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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. 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. ADJ1282419 (LAO 0846452) ADJ915214 (LAO 0854736)
Regular
Feb 01, 2010

VALERIE VANCE DILLON vs. TJ MAXX, CNA CLAIMS PLUS

This case involves a Compromise and Release agreement between the applicant and defendants. The Board granted reconsideration, rescinded the prior decision, and returned the matter to the trial level. This action is contingent on the workers' compensation administrative law judge approving the settlement. If not approved, the original decision could be reinstated, with the right to seek reconsideration.

Compromise and ReleasePetition for ReconsiderationGrant ReconsiderationRescind DecisionTrial LevelWorkers' Compensation Appeals BoardAdministrative Law JudgeSalvage and ClaimsSalvage and ClaimsSalvage and Claims
References
Case No. ADJ11900759
Regular
Oct 20, 2025

Luis Hernandez vs. Cesar Chavez Foundation, Berkshire Hathaway Homestate Insurance Company

The Workers' Compensation Appeals Board denied defendant Berkshire Hathaway Homestate Insurance Company's petition for reconsideration. The defendant challenged an earlier decision that found a contested claim existed when cost petitioner DocCentral provided subpoena services. The Board affirmed its previous finding, clarifying that a claim becomes contested upon an employer's delay notice, thus allowing discovery. The Board rejected the defendant's argument that a denial was required for a contested claim, citing prior en banc decisions to support its position on discovery during delay periods.

Contested claimLabor Code § 4620(b)8 CCR § 9793(b)Petition for ReconsiderationOpinion and Order DenyingDocCentralsubpoena servicesdelay noticemedical-legal expenseAdjudication of Claim
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. ADJ9537329 ADJ9537436
Regular
Oct 10, 2019

LINDA RAMIREZ vs. PACIFIC ASIAN CONSORTIUM IN EMPLOYMENT, INC., CYPRESS INSURANCE COMPANY

This case involves a lien claimant, Med-Legal Photocopy, seeking reconsideration of a WCJ's decision that disallowed their lien for photocopy costs. The WCJ initially found no contested claim existed during the period the costs were incurred, thus invalidating the lien. However, the Appeals Board granted reconsideration, amending the F&O to find that a contested claim did exist during the period in question. Consequently, the lien of Med-Legal Photocopy is now deferred for further proceedings before the WCJ.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings and OrderMedical-legal costsContested claimApplication for Adjudication of ClaimCompromise and ReleaseBurden of proofLabor Code
References
Case No. ADJ8725365
Regular
Oct 15, 2019

ADAM STEWART vs. KUNZIK AND SARA CONSTRUCTION, CYPRESS INSURANCE COMPANY, BERKSHIRE HATHAWAY HOMESTATE COMPANIES

This case involves a lien claimant seeking reconsideration of a decision disallowing their lien for copying services. The Administrative Law Judge (ALJ) initially found no substantial evidence that the services were reasonable and necessary because there was no "contested claim." However, the Appeals Board rescinded the decision, finding the ALJ's reasoning based on stipulations and the "immediately accepted case" status was insufficient. The Board remanded the case for further proceedings, emphasizing that a contested claim exists when an employer rejects liability or fails to respond to benefit demands, and the lien claimant bears the burden of proving this.

WORKERS' COMPENSATION APPEALS BOARDMed-Legal PhotocopyFindings and OrderWCJreconsiderationlien claimantreasonable and necessarycontested claimApplication for Adjudication of ClaimCompromise and Release
References
Case No. ADJ8236211
Regular
Oct 24, 2025

JULIE CASTELLANO vs. LOWE'S COMPANIES, INC., SEDGWICK CLAIMS MANAGEMENT SERVICES

The Appeals Board granted reconsideration to Supreme Copy Service, which challenged a Workers' Compensation Judge's (WCJ) finding that it failed to prove a contested claim existed for medical-legal reimbursement and was sanctioned for bad faith. The Board rescinded the WCJ's Findings and Order, determining that a contested claim did exist based on the employer's disagreements over various benefits. The case was returned for further proceedings to evaluate if the expenses were reasonable and necessary, and the Board found no basis for the imposed sanctions.

Medical-legal reimbursementContested claimLabor Code section 4620ColamonicoSanctionsPetition for ReconsiderationCompromise and ReleaseLachesBurden of proofWCAB Rule 10421
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. ADJ3751392
Regular
Sep 02, 2017

SANTIAGO FLORES vs. OC COMPLETE PERSONNEL, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a finding that applicant Santiago Flores sustained an industrial back injury in 2003 and that the claim was contested until 2014. The defendant argued the claim was accepted, not contested, and that a regulation defining a contested claim based on disputed medical facts conflicted with the Labor Code. The Board affirmed the finding, concluding the regulation correctly interpreted the Labor Code by including disputed medical facts as a basis for a contested claim.

Contested claimPetition for ReconsiderationAgreed Medical EvaluatorCalifornia Code of RegulationsLabor CodeWCJWorkers' Compensation Appeals BoardIndustrial injuryMedical-legal expensesDisputed medical fact
References
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