Appeals BoardPetition for ReconsiderationRemovalJoint Findings of FactInjury AOE/COEThreshold IssueInterlocutory IssueMedical Provider NetworkSignificant PrejudiceIrreparable Harm
References
Case No. ADJ8229086 ADJ8229099
Regular
Sep 23, 2019

DANIEL MARTINEZ vs. CONSOLIDADTED PARTITIONS, MARKEL CORPORATION OF AMERICA, SOUTHERN INSURANCE, ZURICH INSURANCE

The Appeals Board dismissed the Petition for Removal and denied the Petition for Reconsideration. While the WCJ's decision addressed a threshold issue making it final, the petitioner only challenged an interlocutory finding. Removal was denied because the petitioner failed to demonstrate significant prejudice or irreparable harm, and that reconsideration would not be an adequate remedy. Thus, the prior decision stands, and further challenges are limited.

Petition for RemovalPetition for Reconsiderationthreshold issueinterlocutory issuefinal decisionnon-final decisionextraordinary remedysignificant prejudiceirreparable harmadequate remedy
References
Case No. ADJ11276421
Regular
Mar 15, 2019

SABAS GAMBOA vs. FULLERTON PACIFIC INTERIORS, INC., INSURANCE COMPANY OF THE WEST

The applicant sought reconsideration of an order dismissing defendant Clark Builders and others, arguing it was improper as Clark Builders was not a party. The Appeals Board dismissed the applicant's petition for reconsideration as untimely and from a non-final order. However, the Board granted removal on its own motion to correct the record, as Clark Builders was never properly a party. The Board rescinded the original dismissal order and issued a new order dismissing Arch Indemnity Insurance Company and Gallagher Bassett Services, Inc. without prejudice.

Workers' Compensation Appeals BoardPetition for ReconsiderationRemovalOrder DismissingLack of EmploymentClark BuildersArch Indemnity Insurance CompanyGallagher Bassett ServicesInc.Fullerton Pacific Interiors
References
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