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

Case No. ADJ7445107
Regular
Oct 13, 2025

JILLIAN DIFUSCO vs. HANDS ON SPA, EMPLOYERS COMPENSATION INSURANCE GROUP

The Appeals Board, en banc, granted reconsideration of a WCJ's decision regarding disclosure requirements for defendants. The WCJ had ruled that the defendant only needed to disclose the name of its insurance carrier as per WCAB Rule 10390. The Board determined that its prior en banc decisions, Coldiron I and II, are binding precedent and require defendants to disclose all entities liable for payment and any insurance policy provisions affecting liability. Consequently, the WCJ's Findings of Fact and Order were rescinded, and the matter was returned to the trial level for further proceedings consistent with this comprehensive disclosure mandate.

En Banc DecisionWCAB Rule 10390Coldiron IColdiron IIDiscovery RequestInsurance Carrier DisclosureSelf-Insured RetentionLarge DeductibleEntity Liable for CompensationThird-Party Administrator
References
Case No. ADJ15820808
Regular
Oct 28, 2025

Carlos Enrique Vicente vs. Samuel Hale, LLC / TWS Facility Services, Inc.; Cannon Cochran Management Services, Inc. on behalf of Clear Spring Property & Casualty Company

The Workers' Compensation Appeals Board denied defendant's petition for removal of a trial setting order, asserting that removal is an extraordinary remedy and the defendant failed to demonstrate substantial prejudice or irreparable harm. The Board clarified that motions for summary judgment are impermissible in workers' compensation cases, emphasizing the need for decisions based on an adequate record with due process. Furthermore, the Board critically addressed defendant's counsel for non-compliance with mandatory rules regarding party identification and disclosure of liable entities, citing conflicting information in various filings. Counsel was advised to resolve these identification issues promptly, with a warning of potential sanctions and unenforceability of awards if not rectified.

RemovalPetition for RemovalOrder of DismissalSummary JudgmentWCJDue ProcessWCAB Rule 10390WCAB Rule 10400Third-Party AdministratorLiability Disclosure
References
Case No. ADJ3633276 (SAC 0360146)
Regular
Jan 24, 2012

GAYE MARTIN vs. LENNAR CORPORATION, BROADSPIRE

The Workers' Compensation Appeals Board denied the Petition for Removal filed by defendants Lennar Corporation and its third-party administrator, Broadspire. The Board adopted the WCJ's report, which recommended denial because the applicant's request to take the case off calendar was granted to allow her to develop her case under a recent *Ogilvie* decision. Additionally, the defendants were admonished for Broadspire's failure to disclose the identity of its client as required by *Coldiron v. Compuware Corp.* and were put on notice that sanctions could be considered at the trial level.

WCABRemovalBroadspireThird-party administratorColdironLabor Code section 3700SanctionsLabor Code section 5813Off calendarMandatory Settlement Conference
References
Case No. SJO 0255977
Regular
May 20, 2008

GRACIELA RAMOS vs. ENTERPRISE RENT A CAR

The Appeals Board denied Enterprise Rent-A-Car's Petition for Reconsideration, upholding the finding of industrial spine injury and 28% permanent disability based on the prior rating schedule. The Board remanded the case to the trial level to clarify the employer's self-insurance and adjustment status, given a contradictory statement from the defendant. This clarification is to determine if sanctions against the defendant are warranted for failing to properly disclose administrative information, as per *Coldiron v. Compuware*.

Workers' Compensation Appeals BoardReconsideration DeniedFindings Award and OrderIndustrial InjurySpine InjuryPermanent DisabilityPrior Rating ScheduleLabor Code section 4061Third-Party AdministratorFrank Gates Services
References
Case No. ADJ9973380
Regular
Nov 13, 2015

VICTOR SANCHEZ vs. SECOND STREET CORPORATION, SEDGWICK CMS

This case involves defendant Second Street Corporation's successful petition for removal, arguing that setting a trial date was premature before obtaining medical evaluations as required by Labor Code section 4061(i). The Appeals Board agreed, finding the record insufficiently developed and rescinding the trial setting order. The matter is returned to the trial level for further proceedings, and the defendant is also ordered to identify its insurance carrier.

Petition for RemovalAgreed Medical EvaluatorPanel Qualified Medical EvaluatorLabor Code section 4061(i)Mandatory Settlement ConferencePermanent DisabilityWorkers' Compensation Appeals BoardWCJRescindReturn to Trial Level
References
Case No. ADJ6718294
Regular
Oct 25, 2011

ANTONIO LANGHAM vs. BALTIMORE RAVENS, CLEVELAND BROWN, SAN FRANCISCO 49ERS, TIG SPECIALTY INSURANCE

This case concerns a professional athlete's workers' compensation claim for multiple injuries sustained between 1994 and 2000. The Workers' Compensation Appeals Board (WCAB) granted reconsideration due to a flawed record, including an incorrect defendant identification and insufficient evidence on jurisdiction and venue. The WCAB rescinded the original decision and returned the case for further proceedings. This will allow for proper identification and joinder of the correct defendant(s) and for the development of a complete record, potentially pending consolidation with other related cases.

Workers' Compensation Appeals BoardProfessional AthleteIndustrial InjuryStatute of LimitationsSubject Matter JurisdictionLabor Code section 3600.5(b)Extraterritorial ProvisionsReconsiderationFindings and AwardPetition for Reconsideration
References
Case No. ADJ9510116
Regular
Apr 06, 2016

SUNRISE TERRACE MOBILEHOME OWNERS ASSOCIATION vs. ICW Group/Explorer Insurance Company, Williamsburg National Insurance, Tower Select Insurance

Explorer Insurance Company sought reconsideration of a WCJ's decision awarding vocational expert costs. The parties had previously settled underlying claims for $30,000, with the C&R leaving the decision on vocational expert costs to the WCJ. Explorer argued the WCJ erred in awarding uncertain costs, failing to list all case numbers, and not awarding costs against all defendants. The Appeals Board granted reconsideration, rescinded the WCJ's decision, and returned the matter to the trial level due to the unclear identification of liable carriers across the multiple case numbers and differing insurance coverage stipulations. The WCJ will need to conduct further proceedings to definitively identify liable parties and address a stipulation resolving contribution.

Vocational expert costsOrder Approving Compromise and ReleasePetition for ReconsiderationReport and RecommendationJoint and several liabilityThird-party administratorSubstantial evidenceStipulationCumulative injuryContribution
References
Case No. ADJ7937089
Regular
Jun 18, 2019

SHUPELLA BROWN vs. CRAZY HORSE NIGHT CLUB, ATHENS ADMINISTRATORS

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the prior award due to conflicting information regarding the defendant's insurance status. The Board adopted the WCJ's findings on the applicant's industrial injury and permanent disability, finding the employer did not meet its burden to prove the six-month employment requirement. However, the WCAB remanded the case to determine the correct entity liable for compensation due to the inconsistent self-insured status disclosures. The applicant was awarded 88% permanent disability, medical treatment reimbursement, and attorney fees.

WCABPetition for ReconsiderationFindings of FactWCJAOE/COEBurden of ProofAffirmative DefenseLabor Code Section 3208.3(d)Credibility DeterminationsPermissibly Self-Insured
References
Case No. ADJ11525908, ADJ11260573
Regular
Feb 07, 2020

SUSAN MOELLER vs. MOLINA HEALTHCARE, INC., GALLAGHER BASSETT SERVICES, INC

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior decision finding injury AOE/COE on December 9, 2016. The Board identified a critical deficiency in the record: the identity of the employer's workers' compensation insurance carrier was not properly established, with the listed defendant Gallagher Bassett Services, Inc. appearing to be an administrator, not an insurer. Consequently, the case was returned to the WCJ for further proceedings to correctly identify and join the appropriate parties, including the insurance carrier, before addressing the merits of the claim.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderAdministrative Law JudgeAOE/COESubstantial EvidenceCredibilityElectronic Adjudication Management SystemThird-Party AdministratorWCIRB
References
Case No. ADJ3910048 (VNO 0417016)
Regular
Jul 30, 2010

NAHID JAVADI vs. SIMI VALLEY HOSPITAL, ADVENTIST HEALTH SYSTEMS WEST

This case involves an employer, Simi Valley Hospital/Adventist Health Systems West, seeking to prevent the joinder of AIG as a defendant in a workers' compensation claim. The employer argues it is permissibly self-insured and self-administered, and joining AIG, an excess carrier, would cause irreparable harm. The Appeals Board found that since there is no third-party administrator involved, the precedent relied upon for joinder is inapplicable. Consequently, the Board rescinded all orders joining AIG and returned the case to the trial level.

Workers' Compensation Appeals BoardPetition for RemovalJoinder of DefendantReinsurance CarrierExcess CarrierPermissibly Self-InsuredSelf-AdministeredIndustrial InjuryFindings and AwardPetition to Reopen
References
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