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

Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. LAO 823855, LAO 823856
Regular
Oct 03, 2007

PEDRO M. RODRIGUEZ vs. RALPHS GROCERY COMPANY

The applicant sought reconsideration of a denial of workers' compensation benefits, which was based on the finding that his claims were filed after notice of termination. The Board affirmed the denial, concluding that the applicant's job abandonment led to a termination prior to the filing of his claims. The Board also determined that the employer properly denied both the specific and cumulative trauma claims, thus negating a presumption of compensability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderFindings of FactAdministrative Law JudgeApplicantDefendantRalphs Grocery CompanySecurity GuardIndustrial Injury
References
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. ADJ11254123
Regular
Oct 28, 2019

SAMANTHA HANSEN vs. ALERE HEALTH SYSTEMS, INC., THE HARTFORD INSURANCE GROUP

This case concerns a workers' compensation claim for a neck and spine injury. The applicant's attorney provided proof of service for the claim form on the defendant employer on March 16, 2018, and later sent a copy to the defendant insurance carrier. The defendant denied the claim on April 29, 2019, and argued that the claim should not be presumed compensable as the applicant did not prove receipt of the claim form. The Board upheld the WCJ's decision, finding that the proof of service created a presumption of receipt that the defendant failed to rebut. Therefore, the applicant's claim is presumed compensable under Labor Code Section 5402 as the defendant did not reject liability within 90 days.

Workers' Compensation Appeals BoardLabor Code Section 5402Presumption of CompensabilityReconsiderationFindings of Fact and OrdersPetition for ReconsiderationRN Case ManagerCumulative InjuryProof of ServiceClaim Form
References
Case No. ADJ3525697 (LAO 0534774) ADJ2342373 (LAO 0512482) ADJ1310306 (LAO 0568035) ADJ2645702 (LAO 0519888) ADJ1384751 (LAO 0568036) ADJ2871875 (ANA 0235799)
Regular
Feb 03, 2017

ALICE BRYANT vs. REGENTS OF THE UNIVERITY OF CALIFORNIA, permissibly self-insured, UCLA MEDICAL CENTER; SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves applicant Alice Bryant's petition for reconsideration of prior dismissed workers' compensation claims and a Labor Code section 132a retaliation claim. The Workers' Compensation Appeals Board (WCAB) denied reconsideration, upholding the administrative law judge's findings. The WCAB concluded that Bryant's claims were previously dismissed, with some dismissed by her own request and others for failure to prosecute. Furthermore, the WCAB found that Bryant failed to demonstrate extrinsic fraud and lacked the required diligence to reopen these final dismissals, even with newly discovered evidence.

Workers' Compensation Appeals BoardRegents of the University of CaliforniaSedgwick Claims Management ServicesPetition for ReconsiderationFindings and OrdersWorkers' Compensation Administrative Law JudgeLabor Code section 132aRetaliation claimExtrinsic fraudDismissed claims
References
Case No. ADJ8475421
Regular
Mar 30, 2017

Jessica Duncan vs. Right At Home, Travelers Diamond Bar

The Workers' Compensation Appeals Board denied reconsideration of a lien claimant's claim for medical services. The Board found that the lien, filed on June 4, 2016, was barred by the 18-month statute of limitations under Labor Code section 4903.5(a). This was because the last date of service was August 8, 2013, which fell after the July 1, 2013, implementation date of the 18-month rule. The Board also held that it lacked the authority to rule on constitutional vagueness claims.

Labor Code section 4903.5(a)Lien claimStatute of limitationsReconsiderationWorkers' Compensation Appeals BoardWCJTimelinessDate of servicesContinuous treatmentUnconstitutionally vague
References
Case No. ADJ15763825
Regular
Sep 16, 2025

CLAUDIO CARDOZO vs. ROCK AND ROLL CAR WASH, REDWOOD FIRE AND CASUALTY INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the Petition for Reconsideration filed by Redwood Fire and Casualty Insurance Company dba Berkshire Hathaway Homestate Companies. The petition challenged a lien trial decision concerning a medical-legal evaluation performed by Dr. Michaels of Premier Psychological Services. The WCJ found that a medical dispute regarding psyche existed at the time of the evaluation, Dr. Michaels was validly designated as the Primary Treating Physician, and the evaluation was not barred by the 60-day rule for new claims as it was an amendment to an already accepted claim. The Appeals Board adopted the WCJ's reasoning and denied the petition.

Workers' Compensation Appeals BoardPetition for ReconsiderationLabor Code Section 5909Adjudication NumberOpinion and Order Denying PetitionWCJ ReportEAMS TransmissionNotice of TransmissionProof of ServiceFindings and Order
References
Case No. AD.J9949974, AD.J9950384
Regular
Apr 21, 2016

KAREN HERCULES vs. BODEGA LATINA CORPORATION dba EI SUPER, YORK RISK SERVICES GROUP

This case involves Karen Hercules' workers' compensation claim against Bodega Latina Corporation. The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The denial was based on the employer's failure to reject the claim within 90 days of filing, creating a presumption of compensability under Labor Code section 5402(b). The employer's subsequent denial on June 18, 2015, was untimely as it occurred 132 days after the claim form dated February 5, 2015. Therefore, the injury is presumed compensable, and the employer failed to rebut this presumption.

Workers' Compensation Appeals BoardBodega Latina CorporationYork Risk Services GroupPetition for ReconsiderationLabor Code section 5402presumption of compensabilityclaim formdenial of claimadministrative law judgespecific injury
References
Case No. ADJ9030735
Regular
Jul 08, 2014

HECTOR CASILLAS vs. XERXES CORPORATION, BROADSPIRE CLAIMS SERVICES

The Workers' Compensation Appeals Board denied Xerxes Corporation's Petition for Removal. The Board found that while the defendant raised legitimate concerns about potential fraud, these issues were not relevant to the applicant's current claim. The Board adopted the administrative law judge's report, concluding that the evidence presented did not support a fraudulent claim and the forum was not appropriate for addressing concerns about running, capping, and steering. Therefore, the petition was denied.

Petition for RemovalWorkers' Compensation Appeals Boardrunningcappingsteeringfraudulent claimadministrative law judge reportADJ9030735Xerxes CorporationBroadspire Claims Services
References
Case No. ADJ736716 (ANA 0400973) ADJ3010829 (ANA 0400924) ADJ7503662 ADJ8980493
Regular
Nov 08, 2013

JAIME RAMIREZ vs. HIGH GRADE FORM, BARRETT BUSINESS SERVICES, STATE COMPENSATION INSURANCE FUND, ZURICH, CHARTIS

This case involved a Petition for Reconsideration challenging a lien dismissal. The Appeals Board dismissed the petition, adopting the WCJ's report. The lien was dismissed because the $100 lien activation fee required by Labor Code section 4903.06(a) was not paid, making the necessity of the services irrelevant. While the dismissal applied to services pre-dating July 31, 2012, the Board noted potential future claims for services rendered on May 6, 2013, would require a $150 filing fee and could be pursued as a petition for costs.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien dismissalLabor Code section 4903.06(a)Lien activation feeInterpreting servicesWCAB hearingINJAB RefundablePetition for costsCalifornia Lien Services
References
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