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

Case No. ADJ9274286
Regular
Feb 19, 2015

RAMON CERVANTES vs. CBS OUTDOOR INC.

The Appeals Board denied reconsideration and dismissed removal, upholding the WCJ's findings. Applicant sought contempt charges and attorney's fees due to an ex parte communication with a PQME, but the Board found such remedies discretionary and not mandated under the circumstances. Declaratory relief regarding PQME report admissibility is premature; admissibility will be determined at trial. The Board dismissed removal as reconsideration is the proper procedural remedy for this final order.

ex parte communicationPQMEdeclaratory reliefcontemptsanctionsremovaladmissibility of reportsdiscretionary powerindirect contemptdirect contempt
References
Case No. ADJ1527853 (WCK 0005092)
Regular
Dec 05, 2013

JEFF MILLMAN vs. CONTRA COSTA COUNTY

The Workers' Compensation Appeals Board (WCAB) affirmed a prior ruling that it lacks jurisdiction over a contract dispute between Contra Costa County and its excess insurer, General Reinsurance Corporation (GRC). The dispute concerns whether GRC must reimburse the County for certain bill review expenses under their excess policy. The Board determined this is a contract issue between insurer and insured, not a workers' compensation insurance coverage dispute subject to mandatory arbitration under Labor Code section 5275. The parties may pursue remedies like declaratory relief in civil court.

Workers' Compensation Appeals BoardReconsiderationJurisdictionContract DisputeExcess InsuranceSelf-Insured EmployerInsurance CoverageArbitrationLabor CodeInsurance Code
References
Case No. ADJ2041939 (SBR 0340035)
Regular
Dec 14, 2016

Carlos Garcia vs. Department of Transportation, State Compensation Insurance Fund

This case concerns petitions for reconsideration of three dismissed medical liens filed by Pinnacle Lien Services (PLS) on behalf of three doctors. PLS failed to appear at a lien conference and did not respond to Notices of Intent to Dismiss. The WCAB denied reconsideration, finding PLS provided insufficient justification for its failures to appear and respond, and that relief under CCP § 473 was not warranted due to lack of proper documentation and communication breakdowns. The Board emphasized the need for a substantial explanation for non-appearance and failure to respond to dismissal notices.

Workers' Compensation Appeals BoardOrders Dismissing LiensPetitions for ReconsiderationLien ConferenceNotices of Intent to DismissFailure to AppearExcusable NeglectCCP § 473Fox v. Workers' Comp. Appeals Bd.Discretionary Relief
References
Case No. ADJ8276740
Regular
Sep 19, 2012

Kim Jaszewski vs. The Regents of the University of California

The Workers' Compensation Appeals Board denied reconsideration of a take-nothing award, finding the applicant's claim untimely. The applicant argued that short-term disability payments tolled the one-year statute of limitations, but failed to provide evidence of such payments. Furthermore, the employer's denial of the claim on March 23, 2011, provided a clear date from which the one-year filing period began to run. The Board also rejected the applicant's attorney's attempt to seek relief under Code of Civil Procedure section 473, as it does not grant relief from jurisdictional deadlines like statutes of limitations.

Workers' Compensation Appeals BoardApplication for Adjudication of Claimstatute of limitationstollingshort-term disability benefitsdenial of claimLabor Code section 5405Code of Civil Procedure section 473jurisdictional deadlinecumulative trauma injury
References
Case No. ADJ9615369, ADJ9615370, ADJ10928806
Regular
Jun 19, 2018

CATALINA REYES QUINTANILLA vs. TARZANA FIVE-FOUR CORNERS INVESTMENT, PUBLIC SERVICE MUTUAL INSURANCE COMPANY, CORVEL CORPORATION

This case concerns Defendant's petition for reconsideration of an order approving a $50,000 settlement for Applicant's workers' compensation claims. Defendant argued the order incorrectly failed to credit $5,913.87 in permanent disability advances paid to Applicant. However, the Compromise and Release agreement clearly indicated zero permanent disability advances and explicitly settled that issue. The Appeals Board found no evidence of mutual mistake and denied reconsideration, ruling that Defendant's failure to ensure the credit was included in the agreement constituted a unilateral mistake due to their own neglect.

Compromise and ReleasePermanent Disability AdvancesPetition for ReconsiderationOrder ApprovingWCJUnilateral MistakeMutual MistakeNeglect of Legal DutyContract InterpretationWaiver of Reimbursement
References
Case No. ADJ10813026
Regular
May 27, 2025

Noureddine Manser vs. Return-to-Work Supplement Program

Applicant Noureddine Manser sought reconsideration of a November 9, 2023 finding that he was not entitled to a second Return-to-Work Supplement Program (RTWSP) benefit under Rule 17302(b), which prohibits a second benefit unless for a subsequent injury. Applicant contended the word "injury" should include a continuing injury. The Appeals Board affirmed the November 9, 2023 Findings of Fact, declining to interpret "injury" as a continuing injury and noting that the validity of Rule 17302(b) is subject to judicial review in the Superior Court, not the Appeals Board. The Board also asserted its jurisdiction to review the WCJ's denial despite arguments to the contrary.

Return-to-Work Supplement ProgramRTWSPRule 17302(b)vocational rehabilitationsubsequent injurySJDBVQMEtemporary total disabilityWCABLabor Code section 139.48
References
Case No. ADJ4657834 (SFO 0500292)
Regular
Jun 07, 2010

LILIA LLERANDI CHAPITAL, GUSTAVO HILDALGO (Deceased) vs. DWIGHT JEFFERS, aka DWIGHT E. JEFFERS, individually and as a substantial shareholder of DEJ ENTERPRISES a NEVADA CORPORATION, illegally uninsured, EXPERT PLASTERING INC. and CALIFORNIA INSURANCE COMPANY, BEHLER ASSOCIATES INC. dba BEHLER CONSTRUCTION and STATE COMPENSATION INSURANCE FUND

This Workers' Compensation Appeals Board decision granted reconsideration to amend a finding. The Board affirmed that the deceased was employed by Dwight Jeffers, individually and uninsured, and not by Expert Plastering, DEJ Enterprises, or Behler Construction. The Court rejected the argument that Labor Code section 2750.5 compelled a finding of employment with Behler due to Jeffers's lack of license, as Jeffers was not a subcontractor of Behler.

WCABdeclaratory reliefsole jurisdictiongeneral employmentspecial employmentalter ego doctrinedual employmentjoint employmentLabor Code section 2750.5unlicensed contractor
References
Case No. ADJ2735858
Regular
Sep 12, 2008

KIMBERLY WILLIAMS vs. BAKER'S BURGERS, CALIFORNIA, INSURANCE GUARANTEE ASSOCIATION, By BROADSPIRE, a CRAWFORD CO., For SUPERIOR NATIONAL INSURANCE CO., In Liquidation

The WCAB granted reconsideration and amended the Findings & Award to reflect that the lien claimant is liable for $3,504.25 in attorney's fees under Labor Code § 5813 for filing a frivolous lien claim.

Workers' Compensation Appeals BoardLien claimantReconsiderationLabor Code § 5813Attorney's feesFrivolous filingGross negligenceDeclaration of ReadinessInvalid lien claimCompromise and Release
References
Case No. ADJ11298015
Regular
May 27, 2025

Elideth Balderrama Ramirez vs. Hotcakes No 6 Inc IHOP 817, Preferred Employers San Diego

Elideth Balderrama Ramirez sought reconsideration of a WCJ's finding that she was precluded from a second Return-to-Work Supplement Program (RTWSP) benefit, despite receiving a second Supplemental Job Displacement Benefit (SJDB) voucher. The applicant contended that her second voucher was 'subsequent' to her first RTWSP payment, fulfilling an exception in Rule 17302(b). The Appeals Board clarified that the exception refers to the date of injury being subsequent, not the voucher issuance date. As the record lacked a finding on the cumulative trauma date of injury, the Board rescinded the previous order and returned the case to the trial level for this determination.

Return-to-Work Supplement ProgramSupplemental Job Displacement BenefitSJDB vouchercumulative trauma injuryspecific injurydate of injuryLabor Code section 139.48Rule 17302Rule 17309Administrative Procedures Act
References
Case No. ADJ11110973
Regular
May 23, 2025

Jorge Aragon vs. El Super, Safety National Casualty Corporation, Tristar Risk Management

The applicant, Jorge Aragon, sought reconsideration of a decision denying him a second payment from the Return-to-Work Supplement Program (RTWSP). The Workers' Compensation Administrative Law Judge (WCJ) initially found him ineligible based on Rule 17302(b), which prohibits a second RTWSP payment if the subsequent injury occurs before receiving the previous supplement. The Appeals Board affirmed the WCJ's decision, concluding that the applicant's remedy to challenge the validity of Rule 17302(b) lies with the Superior Court, not the Appeals Board, as the rule is governed by the Administrative Procedures Act. The Board also clarified its jurisdiction to review the WCJ's denial despite RTWSP's contention.

Return-to-Work Supplement ProgramRTWSPSupplemental Job Displacement BenefitSJDBRule 17302(b)Labor Code section 139.48invalid regulationarbitrary and capriciousArticle XIV section 4Administrative Procedures Act
References
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