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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 Consequently, the WCJ's Findings of Fact and Order were rescinded, and the matter was returned to the trial level for further proceedings consistent with this comprehensive disclosure mandate.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. ADJ450513 (GOL 0098571)
Regular
Mar 11, 2011

MONICA LEDESMA vs. FIRESTONE VINEYARD, STATE COMPENSATION INSURANCE FUND

The Board granted reconsideration of the WCJ's award, finding the physician's permanent disability opinion lacked substantial evidence. Specifically, Dr. Scheinberg failed to adequately explain his shift in impairment rating from Category II to Table 6-9, which addresses herniation, without providing sufficient justification. Consequently, the Board rescinded the award and returned the case to the trial level for further proceedings to ensure the decision is based on substantial medical evidence. The WCJ may also address the defendant's other contentions, including temporary disability offset.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryLumbar SpineSleep DisorderTemporary DisabilityPermanent DisabilitySubstantial EvidenceAMA Guides
References
Case No. ADJ7690958
Regular
Jul 17, 2012

MICHEL SALMO vs. PHASE II TRANSPORTATION, GREAT AMERICAN INSURANCE COPANY

The Workers' Compensation Appeals Board denied reconsideration of an administrative law judge's decision. The judge found the applicant, Michel Salmo, to be an independent contractor, not an employee of Phase II Transportation, at the time of his alleged injury. This finding was based on the judge's assessment of Salmo's testimony as unreliable and contradictory regarding his truck ownership and lease arrangements. The Board adopted the judge's report and recommendations, emphasizing the great weight given to credibility findings.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ ReportGarza v. Workers' Comp. Appeals Bd.independent contractoremployeeemployment relationshiplease agreementowner-operatorcontrol
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. ADJ9460638
Regular

DAVID HAMALIAN vs. HANSEL FORD, SECURITY NATIONAL INSURANCE CO.

The Workers' Compensation Appeals Board granted the defendant's Petition for Reconsideration regarding a WCJ's order that rescinded a prior finding of no material defect in the defendant's Utilization Review (UR). This decision was based on a subsequent en banc ruling, *Dubon II*, which held that UR decisions are invalid only if untimely. Consequently, the Board rescinded the WCJ's Amended Findings & Order and remanded the case for further proceedings and a new decision consistent with *Dubon II*. The prior finding that the UR was not materially defective was rescinded, and the matter will be reheard to determine the UR's timeliness and applicant's need for surgery.

Utilization ReviewMaterial DefectDubon IDubon IIPetition for ReconsiderationFindings & OrderRescindedAdministrative Law JudgeAppeals BoardEn Banc Decision
References
Case No. ADJ2172104 (SAC 0326562)
Regular
Jan 15, 2015

THOMAS MEEKER vs. OREGON PACIFIC BUILDING PRODUCTS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT COMPENSATION INSURANCE COMPANY

This case involves a dispute over the validity of a utilization review (UR) denial for an applicant's requested prescription medication. Initially, the administrative law judge found the UR denial invalid because the reviewing physician did not examine all relevant medical reports. However, following the en banc decision in *Dubon II*, the Appeals Board reversed this finding. The Board ruled that under *Dubon II*, only untimely UR decisions are invalid; other defects, like incomplete medical review, must be addressed through the Independent Medical Review (IMR) process. Therefore, the UR denial was deemed valid as it was timely.

Utilization ReviewRequest for AuthorizationProvigilDubon IIIndustrial InjuryPermanent DisabilityFuture Medical TreatmentPetition for ReconsiderationAdministrative Law JudgeWorkers' Compensation Appeals Board
References
Case No. LBO 0362735, LBO 0362734
Regular
Jan 29, 2008

Steven A. Hill vs. TEK SYSTEMS/ALLEGIS, AIG, Administered by BRGADSPIRE, PASADENA UNIFIED SCHOOL DISTRICT, ZURICH NORTH AMERICA

This case concerns two workers' compensation injuries sustained by the applicant with different employers. The Appeals Board rescinded the original decision because the Administrative Law Judge erred in applying the old Permanent Disability Rating Schedule (PDRS) and the Wilkinson rule for successive injuries. The Board remanded the case for a new decision, requiring the judge to re-evaluate permanent disability and apportionment under current case law, including the recent Benson decision, and to reconsider the applicable PDRS based on subsequent legal interpretations.

Appeals BoardReconsiderationJoint Findings and AwardApplicantDefendantIndustrial InjuryPermanent Disability1997 PDRS2005 PDRSWilkinson
References
Case No. ADJ4409748 (MON 0316373)
Regular
Jul 27, 2009

KIMBERLY HOLLIS vs. KDS BUSINESS SYSTEMS, INC., HARTFORD ACCIDENT \u0026 INDEMNITY CO.

The WCJ's decision to use the 1997 PDRS instead of the 2005 PDRS is rescinded because it did not explain how the 1997 PDRS was used. The case is returned for a decision addressing the Labor Code section 4660(d) requirement.

WCABReconsiderationPost-Reconsideration Findings and AwardPermanent Disability Rating Schedule1997 PDRS2005 PDRSLabor Code Section 4660(d)Cumulative TraumaIndustrial InjuryRes Judicata
References
Case No. SDO 0323941
Regular
Aug 20, 2007

CAPRICE SMITH vs. KINDERCARE LEARNING CENTER, SPECIALTY RISK SERVICES, AIG

This case concerns whether the old or new workers' compensation permanent disability rating schedule applies to an injury predating the 2005 schedule changes. The Board affirmed the WCJ's prior determination that the 1997 schedule applies due to a final, unchallenged finding on the matter. However, the Board granted reconsideration to amend the award, deferring the issue of permanent disability and attorney's fees for further proceedings at the trial level due to the WCJ's insufficient explanation of the disability rating and apportionment.

Workers' Compensation Appeals BoardKindercare Learning CenterSpecialty Risk ServicesAIGCaprice SmithSDO 0323941Petition for ReconsiderationAmended Findings and AwardPreschool TeacherIndustrial Injury
References
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