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

Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
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. ANA 0385112
Regular
Feb 15, 2008

LIANA SAENZ vs. ORANGE COUNTY DEPARTMENT OF EDUCATION, Permissibly Self-Insured, Adjusted By SOUTHERN CALIFORNIA RISK MANAGEMENT ASSOCIATES, INC.

This case involves a dispute over which workers' compensation permanent disability rating schedule to apply. The applicant sustained injury before January 1, 2005, but the defense QME report determining her permanent and stationary status was dated November 2004 but not signed until February 2005. The Appeals Board granted reconsideration to apply the 1997 Schedule, finding that the date of the physician's evaluation, not the signing date of the report, should control when an exception to the 2005 Schedule is invoked for pre-2005 injuries.

Workers' Compensation Appeals BoardCumulative trauma injuryPermanent disability rating2005 Schedule1997 ScheduleLabor Code section 4660(d)Qualified Medical EvaluatorComprehensive medical-legal reportPermanent and stationary statusDate of evaluation
References
Case No. ADJ4522362
Regular
Sep 26, 2008

CELESTE LILJEBLAD-THOMAS vs. BARONE'S RESTAURANT, STATE COMPENSATION INSURANCE FUND

The WCAB reversed the Supplemental Findings and Award granting reconsideration to the defendant, State Compensation Insurance Fund. The WCJ lacked jurisdiction to award temporary disability more than five years after the injury date.

WORKERS' COMPENSATION APPEALS BOARDCeleste Liljeblad-ThomasBarone's RestaurantState Compensation Insurance FundSupplemental Findings and Awardtemporary disability indemnityactual earnings25% penaltiesfurther medical treatmentreimbursement for mileage
References
Case No. SAC 354144
Regular
Apr 25, 2008

CHANDRA BOERSMA vs. RITE AID PHARMACY, ST. PAUL FIRE & MARINE INSURANCE COMPANY

The Appeals Board granted removal, rescinded the order to select a panel QME, and returned the case to the trial level. The Board found that while the WCJ properly identified deficiencies in the prior QME reports, the procedures under Labor Code section 4062.2 were inapplicable due to the pre-2005 injury date. Consequently, the WCJ must now appoint a "regular physician" to further develop the medical record.

Workers' Compensation Appeals BoardRemovalQualified Medical EvaluatorAgreed Medical EvaluatorLabor Code Section 4062.2Date of InjuryCumulative TraumaSubstantial EvidenceMedical-Legal EvaluationComprehensive Medical Evaluation
References
Case No. VNO 0380163
Regular
Dec 14, 2007

LAWRENCE REICHELT vs. CITY OF LOS ANGELES (LAPD), Permissibly Self-Insured

The City of Los Angeles sought removal to obtain a psychiatric QME evaluation for an applicant who claimed psychiatric injury related to a past industrial injury. The Board granted removal, holding that Labor Code section 4062.1 applies prospectively to all injuries, regardless of date. The Court amended the previous order to allow the defendant to request a panel of three psychiatric QMEs under section 4062.1(b).

RemovalPetition for RemovalQualified Medical EvaluatorPsychiatric EvaluationLabor Code Section 4062.1SB 899Date of InjuryProspective ApplicationSection 4067.5Competing Statutory Provisions
References
Case No. ADJ9845740
Regular
Dec 18, 2019

RICHARD OKUNIEWICZ vs. CHRISTOFFERSON TRANSPORTATION, QBE-PRAETORIAN INSURANCE COMPANY

This case concerns an employer's petition for removal challenging a judge's order denying a motion to compel an in-person vocational evaluation. The Appeals Board denied the petition, treating it as a reconsideration request because the underlying order resolved threshold issues. Although the decision was final regarding threshold matters, the Board reviewed the discovery dispute under the extraordinary removal standard. The majority found no significant prejudice or irreparable harm from denying the in-person evaluation, as a remote evaluation was deemed sufficient.

Petition for ReconsiderationPetition for RemovalFindings and OrderMedical-Legal EvaluationCompelSignificant PrejudiceIrreparable HarmThreshold IssueInterlocutory IssueVocational Evaluation
References
Case No. ADJ9836001; ADJ9836002 ADJ9836004; ADJ9836542 ADJ10301695
Regular
Sep 28, 2016

BEATRIZ HERNANDEZ vs. RAMCO ENTERPRISES

This case concerns whether the applicant is entitled to a new Qualified Medical Evaluator (QME) for a later reported injury. The defendant argued that under *Navarro v. City of Montebello*, the same QME should evaluate all injuries reported prior to an initial evaluation. However, the Board found *Navarro* distinguishable because the applicant's fifth injury was reported *after* the initial QME evaluation, despite occurring earlier. Therefore, the applicant is entitled to a new PQME for the later reported injury, and the defendant's petition for reconsideration was denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderQualified Medical Evaluator (QME)Panel QME (PQME)Navarro v. City of MontebelloLabor CodeMedical-Legal EvaluationsApplication for Adjudication of ClaimDeclaration of Readiness to Proceed
References
Case No. ADJ10544763
Regular
Oct 25, 2019

DAVID JENSEN vs. CITY OF ORANGE

The Workers' Compensation Appeals Board granted reconsideration to defer issues of industrial injury to the shoulders, knees, and hypertension. The Board also deferred the determination of permanent disability, finding the medical evidence insufficient to establish a permanent and stationary condition, especially given pending surgeries. Further proceedings will require a new medical evaluation addressing specific orthopedic impairments and apportionment to the cervical spine. Finally, the Board will require a determination of the Labor Code section 5412 date of injury.

Petition for ReconsiderationAmended Findings and AwardWorkers' Compensation Appeals BoardIndustrial InjuryCervical SpineLumbar SpineCoronary Heart DiseaseCarpal Tunnel SyndromeSkin CancerPermanent Disability
References
Case No. ADJ9011624
Regular
Dec 13, 2019

ELISHA HARDEN vs. COUNTY OF SACRAMENTO

This case concerns whether specific medical reports obtained for a disability retirement claim are admissible in a workers' compensation proceeding. The Appeals Board rescinded the prior ruling, holding these reports are relevant and may be provided to the orthopedic Agreed Medical Evaluator (AME) and psychiatric Qualified Medical Evaluator (QME). The Board found the reports relevant to the medical issues, even though they were not obtained through the standard workers' compensation medical-legal evaluation process. Consequently, the applicant's objection to providing these reports to the evaluators was overruled.

RemovalReconsiderationAgreed Medical Evaluator (AME)Qualified Medical Evaluator (QME)Medical-legal evaluatorsMedical recordsLabor CodeFindings and Orders (F&O)Disability retirementPermanent impairment
References
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