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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 The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr.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. 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. AHM 0048021
Regular
Apr 02, 2008

SEBASTIAN CORNIEL vs. KASLER CORPORATION, Permissibly SelfInsured, CAMBRIDGE INTEGRATED SERVICES

The Workers' Compensation Appeals Board granted reconsideration and rescinded an award for pool and lawn maintenance services. The Board found that the prescribed services, intended to prevent re-injury while performing these activities, were not medically necessary under Labor Code Section 4600. The medical reports lacked substantial evidence by failing to connect the activities directly to curing or relieving the effects of the applicant's industrial injury.

Workers' Compensation Appeals BoardKasler CorporationCambridge Integrated Servicespool and lawn maintenancemedical awardpermanent disabilityfuture medical careLabor Code §4600substantial evidenceancillary services
References
Case No. ADJ8572033
Regular
Jan 23, 2017

NELLY MOLINA vs. MACY'S CORPORATE SERVICES, Permissibly Self-Insured, Administered By MACY'S

This case involves a lien claim by Industrial Healthcare for medical services provided to applicant Nelly Molina from November 6, 2012, to September 10, 2013. The Workers' Compensation Appeals Board (WCAB) denied reconsideration of an order dismissing the lien, upholding the administrative law judge's finding that the lien was untimely. The WCAB ruled that because the last date of service (September 10, 2013) was after July 1, 2013, the 18-month statute of limitations under Labor Code section 4903.5(a) applied, making the lien filed on September 2, 2015, tardy. A dissenting opinion argued that continuous services provided both before and after July 1, 2013, should be subject to the three-year statute of limitations, allowing for a single lien filing.

Labor Code section 4903.5(a)statute of limitationslien claimreconsiderationOrder Dismissing Lienworkers' compensation administrative law judgeIndustrial HealthcareInnovative Medical ManagementMacy's Corporate Servicescontinuous treatment
References
Case No. ADJ1784264 (MON 0302991) ADJ2898466 (MON 0339769)
Regular
Oct 14, 2011

GIRGIS FAM vs. UCLA MEDICAL CENTER, permissibly self-insured, Administered by Sedgwick Claims Management Services

This case concerns the selection of a child care provider for a permanently and totally disabled applicant. The Workers' Compensation Appeals Board (WCAB) granted the applicant's petition for reconsideration. The WCAB reversed the judge's decision, allowing the applicant to select his own child care provider, reasoning that this service is personal, similar to selecting a physician. The Board emphasized that the continuity of care and applicant's confidence in the provider outweigh the employer's desire to use a licensed and bonded provider selected by them.

Workers' Compensation Appeals BoardPetition for ReconsiderationSupplemental Findings and AwardPermanently totally disabledCaretaking servicesChild care servicesGardening servicesPool maintenance servicesStructural modificationsCauda-equina syndrome
References
Case No. ADJ8493192, ADJ8386046
Regular
Feb 05, 2016

HECTOR CAMPOS vs. CELL-CRETE CORPORATION, OLD REPUBLIC GENERAL INSURANCE CORPORATION, GALLAGHER BASSETT SERVICES, INC., INFRASOURCE, OLD REPUBLIC INSURANCE COMPANY

This case involves applicant Hector Campos seeking reconsideration of a Findings and Award concerning cumulative injuries sustained while employed by Cell-Crete Corporation and Infrasource. The Workers' Compensation Judge (WCJ) found applicant sustained a curable injury at Cell-Crete but no injury at Infrasource. Applicant argued improper consolidation and need for further discovery, while Cell-Crete asserted a post-termination defense and challenged the WCJ's reliance on an Agreed Medical Evaluator's opinion. The Workers' Compensation Appeals Board (WCAB) reviewed the petitions and answers, ultimately adopting the WCJ's report and denying reconsideration, affirming the original Findings and Award.

Workers' Compensation Appeals BoardCell-Crete CorporationOld Republic General Insurance CorporationGallagher Bassett ServicesInc.InfrasourceOld Republic Insurance CompanyADJ8493192ADJ8386046Deputy Commissioner
References
Case No. ADJ2664628 (MON 0192129) ADJ3433059 (MON 0117435) ADJ3492686 (MON 0174315) ADJ3519577 (MON 0117436) ADJ3629755 (MON 0210291) ADJ3759663 (MON 0069692) ADJ4060215 (MON 0117437)
Regular
Mar 18, 2019

FAHMY ATTIA vs. GTE CORPORATION, ACE AMERICAN INSURANCE COMPANY, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves applicant Fahmy Attia's petition for reconsideration of an Order Approving Compromise and Release (OACR). The Appeals Board denied reconsideration on the merits, adopting the WCJ's reasoning. Despite a defective service of the OACR by the WCJ, the Board treated the petition as timely filed and accepted a supplemental filing from the applicant. Ultimately, the Board found that the OACR validly settled all of the applicant's claims, including future medical care.

WORKERS' COMPENSATION APPEALS BOARDGTE CORPORATIONACE AMERICAN INSURANCE COMPANYSEDGWICK CLAIMS MANAGEMENT SERVICESPetition for Reconsiderationworkers’ compensation administrative law judgeWCJOrder Approving Compromise and ReleaseOACRdefective service
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. ADJ10878769, ADJ10878746
Regular
Mar 17, 2020

MARIA TORRES vs. ACTION EMBROIDERY CORPORATION, SOMPO AMERICA INSURANCE COMPANY, BROADSPIRE SERVICES, INC.

The Workers' Compensation Appeals Board granted reconsideration of a prior order. The Board affirmed the January 14, 2020 order to pay Labor Code § 5811 costs but amended it to specifically award $225.00 for interpreting services. The case is returned to the trial level for further proceedings, and issues of sanctions and costs have been deferred.

Petition for ReconsiderationLabor Code § 5811 CostsWorkers' Compensation Appeals BoardDecision After ReconsiderationWCJ reportDolores I. Campos Interpreting ServicesInc.sanctionsdeferred issuesVan Nuys District Office
References
Case No. ADJ7232076
En Banc
Sep 26, 2011

Tsegay Messele vs. Pitco Foods, Inc.; California Insurance Company

The Appeals Board holds that the 10-day period for agreeing on an AME under Labor Code § 4062.2(b) is extended by five days when the initial proposal is served by mail, and clarifies the method for calculating this time period, finding both parties' panel requests premature.

Workers' Compensation Appeals BoardTsegay MesselePitco FoodsInc.California Insurance CompanyADJ7232076Opinion and Decision After ReconsiderationOrder Granting RemovalDecision After RemovalEn Banc
References
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