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

Case No. ADJ7505520
Regular
Jul 01, 2014

ALBERT LOBO vs. COUNTY OF SAN BERNADINO

In this case, the Workers' Compensation Appeals Board amended a prior award concerning applicant Albert Lobo's industrial injury. The Board clarified that applicant is entitled to home health care services, including reimbursement for caregiver Halimah Shenghur. However, specific issues regarding the commencement date of liability and reimbursement for certain other individuals are deferred for further development of the record. The Board affirmed the entitlement to services based on a physician's prescription and the caregiver's extensive documented care, while emphasizing the employer's duty to investigate and provide benefits promptly.

Industrial injurybilateral upper extremitiesbilateral lower extremitiesinternal systemsself-procured medical treatmentcaregiver serviceshome health care serviceshome modificationsNeri Hernandezprescription requirement
References
Case No. ADJ10873991
Regular
Dec 24, 2018

CARLA AGUILAR vs. UNITED CEREBRAL PALSY/SPASTIC CHILDREN’S FOUNDATION OF LOS ANGELES AND VENTURA COUNTIES

The Workers' Compensation Appeals Board granted reconsideration and affirmed the WCJ's decision, with minor amendments. The Board gave great weight to the WCJ's credibility determinations, finding no substantial evidence to overturn them. Applicant Carla Aguilar sustained an injury to her right shoulder, elbow, and wrist on March 27, 2017, while employed as a caregiver. The employer was United Cerebral Palsy/Spastic Children's Foundation, permissibly self-insured and administered by York Risk Services, Inc.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJcredibility determinationsGarza v. Workmen's Comp. Appeals Bd.self-insuredadministeredinjurycaregiverdirect support staff
References
Case No. ADJ7517959, ADJ7517960, ADJ10843671
Regular
Sep 22, 2017

Kobra Ghosemi vs. Sunrise Senior Living, Ace American Insurance Company

This case involves three separate workers' compensation claims filed by Kobra Ghosemi for injuries sustained as a caregiver. The Employment Development Department (EDD) sought reconsideration, arguing that the original decisions failed to award statutory interest on unemployment benefits paid. The Appeals Board granted reconsideration, rescinded the prior decisions, and issued a joint decision. This new decision clarifies the defendant's liability to both the applicant and EDD, crucially including the EDD's entitlement to Unemployment Insurance Code section 2629.1(e) interest.

Employment Development DepartmentEDD lienUnemployment Insurance Code section 2629.1(e)interestreconsiderationFindings of Facttemporary disabilitypermanent disabilityjoint decisioncaregiver
References
Case No. ADJ19575926
Regular
Jun 30, 2025

MIGUEL ENRIQUE MARTINEZ CASTILLO vs. AROSA HOME CARE, NORTH RIVER INSURANCE COMPANY

Defendant sought reconsideration of the WCJ's finding that applicant, a caregiver, sustained an industrial injury to multiple body parts while employed. Defendant argued for re-opening the record to present new evidence and contended that the injury occurred after the applicant clocked out, thus not arising from employment, and questioned applicant's credibility. The Appeals Board denied the petition, finding insufficient diligence for new evidence and concluding that clocking out did not negate the industrial nature of the injury as applicant was still performing duties incidental to his employment on the premises. The Board affirmed the WCJ's credibility findings.

Industrial injuryCaregiverClocking outCourse of employmentArising out of employmentPetition for reconsiderationReopen recordNew evidenceMandatory settlement conferenceDiscovery
References
Case No. ADJ10728990
Regular
Jul 25, 2025

XYZ ADJ10728990 vs. STATE OF CALIFORNIA DEPARTMENT OF SOCIAL SERVICES (IHSS), Legally Uninsured, Administered by YORK RISK SERVICES GROUP, INC.

The Workers' Compensation Appeals Board affirmed a WCJ's decision denying XYZ ADJ10728990's claim of industrial injury (HIV/AIDS) sustained as a caregiver/dialysis technician. The applicant had sought reconsideration, arguing for more time to develop the evidentiary record. The Board adopted the WCJ's report, which relied on the Qualified Medical Evaluator's opinion. The QME concluded that the timeline of the applicant's AIDS diagnosis in May 2015 indicated the HIV infection occurred many years prior, thus precluding the claimed employment period (August-December 2013) as the cause, rendering further discovery on the patient's HIV status irrelevant.

Workers' Compensation Appeals BoardIHSSLegally UninsuredYork Risk Services GroupPetition for ReconsiderationWCJFindings of Fact and Orderindustrial injuryAcquired Immune Deficiency SyndromeAIDS
References
Case No. ADJ8430282 ADJ8430286
Regular
Jun 20, 2014

GUADALUPE VALENZUELA vs. ALTRUIST HOMECARE SERVICES, ACE AMERICAN INSURANCE, ESIS

This case concerns a caregiver, Guadalupe Valenzuela, who sustained industrial injuries while working for Altruist Homecare Services. Altruist sought to have Valenzuela classified as an independent contractor, arguing that Civil Code section 1812.5095 applied and exempted them from employer liability. However, the Workers' Compensation Appeals Board denied Altruist's petition, upholding the finding that Valenzuela was an employee. The Board found Altruist failed to meet all the statutory requirements for independent contractor status under the Civil Code and that Valenzuela's circumstances indicated an employer-employee relationship under the *Borello* factors. Specifically, Valenzuela's inability to freely renegotiate pay and her belief that Altruist could terminate her employment were critical to the decision.

Workers' Compensation Appeals BoardApplicantDefendantFindings of Fact and AwardIndustrial InjuryLow BackLeft LegHome Care ServicesRight ElbowRight Arm
References
Case No. ADJ7476556
Regular
Nov 09, 2010

MAXIMA ANDRES vs. MATCHED CAREGIVERS, INC., HEALTH CARE INDUSTRY SELF INSURANCE, PRIVATE ADJUSTING RANCHO CUCAMONGA

This case involves a petition for reconsideration filed by the defendant after an Order Approving Compromise and Release (OACR). However, the Workers' Compensation Appeals Board (WCAB) dismissed the petition as moot. This is because the Administrative Law Judge (ALJ) had already rescinded the OACR on October 21, 2010, prior to the defendant's petition. Therefore, the action sought by the defendant's petition had already been taken.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Approving Compromise and ReleaseOrder RescindingWCJMootDismissalMatched CaregiversInc.Health Care Industry Self Insurance
References
Case No. AD 6745689
Regular
Aug 30, 2010

JORGE PEREZ vs. TK SYSTEMS, INC., INSURANCE COMPANY OF THE WEST

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior award, and remanded the case for further proceedings. The Board found that while family providing attendant care is compensable, crucial medical evidence was lacking to determine the appropriate rate for the services. Specifically, there was no medical evidence establishing the necessity of medication administration by the caregiver. The matter is returned to the trial level for development of the record on applicant's home care needs and the cost of such services.

attendant carereasonable valueindustrial injury24 hour caremedication administrationmedical evidencehome care needsLVNregistered nurselive-in caregiver
References
Case No. ADJ7748945
Regular
Feb 22, 2013

KAREN MURRAY vs. KERN VILLAGE ASSISTED LIVING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The applicant claimed industrial injury to her neck and shoulders on February 10, 2011, while working as a caregiver. The administrative law judge found the applicant failed to prove the injury arose out of and occurred in the course of employment (AOE/COE), citing a lack of credibility in her testimony and conflicting testimony from a co-worker. Because the AOE/COE claim failed, the issue of the claim being barred as a post-termination claim became moot.

AOE/COELabor Code 3600(a)(10)post-termination claimcaregiver injuryindustrial injuryWorkers' Compensation Appeals BoardWCJ credibilitypreponderance of the evidencesubstantial evidencepetition for reconsideration
References
Case No. ADJ8832609
Regular
Sep 30, 2014

ROBERTA FIGURES vs. DEPARTMENT OF SOCIAL SERVICES - IHSS, legally uninsured, administered by YORK RISK SERVICES GROUP, INC.

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration of an order dismissing her case for lack of prosecution. The applicant claimed injury as an in-home caregiver, but the case was dismissed after the applicant failed to properly object to a Notice of Intention to Dismiss. The majority found that the applicant's arguments for reconsideration, including her counsel's alleged efforts and procedural errors, were insufficient. However, one Commissioner dissented, arguing that the applicant's counsel had made demonstrable efforts to prosecute the claim by subpoenaing medical records.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Dismissing CaseLack of ProsecutionRule 10582In-home caregiverLower extremitiesNeckTrunkBack
References
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