CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

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. MISSING
Regular Panel Decision

Claim of Perez v. Licea

A claimant sought workers' compensation benefits after sustaining injuries in an explosion while performing maintenance work, leading to a dispute over the employer-employee relationship with Luis Licea and 2180 Realty Corporation. A Workers’ Compensation Law Judge found Licea to be the general employer and 2180 Realty Corporation a special employer, assigning 75% and 25% liability, respectively. Both the claimant and 2180 Realty's insurer, Rochdale Insurance Company, appealed this determination, challenging the special employment relationship. The Workers’ Compensation Board affirmed the initial finding, denying requests for reconsideration, and the Appellate Division further upheld the Board's decision, citing substantial evidence of 2180 Realty's control over the work and materials supplied.

Workers' CompensationSpecial EmploymentEmployer-Employee RelationshipSubstantial EvidenceControl TestLiabilityAppealsBoard ReviewMaintenance WorkInjury
References
6
Case No. MISSING
Regular Panel Decision
Jul 01, 2010

Claim of Moreno v. Licea

This case involves appeals from two decisions by the Workers' Compensation Board. The first decision, filed April 6, 2009, established an employer-employee relationship between the claimant and 2180 Realty Corporation. The second decision, filed October 16, 2009, denied the claimant's request for reconsideration or full Board review. The court affirmed these decisions, aligning with the reasons set forth in *Matter of Perez v Licea*, a case with identical issues decided herewith. Additionally, the court noted Joseph Edelman's acknowledgment of discussing work performance with the claimant. The claimant's appeal regarding the denial of full Board review or reconsideration was deemed abandoned.

Workers' CompensationEmployer-Employee RelationshipBoard DecisionsReconsiderationFull Board ReviewAppellate ReviewAffirmed DecisionsAbandoned AppealJudicial Concurrence
References
2
Case No. ADJ1117931 (LAO 0743685) ADJ1499748 (LAO 0743689) ADJ4716197 (LAO 0743687)
Regular
May 26, 2010

CARMEN LICEA vs. ZACKY FARMS; Administered By BUCKEYE CLAIMS ADMINISTRATORS

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's petition for reconsideration because the WCJ's order denying the admission of additional evidence and witnesses was an interlocutory procedural order, not a final determination of substantive rights. The WCAB denied the applicant's petition for removal, finding no showing of prejudice or irreparable harm. Furthermore, the WCAB denied the applicant's petition to disqualify the WCJ, noting the lack of a required affidavit and finding no evidence of bias or enmity. Ultimately, all of the applicant's post-order filings were denied.

Workers' Compensation Appeals BoardCarmen LiceaZacky FarmsBuckeye Claims AdministratorsPetition for ReconsiderationPetition for RemovalPetition for DisqualificationWCJDr. Procciwork function impairment form
References
8
Case No. LBO 0375714
Regular
Jul 09, 2008

VICENTE CARMEN vs. SKB CORPORATION

This case involves a lien claim by California Pharmacy Management for medication provided to an injured worker, Vicente Carmen. The Workers' Compensation Appeals Board denied reconsideration, upholding the finding that the pharmacy's lien was invalid because the medication was not prescribed by a physician within the defendant employer's Medical Provider Network (MPN). The Board reiterated that once an employer provides a MPN, an employee's self-procured treatment outside that network is not compensable, and the pharmacy's reliance on Labor Code section 4600.2 was misplaced as there was no evidence of a contract with the employer.

MPNLien claimMedical treatmentSelf-procuredPharmacy benefit networkLabor Code section 4600.2Treating physicianWorkers' Compensation Appeals BoardFindings and OrderReconsideration
References
1
Case No. ADJ7905931 (MF) ADJ8066878
Regular
Jun 08, 2016

CARMEN FELIX vs. HORIZON HOBBY, THE HARTFORD

The Appeals Board granted reconsideration, amending the original findings to establish that Carmen Felix sustained a cumulative injury to her mid and low back arising out of and occurring in the course of employment during the period from September 29, 2009, to September 29, 2010. This injury was found not to be barred by Labor Code section 3600(a)(10) as a post-termination claim due to the employer's prior notice. The Board also amended the findings to award temporary disability from September 29, 2010, to the present, requiring reimbursement of the EDD lien, and ordered further medical treatment.

Workers Compensation Appeals BoardReconsiderationFindings of FactBurden of ProofCumulative InjurySpecific InjuryPost-Termination ClaimLabor Code Section 3600(a)(10)Agreed Medical Evaluator (AME)Qualified Medical Evaluator (QME)
References
0
Case No. MISSING
Regular Panel Decision

Feliciano v. Colvin

Plaintiff Carmen Feliciano sought judicial review of a final decision by the Commissioner of Social Security denying her application for Supplemental Security Income. Both the plaintiff and defendant moved for judgment on the pleadings. The court examined whether the Commissioner's decision, which concluded the plaintiff was not disabled under the Social Security Act, was supported by substantial evidence. The court considered new evidence submitted to the Appeals Council, including a report from the plaintiff's treating physician, but found it inconsistent with other substantial evidence, such as reports from three consulting physicians. Ultimately, the court concluded that the Administrative Law Judge's decision was supported by substantial evidence. Consequently, the defendant's motion for judgment on the pleadings was granted, and the plaintiff's cross-motion was denied, leading to a final judgment for the defendant.

Social SecuritySupplemental Security IncomeDisability BenefitsJudicial ReviewAdministrative Law JudgeAppeals CouncilResidual Functional CapacityLight WorkSubstantial EvidenceTreating Physician Rule
References
13
Case No. ADJ3774802 (LBO 0292234), ADJ7623697, ADJ8702721, ADJ8852516
Regular
Feb 27, 2017

CARMEN PARRA vs. RALPHS GROCERY COMPANY, SEDGWICK

The Workers' Compensation Appeals Board dismissed Carmen Parra's petition for reconsideration because it was "skeletal" and improperly served. The petition failed to detail the grounds for reconsideration and lacked specific references to the record and legal principles as required by statute and board rules. Furthermore, the proof of service was defective, as indicated by postmarked mail sent after the purported service date and an incorrect suite number on an envelope. Consequently, the petition was dismissed for these procedural deficiencies.

Petition for ReconsiderationSkeletal PetitionImproper ServiceLabor Code Section 5902Appeals Board Rules 108421084610852Defective Proof of ServiceLabor Code Section 5905Dismissal
References
6
Case No. ADJ7304100, ADJ7941132, ADJ7941133, ADJ7941134
Regular
Oct 28, 2011

MARI CARMEN MERCADO vs. VALLARTA FOOD ENTERPRISES

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration of an approved Compromise and Release agreement. The applicant, Mari Carmen Mercado, sought to withdraw from the settlement, claiming she did not understand the document and found the $10,000 settlement inadequate. The Board found that the applicant was represented by counsel and had the settlement explained by a certified Spanish interpreter, indicating she understood its terms. Furthermore, the settlement addressed disputed medical evidence and a potential defense under Labor Code section 3600(a)(10), making the Board's denial of reconsideration appropriate.

Workers' Compensation Appeals BoardPetition for ReconsiderationCompromise and ReleaseIndustrial InjuryTaqueria CookSpecific InjuryCumulative TraumaAgreed Medical ExaminerLabor Code section 3600(a)(10)Post-Termination Defense
References
0
Case No. ADJ9284951
Regular
Dec 30, 2015

Carmen Villanueva vs. SEARS HOLDING CORPORATION, SEDGWICK CMS

The Workers' Compensation Appeals Board granted Carmen Villanueva's petition for reconsideration, overturning the initial award of 4% permanent disability with 25% apportionment. The Board found that the prior medical evaluator's apportionment to a non-industrial bunionectomy was not supported by substantial evidence, as the reasoning was speculative and contradictory. Consequently, the Board amended the award to 5% permanent disability with no apportionment to non-industrial causes.

Petition for ReconsiderationFindings and AwardsAdministrative Law JudgePermanent DisabilityApportionmentSubstantial EvidenceQualified Medical EvaluatorWhole Person ImpairmentBunionectomyIndustrial Injury
References
4
Showing 1-10 of 78 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational