Updated Daily

Case Law Database

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

Case No. RDG 0115958

En Banc

Nov 16, 2004

Brice Sandhagen vs. Cox & Cox Construction, Inc.; State Compensation Insurance Fund

The Appeals Board held that utilization review time deadlines under Labor Code section 4610(g)(1) are mandatory. A defendant's failure to comply precludes the use of the utilization review process, renders the resulting report inadmissible, and requires the defendant, as the objecting party, to follow the dispute resolution procedures of section 4062(a).

Workers' Compensation Appeals BoardUtilization ReviewLabor Code Section 4610(g)(1)Mandatory DeadlinesAdmissibility of EvidenceACOEM GuidelinesTreating PhysicianMedical Treatment RecommendationAgreed Medical Evaluator (AME)Qualified Medical Evaluator (QME)

References

Case No. MISSING

En Banc

Feb 07, 2005

Brice Sandhagen vs. Cox & Cox Construction, Inc.; State Compensation Insurance Fund

The Appeals Board dismisses the applicant's petition for reconsideration, finding it premature because it was filed in response to an interlocutory order that remanded the case for further proceedings, rather than a final decision.

Labor Code 4610Labor Code 4062(a)Utilization ReviewQME/AMEPetition for ReconsiderationFinal OrderInterlocutory OrderRescinded DecisionRemanded MatterMandatory Deadlines

References

Case No. RDG 0115958

Significant

Brice Sandhagen, Applicant vs. Cox & Cox Construction, Inc., State Compensation Insurance Fund

The Board dismisses the applicant's petition for reconsideration because it was made from an interlocutory (non-final) order, as the matter had been remanded to a WCJ for further proceedings. The Board also observes that utilization review is not a mandatory prerequisite for a defendant to use the QME/AME process.

WORKERS' COMPENSATION APPEALS BOARDEN BANCOPINION AND ORDER DISMISSING PETITION FOR RECONSIDERATIONBrice SandhagenCox & Cox ConstructionInc.State Compensation Insurance FundLabor Code section 4610(g)(1)utilization reviewWCJ

References

Case No. RDG 0115958

Significant

Nov 16, 2004

Brice Sandhagen, Applicant vs. Cox & Cox Construction, Inc.; State Compensation Insurance Fund

The Appeals Board held that the utilization review time deadlines are mandatory; if a defendant fails to meet these deadlines, any utilization review report is inadmissible, and the defendant must use the AME/QME procedure as the objecting party.

Workers' Compensation Appeals BoardUtilization ReviewLabor Code Section 4610Time DeadlinesAdmissibility of EvidenceMedical Treatment RecommendationACOEM GuidelinesAgreed Medical EvaluatorQualified Medical EvaluatorSection 4062

References

Case No. ADJ1644038 (VNO 0526507)

Regular

Mar 11, 2014

LAMONT COX vs. TALENT PARTNERS, ESIS/ACE/U.S.A.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to address applicant Lamont Cox's petition. The WCAB amended the temporary disability award to the current maximum rate of $1,074.64 per week, affirming the denial of industrial injury for headaches and sleep disorders based on persuasive medical evidence. However, the WCAB found the Agreed Medical Examiner's apportionment of 90% of cervical disability to non-industrial factors insufficient and deferred permanent disability determination pending further record development regarding apportionment.

Workers' Compensation Appeals BoardReconsiderationStunt CoordinatorStunt PerformerPermanent DisabilityApportionmentNon-Industrial FactorsTemporary DisabilityAgreed Medical ExaminerRotator Cuff Tear

References

Case No. ADJ9860231

Regular

Apr 05, 2023

GARY COX vs. APPLIED PROCESS COOLING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) dismissed a Petition for Removal in the case of *Gary Cox v. Applied Process Cooling; State Compensation Insurance Fund*. The dismissal occurred because the petitioner voluntarily withdrew their request for removal. Consequently, the Board issued an order formally dismissing the petition. This decision does not address the merits of the underlying workers' compensation claim.

Petition for RemovalDismissedWithdrawnWorkers' Compensation Appeals BoardAdjudication NumberOpinion and OrderGary CoxApplied Process CoolingState Compensation Insurance FundStockton District Office

References

Case No. ADJ1957961

Regular

Feb 15, 2011

ANTHONY COX vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied applicant Anthony Cox's Petition for Removal, upholding the judge's decision to take the case off calendar. This was done to allow the defendant to depose the agreed medical examiner regarding apportionment of the applicant's permanent disability to non-industrial obesity. The Board found that clarification of the AME's opinion served both parties' interests and that removal was not warranted as applicant failed to demonstrate substantial prejudice or irreparable harm. The dissenting opinion argued that discovery should have closed per statute and that further development of the record was premature before trial.

Petition for RemovalWCJOff CalendarAgreed Medical Evaluator (AME)ApportionmentObesityPre-existing Degenerative ChangesDeclaration of Readiness to ProceedMandatory Settlement Conference (MSC)Discovery

References

Case No. BAK 144220, BAK 147172

Regular

Dec 14, 2007

RICHARD GLEGHORN vs. COX PETROLEUM, COMMERCE INDUSTRY INSURANCE CO., AIG CLAIM SERVICES, INC.

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding continuing temporary disability for a tanker driver, Cox Petroleum, based on admitted spinal injuries. While the parties stipulated to a cumulative injury date of April 18, 2004, the Board found insufficient evidence that this cumulative injury caused temporary disability. Therefore, the case was returned to the trial level for further medical development to determine causation and apportion temporary disability to the cumulative injury, which would affect the applicability of the 104-week/two-year cap under Labor Code § 4656(c)(1).

Workers Compensation Appeals BoardReconsiderationFindings & AwardTemporary DisabilityLabor Code § 4656(c)(1)104 compensable weeksTwo year capCumulative injurySpecific injuryDate of injury

References

Case No. ADJ3002774

Regular

Jun 10, 2014

ROWLAND COX vs. J.F. SHEA CONSTRUCTION, INC., AMERICAN HOME ASSURANCE INSURANCE COMPANY, CHARTIS CLAIMS, INC.

The Workers' Compensation Appeals Board denied a Petition for Removal filed by Rowland Cox against J.F. Shea Construction, Inc. and its insurer. The Board adopted and incorporated the reasoning of the workers' compensation administrative law judge's report. No specific grounds for the denial or details of the underlying case are provided in this order.

Petition for RemovalWorkers' Compensation Appeals BoardJ.F. Shea ConstructionAmerican Home AssuranceChartis ClaimsWorkers' Compensation Administrative Law JudgeADJ3002774LAO 0882805Anaheim District OfficeDenying Removal

References

Case No. ADJ4047184 (RDG 0115958)

Regular

Dec 02, 2009

BRICE SANDHAGEN vs. STATE COMPENSATION INSURANCE FUND

The court affirmed the WCJ's decision that the defendant was barred from relying on the utilization review process due to missed deadlines. The UR process is the employer's only avenue for resolving treatment requests.

RemittiturUtilization ReviewLabor Code section 4610(g)(1)Labor Code section 4062(a)Treating Physician RecommendationWCJFindings and Award and OrderPetition for ReconsiderationEn Banc DecisionCourt of Appeal

References

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Updated Daily

Case Law Database

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

Case No. RDG 0115958

En Banc

Nov 16, 2004

Brice Sandhagen vs. Cox & Cox Construction, Inc.; State Compensation Insurance Fund

References

Case No. MISSING

En Banc

Feb 07, 2005

Brice Sandhagen vs. Cox & Cox Construction, Inc.; State Compensation Insurance Fund

Labor Code 4610Labor Code 4062(a)Utilization ReviewQME/AMEPetition for ReconsiderationFinal OrderInterlocutory OrderRescinded DecisionRemanded MatterMandatory Deadlines

References

Case No. RDG 0115958

Significant

Brice Sandhagen, Applicant vs. Cox & Cox Construction, Inc., State Compensation Insurance Fund

References

Case No. RDG 0115958

Significant

Nov 16, 2004

Brice Sandhagen, Applicant vs. Cox & Cox Construction, Inc.; State Compensation Insurance Fund

References

Case No. ADJ1644038 (VNO 0526507)

Regular

Mar 11, 2014

LAMONT COX vs. TALENT PARTNERS, ESIS/ACE/U.S.A.

Workers' Compensation Appeals BoardReconsiderationStunt CoordinatorStunt PerformerPermanent DisabilityApportionmentNon-Industrial FactorsTemporary DisabilityAgreed Medical ExaminerRotator Cuff Tear

References

Case No. ADJ9860231

Regular

Apr 05, 2023

GARY COX vs. APPLIED PROCESS COOLING, STATE COMPENSATION INSURANCE FUND

Petition for RemovalDismissedWithdrawnWorkers' Compensation Appeals BoardAdjudication NumberOpinion and OrderGary CoxApplied Process CoolingState Compensation Insurance FundStockton District Office

References

Case No. ADJ1957961

Regular

Feb 15, 2011

ANTHONY COX vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

Petition for RemovalWCJOff CalendarAgreed Medical Evaluator (AME)ApportionmentObesityPre-existing Degenerative ChangesDeclaration of Readiness to ProceedMandatory Settlement Conference (MSC)Discovery

References

Case No. BAK 144220, BAK 147172

Regular

Dec 14, 2007

RICHARD GLEGHORN vs. COX PETROLEUM, COMMERCE INDUSTRY INSURANCE CO., AIG CLAIM SERVICES, INC.

Workers Compensation Appeals BoardReconsiderationFindings & AwardTemporary DisabilityLabor Code § 4656(c)(1)104 compensable weeksTwo year capCumulative injurySpecific injuryDate of injury

References

Case No. ADJ3002774

Regular

Jun 10, 2014

ROWLAND COX vs. J.F. SHEA CONSTRUCTION, INC., AMERICAN HOME ASSURANCE INSURANCE COMPANY, CHARTIS CLAIMS, INC.

References

Case No. ADJ4047184 (RDG 0115958)

Regular

Dec 02, 2009

BRICE SANDHAGEN vs. STATE COMPENSATION INSURANCE FUND

References

Showing 1-10 of 28 results

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