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

Case No. ADJ1566453 (AHM 0145804)
Regular
Nov 16, 2017

EVELYN SOLIS vs. CHILDREN'S DENTAL GROUP, NATIONAL LIABILITY & FIRE INSURANCE COMPANY

In Evelyn Solis v. Children's Dental Group, the Workers' Compensation Appeals Board granted reconsideration and amended the original Findings and Orders. The Board deferred specific issues concerning a lien claimant's claim and compliance with Rule 9982. The case is returned to the Workers' Compensation Judge for further proceedings on these deferred matters. The applicant's injury to her right wrist, hand, and shoulder was affirmed, but not to her cervical spine.

Workers' Compensation Appeals BoardEvelyn SolisChildren's Dental GroupNational Liability & Fire Insurance CompanyBerkshire Hathaway Homestate CompaniesCompromise and ReleaseLien TrialPetition for ReconsiderationFindings and OrdersMed-Legal LLC
References
Case No. ADJ16824578, ADJ16974663
Regular
Sep 15, 2025

KOKAYI ELDRIDGE vs. CALIFORNIA HEALTH BENEFIT EXCHANGE, STATE COMPENSATION INSURANCE FUND

The applicant, Kokayi Eldridge, sought reconsideration of an order dismissing her applications for adjudication due to an inability to appear at hearings. The Workers' Compensation Appeals Board dismissed the petition for reconsideration, finding it to be successive and duplicative of an earlier petition. The Board noted that no new evidence was presented and cautioned the applicant against filing further successive petitions, recommending that the WCJ set a new date for an MSC or status conference.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissalApplications for Adjudication of ClaimWith PrejudiceDental EmergencyFamily EmergencyNotice of IntentionReport and RecommendationLabor Code Section 5909
References
Case No. ADJ3776569, ADJ3927273
Regular
Apr 01, 2025

MARIA MARTINEZ vs. BOSS FASHION, INC.; CIGA for CALIFORNIA COMPENSATION INSURANCE COMPANY

Lien claimant The Dental Trauma Center sought reconsideration of a previous Workers' Compensation Administrative Law Judge (WCJ) order. The original order found that applicant Maria Martinez sustained industrial injuries but denied the lien claimant additional reimbursement for medical treatment. The Appeals Board granted the petition for reconsideration, citing potential errors by the WCJ regarding reimbursement entitlement and defendant's estoppel from denying reimbursement for dental reporting. However, the Board deferred a final decision after reconsideration, indicating further review of the merits and the entire record is required.

Lien ClaimantPetition for ReconsiderationUtilization ReviewDental Treatment ReimbursementDental ReportingEstoppelSubstantial EvidenceBurden of ProofPrimary Treating PhysicianQualified Medical Evaluator
References
Case No. ADJ3108970
Regular
Feb 14, 2023

RUSSELL BLAIR vs. TRUGREEN LANDSCAPE, TERMINIX, SERVICEMASTER BRANDS, ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration to further develop the record. The Board found that the treating physician's psychiatric reports were stale and lacked sufficient detail regarding apportionment of permanent disability. Additionally, the Board determined that the applicant's dental injury claim requires further medical evaluation to establish industrial causation. Consequently, the case is remanded to the Workers' Compensation Judge for further proceedings regarding the dental injury, psychiatric disability, and overall permanent disability.

Workers' Compensation Appeals BoardFindings and AwardPetition for ReconsiderationAdministrative Law JudgeArising Out of and In the Course of Employment (AOE/COE)Lumbar SpineRight HipPsychePsychiatric Permanent DisabilityDental Injury Claim
References
Case No. ADJ1271468 (LAO 0838972) ADJ3841157 (LAO 0840312) ADJ249664 (LAO 0843194)
Regular
Mar 03, 2009

JORGE PEREZ vs. REGENT MANUFACTURING, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award concerning industrial injuries sustained by Jorge Perez. The primary issue was whether the applicant was entitled to recommended dental treatment, which the defendant had denied via utilization review (UR). The Board found the record unclear regarding the timeliness of the defendant's UR denial and the applicant's subsequent objection process. Consequently, the case was remanded for further development of the record, particularly concerning the UR timeline and the dispute resolution procedures under Labor Code sections 4062 and 4062.2.

Workers' Compensation Appeals BoardRegent ManufacturingState Compensation Insurance FundJorge Perezindustrial injurieslow backright lower extremityneckleft earside of face
References
Case No. VNO 0386181
Regular
Apr 05, 2007

SUSAN PASCALE vs. BLUE CROSS/WELLPOINT DENTAL, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION on behalf of FREMONT INDEMNITY

This case concerns applicant Susan Pascale's claim for workers' compensation benefits due to industrial injuries resulting in fibromyalgia and other conditions. The WCJ awarded 80% permanent disability, apportioning 20% to applicant's pre-existing personality traits based on medical opinions. The Appeals Board affirmed this decision, finding the apportionment was supported by substantial medical evidence of causation, as allowed by recent statutory changes.

Workers' Compensation Appeals BoardSusan PascaleBlue Cross/Wellpoint DentalCalifornia Insurance Guarantee AssociationFremont IndemnityVNO 0386181Opinion and Decision After ReconsiderationApplicantDefendantWCJ
References
Case No. ADJ9317950
Regular
Nov 27, 2017

PEFLEY, Twana vs. FOOTHILL DENTAL, INC., HARTFORD INSURANCE

The Workers' Compensation Appeals Board denied Twana Pefley's Petition for Removal in the case against Foothill Dental, Inc. Removal is an extraordinary remedy granted only upon a showing of substantial prejudice or irreparable harm. The Board found that Pefley failed to demonstrate such harm, and that reconsideration would be an adequate remedy if an adverse decision were to issue. Therefore, the petition was denied.

Petition for RemovalExtraordinary RemedySubstantial PrejudiceIrreparable HarmReconsideration Adequate RemedyWorkers' Compensation Appeals BoardWCJ ReportCortez v. Workers' Comp. Appeals Bd.Kleemann v. Workers' Comp. Appeals Bd.Cal. Code Regs. tit. 8 § 10843(a)
References
Case No. ADJ7594309
Regular
Dec 08, 2014

ANA DURAND ACOSTA vs. WESTERN DENTAL SERVICE, HARTFORD ACCIDENT & INDEMNITY CO.

In this Workers' Compensation Appeals Board case, the applicant, Ana Durand Acosta, successfully established that she sustained a work-related injury to her spine and wrists while employed by Western Dental Service. The administrative law judge awarded temporary and permanent disability benefits based on this finding. The employer and their carrier sought reconsideration, arguing the trial proceeded prematurely and lacked sufficient medical evidence. The Board denied the petition, adopting the judge's report and affirming the original award.

Western Dental ServiceHartford Accident & Indemnity Co.cervical spine injurylumbar spine injurywrist injurytotal temporary disabilitypermanent disabilityapportionmentPetition for ReconsiderationFindings and Award
References
Case No. ADJ1456139
Regular
Apr 09, 2012

JOYCE TIGHE vs. LONG BEACH UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied reconsideration of a decision disallowing a lien claim from The Dental Trauma Center. The lien claimant's attorney failed to comply with Board regulations, including proper formatting and exhibit identification. The Board adopted the judge's report, which found that the lien claimant failed to meet its burden of proof in demonstrating that its dental services were reasonable and necessary to cure or relieve the effects of the applicant's stipulated industrial injuries, which did not include dental issues. Furthermore, the report of a consulting dentist, admitted over objection, also indicated that many of the services and charges were unreasonable or excessive.

Workers' Compensation Appeals BoardLong Beach Unified School DistrictPermissibly Self-InsuredADJ1456139LBO 0298310Order Denying ReconsiderationLien ClaimantPetition for ReconsiderationWCJReport of Administrative Law Judge
References
Case No. ADJ13061844
Regular
Dec 28, 2020

RON PETTWAY vs. TRILLIUM STAFFING SOLUTIONS, CORVEL CORPORATION

The Workers' Compensation Appeals Board granted the defendant's petition for removal, rescinding a prior order that denied the defendant's request to compel the applicant's attendance at an in-person medical evaluation. The WCAB found that the administrative law judge improperly denied the petition solely due to the Shelter in Place Order. The Board clarified that emergency regulations permit medical-legal evaluations during the state of emergency and returned the matter to the trial level to determine if the evaluation could proceed under these regulations.

Workers' Compensation Appeals BoardPetition for RemovalMedical Legal EvaluationQualified Medical EvaluatorShelter in Place OrderLabor CodeCompel AttendanceRescind OrderReturn to Trial LevelTelehealth
References
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