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

Case No. ADJ3133261 (VNO 0400017)
Regular
Aug 17, 2010

FELIPE TOLENTINO vs. CONCO CEMENT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, XCHANGING INC., FREMONT COMPENSATION

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration as premature. The WCAB granted the defendant's petition for reconsideration regarding the temporary disability overpayment issue, deferring it for further proceedings. The Board affirmed the WCJ's findings on injury causation and permanent disability but amended the decision to clarify the overpayment issue. Finally, the WCAB issued a notice of intention to sanction defendant's counsel for attaching and citing unadmitted evidence.

Workers' Compensation Appeals BoardFELIPE TOLENTINOCONCO CEMENTCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONXCHANGING INC.FREMONT COMPENSATIONliquidationADJ3133261VNO 0400017OPINION AND ORDERS DISMISSING PETITION FOR RECONSIDERATION AND GRANTING PETITION FOR RECONSIDERATION
References
Case No. ADJ7188251 ADJ7188272
Regular
Jan 29, 2010

Raymond Mark vs. City of Los Angeles

The Workers' Compensation Appeals Board granted reconsideration of an Arbitrator's award of temporary partial disability for a sleep disorder. The defendant argued that the case fell under an ADR "carve-out" provision and that the chosen Qualified Medical Evaluator found the sleep disorder non-industrial. The Board rescinded the Arbitrator's decision because the record lacked a proper Minutes of Hearing and Summary of Evidence, which is crucial for meaningful review of ADR cases. The matter was returned to the Arbitrator for further proceedings and a new decision.

ADRCarve-out caseQualified Medical EvaluatorAgreed Medical EvaluatorSleep disorderTemporary partial disabilityArbitrator's DecisionReconsiderationMinutes of Hearing and Summary of EvidenceDue process
References
Case No. ADJ18890787; ADJ10622598; ADJ10936287; ADJ11180688
Regular
Apr 01, 2025

Kevin Perry vs. Asset Protection and Security Services L.P., Insurance Company of the State of PA

The applicant, Kevin Perry, sought reconsideration of a prior Order Dismissing Case with Prejudice, which was based on the doctrine of res judicata. The Workers' Compensation Appeals Board (WCAB) acknowledged that the petition was timely filed within the 60-day statutory period. However, due to the absence of a complete evidentiary record from the lower tribunal, the WCAB was unable to adequately review the applicant's contentions. Consequently, the Petition for Reconsideration was dismissed as premature, and the matter was returned to the Presiding Workers' Compensation Judge (PWCJ) with a recommendation to treat the original petition as one to set aside the initial Order Dismissing, allowing for further proceedings and a new decision that can then be subject to reconsideration.

Res judicataVexatious litigantPetition for reconsiderationOrder dismissing case with prejudiceLabor Code section 5909Cumulative traumaAsset Protection and Security ServicesGallagher Bassett ServicesAIG ClaimsApplication for Adjudication of Claim
References
Case No. ADJ9317919
Regular
Feb 02, 2016

STEVEN SPALIONE vs. ACCO ENGINEERED SYSTEMS, XL SPECIALTY INS. CO.

The Appeals Board dismissed the applicant's attorney's Petition for Reconsideration, finding it untimely filed and non-compliant with WCAB rules. The attorney was personally served with the Compromise and Release on July 9, 2015, but did not file the petition until August 3, 2015. Furthermore, the petition failed to be served on the arbitrator and did not follow proper procedure for carve-out cases. Even if considered on the merits, the attorney would not have been entitled to fees as they were not involved in procuring the settlement.

Workers Compensation Appeals BoardPetition for ReconsiderationCompromise and ReleaseADRArbitratorAttorney's FeesWCAB Rule 10865TimelinessPersonal ServiceJurisdiction
References
Case No. ADJ2501619 (OAK 0286955)
Regular
Nov 10, 2008

JAMES BRADFORD vs. MCMILLAN BROS. ELECTRIC, INC., PACIFIC EAGLE INSURANCE CO./tpa SEABRIGHT INSURANCE CO.

The Workers' Compensation Appeals Board vacated its prior order granting reconsideration and dismissed the defendant's petitions for reconsideration, removal, and stay of execution. The petition for reconsideration was dismissed as untimely because it was filed with the Appeals Board more than 25 days after the arbitrator's decision. The Board also lacked jurisdiction to grant the petition for removal or stay of execution, as these actions are not permitted for an arbitrator's decision in a Labor Code section 3201.5 carve-out case.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalPetition for Stay of ExecutionUntimely FilingLabor Code Section 3201.5Carve-out CaseArbitrator's DecisionJurisdictionAppeals Board Rule 10865
References
Case No. ADJ2987188 (LBO 0277672) ADJ6543172
Regular
Sep 15, 2015

LUPE CHAVEZ vs. COUNTY OF LOS ANGELES, TRISTAR RISK MANAGEMENT

This order denies Lupe Chavez's Petition for Reconsideration in her workers' compensation case against the County of Los Angeles and Tristar Risk Management. The Workers' Compensation Appeals Board adopted the reasoning of the workers' compensation administrative law judge's report. Therefore, the denial of reconsideration stands.

Petition for ReconsiderationWorkers' Compensation Appeals BoardAdministrative Law Judge ReportDenying ReconsiderationCounty of Los AngelesTristar Risk ManagementCase Number ADJ2987188Case Number ADJ6543172San FranciscoCalifornia
References
Case No. FRE 0191303
Regular
Nov 27, 2007

NORMA OZUNA vs. COUNTY OF FRESNO

The Workers' Compensation Appeals Board (WCAB) rescinded a finding that the defendant was not responsible for the costs of the applicant's vocational expert. The WCAB remanded the case to the trial level for further analysis, instructing the judge to consider the factors outlined in *Costa v. Hardy Diagnostic* regarding the reasonableness and necessity of expert costs. The decision does not comment on the merits of whether the costs are ultimately reimbursable.

Vocational expert costsLabor Code section 5811Costa v. Hardy DiagnosticPermanent Disability Rating ScheduleAppeals Board en banccumulative traumaHepatitis Ccorrectional officeragreed medical evaluatorfindings of fact and award
References
Case No. ADJ6766619 (MF) ADJ6766620
Regular
Feb 28, 2018

MARIA DURAN vs. FOREVER 21 RETAIL, INC., CHUBB GROUP

This case involves Maria Duran's request for home health care services, which was initially denied by utilization review (UR) and upheld by Independent Medical Review (IMR). The applicant argued that her need for assistance with household chores and personal hygiene fell outside the scope of the Medical Treatment Utilization Schedule (MTUS) guidelines as applied. While the Board acknowledges that the specific MTUS guideline used in this case was later found to be an invalid regulation in a related case, it affirmed the original decision. This affirmance was based on the finding that the initial request for services was too vague, lacking specific details on the type, frequency, and duration of care, and that a revised request could be made.

Workers' Compensation Appeals BoardMaria DuranForever 21 RetailInc.Chubb GroupOpinion and Decision After ReconsiderationIndependent Medical ReviewIMRUtilization ReviewUR
References
Case No. ADJ3180407 (LAO 0785803)
Regular
Nov 10, 2008

Carl Brewer vs. CAPITAL REPROGRAPHICS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for VILLANOVA INSURANCE, In Liquidation

This case concerns CIGA's petition for reconsideration of a WCJ's award of penalties for various payment failures, including attorney fees, home health care, and a case management nurse. CIGA argues these penalties are not "covered claims" under its statutory exemption. The Appeals Board granted reconsideration, rescinded the prior order, and returned the case to the trial level due to a missing case file.

CIGAVillanova InsurancePenaltiesAttorneys FeesHome Health CareGuardian Ad LitemCase Management NurseInsurance Code Section 1063.1(c)(8)Covered ClaimsReconsideration
References
Case No. ADJ7160971
Regular
Jan 12, 2015

JACINTO CATILLO vs. SANTA CLARITA INTERIORS, ZURICH AMERICAN INSURANCE CO

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of the defendant's petition to review an arbitrator's award finding the applicant sustained a lumbar spine injury. The defendant's petition for reconsideration was potentially untimely and filed with the incorrect district office for this ADR carve-out case. The WCAB will issue a notice of intention to dismiss unless the defendant provides proof of timely filing with the correct office. The defendant has 15 days to submit documentation demonstrating the petition was timely filed.

Petition for ReconsiderationArbitrator's Findings and AwardJourneyman CarpenterLumbar SpinePermanent DisabilityApportionmentTemporary Total Disability IndemnityArbitrator's Report and RecommendationElectronic Adjudication Management SystemADR carve-out case
References
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