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

Case No. ADJ1528752 (FRE 0238108) ADJ2715270 (FRE 0238107) ADJ4356655 (FRE 0238106)
Regular
Mar 10, 2014

JUANITA GUZMAN vs. BEST BUY, GALLAHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The Board found that the applicant's orthopedic injuries were established, resulting in a $29\%$ permanent disability rating. However, the applicant failed to provide substantial medical evidence that her industrial injuries caused or contributed to her alleged cardiovascular system issues, sleep apnea, GERD, or hypertension. Specifically, the opinion of the applicant's expert, Dr. Cayton, was deemed not substantial evidence due to reliance on an inaccurate and unverified history of the applicant's weight.

Workers' Compensation Appeals BoardJoint Findings of Fact and AwardPetition for ReconsiderationAdministrative Law JudgeBest BuyGallaher Bassett ServicesInc.Permanent DisabilityIndustrial InjuriesOrthopedics
References
Case No. ADJ7258268
Regular
Dec 20, 2013

PATRICIA SMITH vs. WELLPOINT HEALTH NETWORKS, INC.; and ZURICH NORTH AMERICA INSURANCE CO.

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the original award. The Board found substantial evidence supported the necessity of a Jenny Craig weight loss program, including special diet food products, as reasonably necessary treatment. This was based on the applicant's need to lose weight for industrial back surgery and the program's proven success, evidenced by the applicant's 54-pound weight loss. The Board adopted the administrative law judge's report and recommendation in its entirety.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationDENIEDJenny Craigweight loss programspecial diet food productsreasonably necessary treatmentindustrial back surgerysubstantial evidencemedical treatment
References
Case No. ADJ13768010
Regular
May 06, 2025

ROBERT NICHOLS vs. COMCAST, ACE AMERICAN INSURANCE COMPANY

Robert Nichols, the applicant, sustained injuries while employed by Comcast. A petition for reconsideration was filed regarding whether the medical treatment received by the applicant qualified as pre-admission or emergency services, and the defendant's alleged failure to conduct a second bill review. The Workers' Compensation Appeals Board denied the petition for reconsideration, concurring with the WCJ's report that the lien claimant did not provide sufficient evidence to demonstrate that the treatment fell under pre-admission or emergency status. The Board also noted that the issue concerning the defendant's non-response to the second bill review was not a contested matter at the trial.

PETITION FOR RECONSIDERATIONLABOR CODE SECTION 5909ELECTRONIC ADJUDICATION MANAGEMENT SYSTEM (EAMS)TRANSMISSION DATEREPORT AND RECOMMENDATIONLIEN CLAIMANTPRETREATMENT SERVICESEMERGENCY SERVICESMEDICARE PROSPECTIVE PAYMENT SYSTEMSECOND BILL REVIEW
References
Case No. ADJ8223604
Regular
Nov 14, 2013

DEEANNA FOBBS vs. UC DAVIS MEDICAL CENTER

The Workers' Compensation Appeals Board denied Dee Anna Fobbs' petition for reconsideration. The Board adopted the Workers' Compensation Administrative Law Judge's report and recommendations, finding that the applicant did not sustain an injury to her right knee arising out of and in the course of employment. The Board gave great weight to the WCJ's credibility findings and concluded that the overwhelming weight of the evidence supported the WCJ's decision. Applicant's claims of impeachment errors, improper denial of testimony, and adverse inference for destroyed evidence were rejected.

DEEANNA FOBBSUC DAVIS MEDICAL CENTERSEDGWICK CMSPETITION FOR RECONSIDERATIONDENIEDWCJ REPORTGARZA V. WORKMEN'S COMP. APPEALS BD.WITNESS STATEMENTSIMPEACHMENTADMISSIBILITY
References
Case No. ADJ2117331 (OAK 0261803)
Regular
May 31, 2017

Janice Payne vs. Federal Express, BROADSPIRE

This case involves Janice Payne seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision denying her weight loss program extension. The WCJ initially ruled he lacked jurisdiction due to prior Utilization Review (UR) and Independent Medical Review (IMR) denials, which were not appealed. However, the applicant argued a 2003 Compromise and Release agreement designated Dr. Mandel as the ultimate medical arbiter for treatment disputes, superseding UR/IMR. The WCAB granted reconsideration, finding the contractual agreement to use Dr. Mandel remains enforceable despite subsequent UR/IMR legislation. The case is remanded to the trial level to consider Dr. Mandel's opinions on the weight loss program's medical necessity.

Compromise and ReleaseMedical ArbiterUtilization ReviewIndependent Medical ReviewWeight Loss ProgramContractual AgreementJurisdictionSubstantial JusticeStipulationMedical Treatment Dispute
References
Case No. ADJ9610649
Regular
Sep 18, 2015

MARIA CASTELLANOS vs. MEDTRONICS, ESIS CHATSWORTH

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The Board adopted the findings of the Workers' Compensation Administrative Law Judge (WCJ) who found the applicant did not sustain the alleged injury. The WCJ found the applicant's supervisor's testimony regarding the applicant's job duties to be credible, contradicting the applicant's account of heavy lifting. The Board gave great weight to the WCJ's credibility determinations, as the judge observed the witnesses directly.

WCABPetition for ReconsiderationWCALJcredibility determinationcumulative traumaindustrial causationstock clerkMedtronicsACE USAExhibit 1
References
Case No. ADJ4702650 (MON 0094741), ADJ1144686 (MON 0124794)
Regular
2012-2011

ANA SAMI vs. HUGHES AIRCRAFT COMPANY, SPECIALTY RISK SERVICES, INC.

The Appeals Board partially granted reconsideration, reversing most penalties for unreasonable delay and sanctions against the applicant's attorney, finding insufficient evidence for these claims. However, they affirmed the WCJ's finding of unreasonable delay regarding Weight Watchers coupons, deferring the penalty amount for further determination. The Board also affirmed that the applicant's attorney is entitled to fees for enforcing the medical treatment award related to the coupons. The matter was returned for further proceedings on the penalty amount and attorney's fees.

Workers Compensation Appeals BoardReconsiderationJoint Findings and AwardPenaltiesSanctionsLabor Code Section 5813Labor Code Section 5814Labor Code Section 5814.5Unreasonable DelayMedical Treatment
References
Case No. ADJ7715497
Regular
Jan 17, 2015

SUDJAI SUKSAMRARN (Deceased) TUENJAI SUKSAMRARN (Widow) vs. BARRETT BUSINESS SERVICES, INC.

The Workers' Compensation Appeals Board granted the applicant's Petition for Removal, overturning an earlier decision that barred Edward Steinbrecher from testifying as an expert witness. The Appeals Board found that while Steinbrecher's prior representation of the applicant in a third-party action raised questions about his impartiality, this affected the weight of his testimony, not its admissibility. The judge erred by disallowing testimony solely because the expert was not deemed "disinterested," as this is not a legal requirement for expert qualification. Therefore, Steinbrecher is now permitted to testify as an expert witness.

Petition for RemovalExpert Witness TestimonyDisinterested WitnessAdmissibilityWeight of EvidenceThird Party CreditIndustrial InjuryDeath BenefitQualified ExpertPrior Representation
References
Case No. GOL 0099075 GOL 0099076 GOL 0099077 GOL 0100393
Regular
Jan 10, 2008

LOIS M. HOUSMAN vs. SANTA BARBARA COTTAGE HOSPITAL, KEENAN & ASSOCIATES

The Workers' Compensation Appeals Board granted reconsideration to amend a prior award concerning Lois Housman's entitlement to medical treatment. The Board ordered that the parties must follow the process outlined in Labor Code section 4062.2 to resolve the dispute regarding a pain psychology evaluation recommended by the applicant's treating physician. The finding that the applicant is entitled to a weight loss program was affirmed.

Workers' Compensation Appeals BoardSanta Barbara Cottage HospitalKeenan & AssociatesLois M. HousmanPetition for ReconsiderationFindings and AwardAdministrative Law Judge (WCJ)Weight Loss ProgramPsyche EvaluationDr. Errico
References
Case No. VNO 343876
Regular
Jan 15, 2008

CASSANDRA GIBSON vs. COUNTY OF LOS ANGELES

The Workers' Compensation Appeals Board denied the County of Los Angeles' petition for reconsideration, upholding an award for the applicant's future medical treatment. This treatment included a weight loss program, bariatric surgery consultation, physical therapy, and an orthopedic mattress, which the defendant had unreasonably delayed providing. The Board found substantial medical evidence supported the necessity of this treatment and justified penalties for the defendant's delay.

Workers' Compensation Appeals BoardReconsiderationFuture Medical TreatmentWeight Loss ProgramBariatric Surgery ConsultationPhysical TherapyLumbar SpineOrthopedic MattressUnreasonable DelayLabor Code Section 5814 Penalties
References
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