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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
Case No. ADJ9795000
Regular
Sep 15, 2015

JACQUITA HUNTLEY vs. A.H. 2005 MANAGEMENT, PENNSYLVANIA MANUFACTURERS ASSOCIATION INSURANCE COMPANY

The applicant sought removal of a WCJ's finding that the defendant's request for a Qualified Medical Examiner (PQME) was valid. Applicant argued her prior PQME request and the defendant's failure to attach proper documentation invalidated their request. The Board denied the removal petition, adopting the WCJ's report which noted the applicant stipulated to the invalidity of her own PQME request. Furthermore, the Board admonished applicant's attorneys for making false statements and potentially violating Labor Code section 5813.

Petition for RemovalQualified Medical Examiner (PQME)Labor Code section 4061Rule 31.1StipulationTreating PhysicianOrthopedic Surgical PanelChiropractic PQMEBad Faith ActionsFrivolous Tactics
References
Case No. ADJ7626422
Regular
Dec 03, 2014

JOSE AHUMADA vs. BUILDING MATERIALS HOLDING, ACE AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's petition for reconsideration because it sought review of an interlocutory order, not a final decision. However, the WCAB granted removal on its own motion to address the WCJ's order. This order, which directed the parties to obtain a new Qualified Medical Evaluator (PQME), was rescinded because the issue was moot after the defendant canceled the deposition and the PQME became available within the statutory timeframe. The WCAB cautioned the defendant for seeking reconsideration of a non-final procedural order.

PQMEPetition for ReconsiderationWCJ Orderdepositionreplacement PQMEinterlocutory orderremovalrescindedmoot issuevocational expert
References
Case No. ADJ7674144
Regular
Oct 21, 2015

CHERYL FRANK vs. NOVATO UNIFIED SCHOOL DISTRICT, YORK RISK SERVICES GROUP

The Workers' Compensation Appeals Board (WCAB) affirmed a prior decision finding that most alleged industrial stressors leading to the applicant's psyche injury claim were not barred by Labor Code section 3208.3(d). The WCAB upheld the administrative law judge's (WCJ) determination that the panel Qualified Medical Evaluator's (PQME) reports lacked substantial evidence and removed the PQME. The WCAB dismissed the defendant's petition for removal, finding reconsideration to be the appropriate remedy and giving significant weight to the WCJ's credibility determinations.

Workers' Compensation Appeals Boardpsychiatric injuryindustrial stressorLabor Code section 3208.3(d)removalQualified Medical EvaluatorPQMEsubstantial evidencecredibility determinationsPetition for Reconsideration
References
Case No. ADJ8898297
Regular
Mar 27, 2015

MARY ROBY-LEWIS vs. COUNTY OF SACRAMENTO

This case involves the County of Sacramento's attempt to overturn an order striking their chosen Qualified Medical Examiner (PQME) and a consulting physician. The defendant argued this order caused irreparable harm and that the applicant waived objections by delaying their request. The Appeals Board dismissed the reconsideration petition as untimely because the order wasn't final, but granted removal and rescinded the WCJ's order. The majority found the applicant's objections lacked merit and that denying removal would cause prejudice, while a dissenting opinion argued the defendant failed to comply with procedural rules regarding document submission to the PQME.

PQMEPetition for ReconsiderationPetition for RemovalOrder Striking PQMELabor Code Section 4062.3(b)Panel Qualified Medical ExaminerWCJ OrderApplicantDefendantSubstantial Prejudice
References
Case No. ADJ6914890
Regular
Nov 29, 2012

MIGUEL AGUILAR vs. HYDER PROPERTY MANAGEMENT, INSURANCE COMPANY OF THE WEST

This case involves a lien claimant's petition for reconsideration of a prior order denying its reimbursement claim. The lien claimant argued the administrative law judge erred by not relying on specific medical reports. However, the petition was improperly filed and the cited medical reports were not admitted into evidence. Consequently, the Workers' Compensation Appeals Board denied the petition for reconsideration on its merits and due to procedural deficiencies.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings of Fact and OrderCompromise and ReleaseQualified Medical EvaluatorPQMELabor Code Section 5909Operation of LawVerified Pleadings
References
Case No. ADJ2513573
Regular
Jun 02, 2010

SUSAN PORTER vs. SHERROD CHIROPRACTIC, INC., dba PLACER CHIROPRACTIC

The Workers' Compensation Appeals Board denied Susan Porter's petition for reconsideration of the arbitrator's decision. The Board adopted and incorporated the arbitrator's report as the basis for its denial. The specific reasons for the denial are contained within the arbitrator's report, which was not provided in this excerpt. Therefore, the original decision stands.

Workers' Compensation Appeals BoardReconsideration DeniedArbitrator's ReportApplicantDefendantSherrod ChiropracticPlacer ChiropracticADJ2513573SAC 0369934Petition for Reconsideration
References
Case No. ADJ9099536
Regular
Sep 09, 2014

MARIA SOTO vs. CCC HOSPITALITY PISMO, LLC dba SEACREST OCEANFRONT HOTEL, STAR INSURANCE COMPANY

In this case, the defendant hospital sought removal after the WCJ ordered a chiropractic QME panel, arguing chiropractors were unqualified for the applicant's knee injury. The defendant had initially requested an orthopedic surgeon QME, but their request was rejected by the Medical Unit as incomplete. The Appeals Board found the defendant's initial request substantially complied with regulations and was improperly rejected. Therefore, the Board granted removal, rescinded the WCJ's order, and directed the Medical Unit to issue a panel of orthopedic surgery QMEs.

Petition for RemovalPQMEMedical UnitChiropractic QMEOrthopedic Surgery QMERequest for QME PanelAdministrative Director Rule 30(b)Labor Code section 4062.2Messele v. Pitco FoodsInc.
References
Case No. ADJ13119496
Regular
Sep 29, 2025

Ariel Prudente vs. RJP Framing, Inc., Alaska National Insurance Company

Applicant Ariel Prudente sought removal of a WCJ's order to replace psychiatric Qualified Medical Evaluator (PQME) Dr. Peter Turek. The WCJ's decision stemmed from applicant's attorney providing "summaries and excerpts from the Kite decisions" to Dr. Turek, which was deemed a violation of Labor Code section 4062.3(b). The Appeals Board found that the WCJ's order lacked sufficient rationale and evidence of prejudice to justify Dr. Turek's replacement. Consequently, the Board granted the petition for removal, rescinded the WCJ's June 18, 2025 Findings and Order, and remanded the matter for further proceedings, emphasizing the need for less drastic measures than QME replacement.

PQMEPetition for RemovalLabor Code section 4062.3(b)Kite decisionsVigil v. County of KernSuon v. California DairiesMaxham v. California Department of Corrections and Rehabilitationex parte communicationsubstantial justiceAOE/COE
References
Case No. ADJ7669411
Regular
Jul 23, 2013

OSCAR HUERTA vs. HIGGINS & LOVETT CONSTRUCTION, TOWER SELECT INSURANCE CO.

This case involves a workers' compensation claim for a laborer injured on November 2, 2010, to his neck and back. The defendant disputes the finding of 51% permanent disability, primarily arguing that the panel qualified medical evaluator's (PQME) report was not substantial evidence. The Appeals Board has granted reconsideration to further review the PQME's lumbar impairment rating, specifically questioning whether "non-verifiable radicular complaints" sufficiently supported the DRE Category III rating. The Board has rescinded the prior award and returned the case for further development of the record.

Occupational Group 480Panel Qualified Medical Evaluator (PQME)Dr. DawdyDRE Category IIIRadiculopathyLumbar ImpairmentSubstantial Medical EvidenceFurther Development of the RecordAmended Findings and AwardLumbar Spine
References
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